Elevance Health brings together the concepts of elevating whole health and advancing health beyond healthcare. It’s a health company dedicated to making real progress toward improving the health of the people and communities they serve.
Geeta Wilson, Chief Technology Officer – Whole Health, Advocacy, and Provider Platforms, joined Elevance Health just over 3 years ago as the company started its journey from a traditional health insurance payer to a consumer-centered organization placing people at the center and helping them improve their health in a way that best works for them.
At PegaWorld iNspire 2023, Geeta explained, “Nothing is more personal than health. And growing customer expectations pose a real challenge to healthcare organizations. When health plan members reach out to us, it is because they want help from a trusted source. That’s why Elevance Health is working to create a higher quality system – one where we connect the dots and ensure we make it easier to offer an improved and personalized experience to the people we serve over the phone and over digital channels as well.”
How associate engagement affects consumer satisfaction
The healthcare industry faces two intertwined workforce challenges: training associates to meet new business and customer demands and managing the costs of recruitment and training.
“Meeting consumer expectations has become increasingly challenging. Consumers expect engagement to be convenient, personalized, and responsive. Whether these expectations are met or not greatly depends on customer service encounters.”
Recent industry studies validate the link between associate and customer satisfaction. A Harvard Business Review Study from March 2022 found that companies in the top quartile of employee experience saw a 45% increase in bottom-line profits. Additionally, a Glassdoor Economic Research study showed a 3.2-point increase in customer satisfaction for each one-star improvement in Glassdoor employee rating.
Geeta explains, "Elevance Health's service technology platform strategy prioritizes reducing complexity for our associates, enabling them to dedicate more time to responding empathetically to people who contact us."
Delivering personalized customer experiences
The healthcare industry has undergone significant technological advancements in recent years. Elevance Health, like other organizations, is leveraging the power of Artificial Intelligence (AI) and workflow automation to simplify processes for associates and members.
Geeta explains, “With around 24,000 customer service associates, Elevance Health aims to empower them with tools and insights to understand customers better. We use workflow automation to eliminate redundant tasks and streamline work between teams, ensuring a smooth customer service journey.”
Through partnerships, like the one with technology partner Pegasystems, Elevance Health has built its customer service tool on an intelligent service automation platform. This platform centralizes and organizes data and processes, enabling associates to receive timely content and instructions, while new associates experience shorter onboarding times.
Integration with multiple systems is key to eliminating associates swiveling between systems, instead freeing associates to devote more time to empathetic and personalized service.
After implementing the customer service tool, Elevance Health observed an 11-point increase in Net Promoter Score and a 3-minute reduction in average handle time.
Voice AI: a co-pilot for every agent on every call
Elevance Health has expanded its commitment to streamlined customer service by introducing voice-activated workflows.
Using Pegasystem's proprietary speech-to-text transcription, natural language processing, and emotion detection capabilities, Elevance Health is equipped with a voice AI technology that listens to live phone conversations and provides contextually relevant suggestions to customer service representatives. These suggestions include case workflow and knowledge suggestions, form autofill suggestions, and script adherence notifications.
This guided experience during phone interactions also helps accelerate agent onboarding, increase productivity, ensure compliance, and deliver a personalized customer experience to members.
From service to self-service: meeting consumers where they want us most
As healthcare consumers increasingly explore other communication channels like online chat and portals, it is crucial to provide the same level of personalization they receive over the phone.
To address this, Elevance Health is expanding self-service capabilities that allow customers to access their service needs at their convenience and on their preferred devices. AI-powered chatbots and email bots will handle commonly asked inquiries, freeing up customer service associates to focus on more complex member needs that require expert human intervention and empathy.
Getting everyone to buy in with effective change management
Geeta, a technologist, emphasizes the importance of reducing complexity and acknowledges that change management plays a significant role in this process. “Initially, it took time for associates to recognize the potential and power of the new solution in improving customer experiences.”
Geeta stresses the need for effective communication and clear vision. “The impact of fragmented systems and knowledge management issues was demonstrated, highlighting the goal of enhancing associates' expertise. The intention was to leverage technology to optimize productivity, minimize wasted time and costs, and address frustrations faced by both associates and members.”
Personalized, empathic, member-centric experiences to advance health
Customer service is a crucial differentiator for healthcare payers as consumer expectations rise. To enhance member experiences and improve efficiency, payers must simplify their operations.
Lessons from Elevance Health's journey are valuable for navigating the evolving landscape. Prioritizing employee experience, simplifying operations, and leveraging technology for personalized member-centric experiences are crucial. These strategies make organizations stand out as leaders in shaping the future of healthcare customer service.
As Geeta emphasizes, "The best service solutions benefit both members and associates. It’s about strategically helping people improve their health and wellbeing."
To hear more about the future of customer service, watch the Elevance Health PegaWorld 2023 presentation.