The Human Face Of Healthcare

(Image credit: unitedhealthgroup.com)

It’s odd that we tend to equate innovation with fast tech startups, or apps that are bolted onto consumer offerings, considering their low success and usage rates usually don’t warrant the value they’re given. They’re more marketing symbols than business outcomes.

UnitedHealthcare is two years into an innovation project that is quietly transforming the company. It’s a significant success, even if the company’s millions of participating customers probably couldn’t name it.

Called Advocate4Me, the program provides consumers with a single point of contact for the duration of any problem, and empowers that contact to provide forward-looking help in maximizing benefits, avoiding new issues, and getting a satisfying experience.

“We get approximately 1 million calls a day, and considering we serve tens of millions of people around the world, that’s a lot of engagement,” said Dr. Richard Migliori, executive vice president and chief medical officer of UnitedHealth Group. “When people call us, it’s to resolve a health issue that is affecting their lives, whether it’s a quick check for approval for a doctor visit, or starting a complicated cancer treatment regimen that will take months.”

Given the complexity that is health care, many of these callers can be bewildered or unnerved.

The company’s ongoing surveys confirmed that 75 percent of callers weren’t sure they understood their benefits, and at least half did not comprehend the cost implications. The need to provide additional support and to improve the customer experience was clear.

So UnitedHealthcare decided to disrupt that process with a better solution, and it knew early on that any innovation would start and stop with its customer interactions.

“We deconstructed the recruiting and training processes for our customer service advocates, because we had to think differently about the job,” said Chris Carlson, vice president of customer experience of UnitedHealthcare. The company identified the core skills required to satisfy its customers’ expectations, like accessing data, managing complex issues over time, and addressing the emotional issues that often accompany chronic health problems. It then built tools and service roles highlighting each of those abilities.

“We changed not only the requirements and types of people we hired, but how we trained them, on everything from handling facts, to empathy and compassion,” Carlson added.

“Our intention was to change our service interactions from transactions to relationships.”

Next came gathering insights from the company’s vast data resources, which are driven by 4.5 billion electronic transactions every year, on roughly 250 million claims, yielding 6.3 petabytes of data on the diagnoses and outcomes involving 850,000 physicians and clinicians.

“Our data told us that at least 60 percent of people who call have a significant clinical issue in their background, yet it may not be the driver of their current call,” said Dr. Migliori. “That’s why we built in the capability to ping the data we have on both the customer and similar inquiries via interactive voice response (IVR), so we can anticipate their questions, and get them to the best-equipped staffer before conversations even begin.”

“We also put the technology on the advocates’ desks, so they can see and manage a single, integrated picture of the customer, as well as offer proactive help. For instance, our data revealed that 20 percent of newly diagnosed breast cancer patients also suffer some form of depression, so our advocates are given such insights and, if needed, the tools to explore it, locate resources, and even make appointments with local in-network health professionals.”

Results so far?

Overall customer satisfaction with the Advocate4Me platform exceeds 96 percent, with over 95 percent ranking their level of trust in their service as “high.” Transfers for callers are down 40 percent (a direct outcome of predictive matching of caller to staffer), and over 99 percent of the time advocates deliver on consumer service commitments within a timeframe that’s specified at the start of each conversation.

The company also reports that 30 percent of its wellness program participation comes from participants in its Advocate4Me offering.

“Enabling easy-to-use tools and insights from our deep data and analytical expertise was crucial in enabling the human potential at the core of a great service experience,” said Migliori. “In making the service experience simple for people, enabled by rich analytical insights and support for our advocates, we can make impactful connections with consumers.”

Since the program is marketed as a better experience, however, media may not have recognized this “human face” of innovation, nor analysts valued it as they would the apps and other overt tech symbols we’ve come to expect.