The Business Challenge

The leaders of a top-rated integrated health system facing a competitive market, an uncertain health insurance landscape, and big cost pressures needed to strengthen the member and patient experience to achieve differentiation and breakthrough performance.

Identifying the Ideal Experience

Leaders realized that the organization was approaching members and patients as two different customers with varying needs. Integrating these journeys through a wholistic customer experience lens would ground the organization in the operational changes needed to deliver the best outcomes for the people they serve. Aveus facilitated ideal member/patient experience mapping with a cross functional team. Critical moments were identified in three areas: care delivery experience, cost transparency, and the ability for a patient to pursue their best care option (including cost, quality outcomes, and time sensitivity). The Aveus team then gathered and synthesized internal and external data to identify key actionable insights for each critical moment.

A Customer-Centered Operating Model

The team launched workstreams for each critical moment using the journey map to ensure alignment with the ideal member and patient experience. This included collaboratively developing charters with internal leaders and kicking off the project teams and partnering with project leads to approach the workstreams using rapid prototyping.

The Aveus team facilitated a Customer Experience Council made up of leaders from around the functional areas of the organization to lead the change required for one key annual initiative in 2019: cost transparency. This required working with key leaders to integrate this workstream into the organization’s broader cultural transformation efforts around affordability and delivering the best care for patients. Aveus then partnered with initiative leaders to organize and implement the change management required to drive the cost transparency work from test to pilot phase.

The results?

Improvements have been registered in consumer ratings, plan member growth and retention. The plan’s JD Power rating has risen consistently year over year since this experience work began.

Additional Benefits Realized

• A clear target member experience has created focus for actions taken across the organization.
• The cost transparency initiative resulted in the scaling of a personalized cost estimate service for members and patients that saw an 6X increase in member engagement in the first quarter.

Engagement Timeline (Multi-Year Relationship)

One final thanks to your Aveus team! Designing the care experience is important and hard work. We value the role your team played in helping us build stronger relationships and trust with our patients and members.

CEO

1.7 million member regional integrated health system