How Smart Communications is enhancing the healthcare customer experience


To address the evolving challenges it faces, the healthcare industry is increasingly adopting cloud-based customer communications management (CCM) software to improve the customer experience.

The healthcare industry has been experiencing a gradual transformation, driven by technology advancements, regulatory policy changes, and shifting plan member demographics.

According to Smart Communications, Medicare Advantage plans, in particular, face challenges in managing complex and demanding customer bases. Customer communications play a crucial role in the enrolment process and beyond, with everything from Annual Notice of Change (ANOC) documents to Appeals and Grievances processes. These communications are vital for building strong customer relationships and enhancing Medicare Advantage plan member engagement.

The U.S. Centers for Medicare & Medicaid Services (CMS) provides guidelines for compliance with federal laws pertaining to Medicare Advantage (MA), Medicare Advantage Prescription Drug (MA-PD), Prescription Drug (PDP), and 1876 Cost Plans. Smart Communications added that compliance can be a challenge for healthcare payers seeking to protect member information while offering a seamless digital customer experience.

Most healthcare payers rely on printed and mailed materials, with some also posting them on their websites or member portals, usually as PDF files. However, they often struggle to manage customer communications effectively, leading to poor customer experiences and friction-filled member engagements.

Further, healthcare payers face challenges in managing the volume and complexity of customer communications. During Medicare Advantage plan enrolment, customers may be overwhelmed by the information they receive. Payers must simplify complex information while still providing necessary details required by law, rule, or regulation.

Smart Communications’ highlighted that inefficient customer communication management leads to frustrated customers who may feel disconnected from their healthcare plan and are less likely to engage with their payer in the future. This can result in increased member churn and lower plan satisfaction, negatively impacting Star Ratings.

To address these challenges, healthcare payers are increasingly adopting cloud-based customer communications management (CCM) software. This allows payers to manage all their customer communications from a single platform, ensuring timely and personalised communications while simplifying the information presented.

Leveraging cloud-based CCM software can improve member engagement, reduce churn, and provide a better healthcare experience. As the industry evolves, customer communications will become more important, making it essential to invest in the right tools and technologies.

Star Ratings are increasingly focusing on member experience and payer administrative operations, and have significant implications for healthcare payers. According to a McKinsey report, 56 percent of seniors consider Star Ratings as a top feature when shopping for Medicare Advantage plans. Effective CCM software can help improve these ratings, leading to better member experiences and higher plan satisfaction. Find the full post here.

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