For 2022, total healthcare expenditures in the United States are estimated to be $4.4 trillion and as much as 18.4% of GDP. This is the highest overall per capita healthcare spending globally, reflecting the enormous size of the healthcare market and astounding variety and volume of support needs for everyone receiving care. More and more, increasingly sophisticated consumers and plan members expect healthcare organizations to improve digital support experiences and be far more customer centric.
Focusing on relationships with patients and members requires investments in mobile apps, self-service support options, virtual care, and other digital solutions that improve end-user experiences. Members expect their healthcare providers to go beyond transactional support and instead focus on long-term health outcomes and well-being.
In healthcare, member interactions connect directly to a person’s well-being, and often lives can be at stake. Beneficial health experiences are especially important for anyone with a serious health issue, and member care must be provided conscious of its effect on physical wellbeing, as well as mental and social wellbeing.
Our advocates encourage Medicare recipients to use all of the benefits that they're paying for—members taking advantage of all of their benefits stay healthier and help produce a 1.5% to 3% increase in our client healthcare plans’ bottom line.
Turning Healthcare Member Support into Healthcare Advocacy
Our healthcare advocacy training focuses on giving every client member a face and linking their needs and concerns to similar issues among our advocates’ older family members and acquaintances. Every contact is more than just a phone call, becoming a real connection grounded in competency, confidence, and compassion.
Our advocates have a strong degree of passion for making a difference in someone’s life and strongly demonstrate an awareness of suffering and a motivation to help. We screen for these attributes and hire extraordinary people able to articulate their feelings, acknowledge and respond well to hardship, and verbally express empathy.
Effective and empathic communication benefits everyone involved in healthcare communication, especially the organizations involved. The Centers for Medicare and Medicaid Services (CMS) recognizes the impact of great support on patient outcomes. This is very apparent in the changing approach to Star ratings, which are linked to billions of dollars in incentive payments as well as to the reputation of every Medicare Advantage plan. Many enrollees choose their plans based on their Star rating.
As part of regular CMS changes to how measurements are determined, by 2023 57% of the Star ratings score will be determined by customer experience metrics. Our advocates regularly demonstrate that they are patient- and member-focused and prepared to provide a high-level of service that can also influence clients’ Star ratings.
Taking a claims adjudication operation offshore for a managed Medicare Insurer was a big win in terms of service quality, financial accuracy, and customer satisfaction.Download Case Study
During the annual enrollment period surge, new advocates using bots were able to match their more experienced and seasoned peers, empowering higher levels ofmember satisfaction and speedier issue resolution.Learn More >
Becky Watkins, Senior Vice President, Client Services describes an outstanding example of healthcare advocacy, where the ResultsCX advocate identified adjacent healthcare issues and made certain a member patient was aware of treatment coverage that could make a big difference in terms of treating chronic disease.Watch Thought Leadership >
When it comes to member support and customer care, healthcare is different. Healthcare organizations must transform the experience and effectiveness of healthcare support into true healthcare advocacy that centers around the member or patient and is laser-focused on helping them throughout their health journey.Learn More >