Huh? Did I Read This Right? CIGNA HealthCare Wins Customer Service Delivery Award Through Focus on Helpful and Easy Interactions!

Gartner Group recently announced the awarding of its Outstanding Customer Service Delivery award for 2010 to CIGNA HealthCare. This follows its 2009 award to CIGNA for Outstanding Customer Service Strategy.

Huh? Outstanding Customer Service Award to a HealthCare Company? Isn't this the same industry that for years has been viewed as the poster child of customer abuse and mistrust? Isn't this the same company that had a nickname amongst doctors and patients as "CIG-NO."

In previous posts, I have often said that if one healthcare company can break from the pack based on a service strategy, it would help transform the industry.

It appears that something significant has indeed been launched at CIGNA and, according to Gartner, has begun to take root. I took a look at CIGNA's website and found just how simple and aspirational its new mission is:

The Mission:

To help individuals enrolled in CIGNA plans achieve their health goals with helpful information, trusted support and excellent service.

To do that we must: communicate simply, consistently, and in ways they find personally relevant, compelling and easy to understand.

Every interaction must be helpful
Every interaction must be easy

The Plan:

If we:
•Make interactions with us positive, productive, and seamless
•Provide helpful information that’s understandable and easy to obtain
•Do this repeatedly and reliably

People will:
•Trust us
•Come to us so we can help them
•Fully use their benefits
•Take better care of their health

And if this happens, the cost of health care will be lower for all.

I like it.

I like big goals, and there is none larger than the goal of lowering the cost of health care for all.

I like simple plans that are easy to understand, and this one points out that "if we do this, then people will do that...."

I like fact-based approaches that outline what the company has to do in order to accomplish the mission. CIGNA's website points out that, among other things, it has:

• eliminated what frustrates--if you want a human, you get one, 24/7


• redesigned explanation of benefits brochure


• redesigned new and simple enrollment guides

My View

CIGNA's efforts are to be applauded, For now, it appears that it is truly focusing on many of the features that matter to customers. Should it continue along this path, we believe what may emerge is a company that is approaches its business differently than others in the benefits industry.

As a former CIGNA employee, I find this a refreshing focus in that the company for years has found itself mired in an expensive technology and re-engineering debacle that cost the company dearly in customer goodwill, client focus, and employee morale.

The caution I put out there is questioning how deep this commitment to Customer Experience may be. As Bill Hogg recently wrote in his blog "Customer Service That Astonishes," companies need to become a premier customer service company in its strategy and culture, rather than having Customer Service as a tactic that sits alongside all other tactics in the corporate tool box.

I look forward to seeing more progress from CIGNA, and other HealthCare companies that must follow suit. This is how we will see leadership in transforming a troubled industry.

Can Healthcare Insurance Companies Transform Their Poor Image? CIGNA Is Going To Try!

There is no question that the Health Benefits, Insurance and Delivery industries are in major flux...increasingly expensive and seemingly not making anyone happy.

For example:

My health plan with United Healthcare simply can't get my dependents right. I have twin sons and the insurance company struggles with their having the same birthday. I also have a junior Christopher and we are constantly letting them know we are not the same person, which was a real problem when we both had the H1N1 flu and needed medicine. Just silly administrative nonsense that gets in the way of a bigger discussion.

Much in the same way that my son tried to order a "Hi C" from the drive-thru at McDonalds and instead received an "Iced T." A nuisance, but almost understandable.

Apparently Health Insurance Companies are beginning to wake up and understand that they have to address this high pay-low service reputation or their very existence may be in jeopardy. For example, CIGNA has enbarked on a mission to improve the clarity of its communications, as one step in its overall service transformation.

According to Linda Ireland, co-owner and partner of Aveus LLC, a global strategy and operational change firm, CIGNA set up a Customer Experience team whose mission is:

To help individuals enrolled in CIGNA plans achieve their health goals with helpful information, trusted support and excellent service. To do that we must: communicate simply, consistently, and in ways they find personally relevant, compelling and easy to understand.

In her blog, Customer Experience For Profit, she writes:

What I like so much about the CIGNA approach is that
they’ve articulated why they’re changing, what the plan is, and what’s been done
so far. I like that the changes they’re working on should strengthen their
experience while improving financial performance – fewer questions and problems
will drive down the cost to serve customers. And I imagine there was
some candid fact sharing in the conversation that triggered this effort, about
how they got to where they are.

You can read the full text of her work at http://www.ceforprofit.com/2010/03/will-cigna-free-its-customers-of-insurance-ese/

My View

The CIGNA focus on its service experience seems to come at a good time. Not only is the industry on an unsustainable path, but its performance has opened the door to government intervention.

CIGNA's Net Performance Scores (NPS), a measure of satisfaction (more on that measuring technique in other posts), is very low.

In late March, 2010, Satmetrix released its annual Industry Benchmark survey. According to the press release, Blue Cross Blue Shield of Illinois was the only health insurance company profiled with a positive NPS, scoring 5% in a sector with an average of negative 13%. CIGNA ranked last among major health insurers with an NPS of negative 28%. Full reports are available for purchase on http://www.satmetrix.com/and http://www.netpromoter.com/. A summary of the press release can be read at :http://www.customerthink.com/news/satmetrix_releases_net_promoter_benchmarks_for_customer_loyalty
A negative score means that more people rate their satisfaction poorly than acceptable. In an industry of major dissatisfaction, CIGNA ranked the worst.

I hope the efforts that CIGNA is undertaking are truly meaningful, not only for their millions of insured, but also to establish a new benchmark for the industry. As a former employee of this company, I hope it works.

This is one industry that can use Perfect Service.

Lessons In Service: Strive For Perfection, Don't Screw Your Customers

Yesterday, I had two experiences that triggered some thoughts about what companies have in mind when they act.
--------------------------------
First--

Watching television with my wife and a commercial appears for "Simply Orange" orange juice. The advertisement was clearly emphasizing the freshness and goodness of the product, features of a typical "product focused" sale. What caught my eye was the "Orange Back Guarantee."

According to the product's website:

"If, after tasting, you don’t agree that Simply Orange orange juice tastes as fresh as biting into a juicy orange, you may make a claim under the Orange Back Guarantee.....On a 3”x 5” card, state why you think Simply Orange orange juice does not taste as fresh as biting into a juicy orange in 50 characters or less.."

What do you get back? A free bag of the competition.....ORANGES!

I have been focusing a lot recently on guarantees, and how they make a market statement as well as focus an organization to deliver. So what does this guarantee do for the product? Well, it clearly caught our attention, more for being unique than anything else. Second, without tasting the product, my mind assumes it is a premium offering....why else would they guarantee such a thing. Third, it was not a true comparative offer, such as "we are guaranteed better than the other brands," yet it tried to position itself that way by comparing its taste to the ultimate competitor...the orange itself...against "the perfect competitor!"

My View:

The commercial worked for us. If you asked consumers to describe the "perfect orange juice," they would likely say that it should taste like freshly squeezed oranges. So Simply Orange guarantees its product is the "perfect orange juice," not that it tastes better than its competitors. I like that.

When trying to differentiate based on a premium offering, companies should look ahead toward perfection rather than simply staying ahead of competitors. Perhaps that's one of the reasons the Health Insurance industry, with its low service reputation, lacks a breakout service competitor...in their minds, it is okay to just beat competitors; they feel they don't have to strive for perfection.

Wrong.

------------------------
Second--

Poland Springs delivers bottled water to our house. Each month, we get a bill in the mail for about $40, which I am usually diligent in paying. A year ago, I noticed that a "Fuel Surcharge" had been added to the bill for about $2.50. I didn't pay too much attention to that since the cost of fuel had been going up dramatically. But I did notice that when the price of fuel went down, the surcharge remained. Well, unfortunately, last month I was two days late in paying my now $42.50 bill, and I see an additional $15 late payment fee. Now my bill is $57.50.

I was furious. So I called Poland Springs to cancel my delivery service. Between a Fuel Surcharge and now Financial Penalties, getting water to our home was getting expensive and complicated. Not worth it....

The Call Center representative transferred my call to a trained specialist who obviously handled all discontinuances. Noting my long tenure with with Delivery Service, she immediately offered to waive the Financial Penalty. As well, when I queried about the Fuel Surcharge, she said she couldn't remove the surcharge, but would discount my water 50% this month which would be the equivalent of about 9 months of fuel surcharge. So my bill goes from $57.50 to about $25.

Mission accomplished. I stayed. But I am not happy.

My View

There is an ugly business practice out there that I refer to as "The Appeal Process":

---Squeeze and underserve your customers and hope customers don't notice;
---Focus on recovery for those customers who do notice.

Like many companies, Poland Springs has set up a game of pushing the revenue envelope as far as it can (adding fees and penalties) to supplement its commodity product offering. For some companies, the money made on penalties, interest, and other charges can rival that of the product or service itself. (One has to question at this point what business these companies are in...is Poland Springs a bottled water company or a financial company?)

But Poland Springs understands that it can only push the envelope so far, and it tries to catch fall out during a recovery process. In the time of a 5 minute phone call and without my asking, the discontinuance specialist waived the penalty and discounted my water 50%. I am staying with the service, but am now wary of the company.

A company that wants to distinguish itself in service must not put its customers in such a predicament. By offering deals only to those who complain, or who know how to play the game, a company is creating a trust gap. I am not going to feel good about a service provider if I have to read and understand all of the small print just to not be taken advantage. Examples abound:

Health Care Insurers--deny coverage or prescription at first, but will accept if appeals are made. Model hopes insured people will not appeal.

Banks/Credit Companies--charge fees for everything but are willing to drop them if challenged or if accounts are threatened to be closed.

Everything Travel--the guy next to me on a vacation flight has paid half for his seat and hotel room because he knew how to work the process.

The true premier service provider would not have forced me to go through the humiliating process of threatening to stop my service before offering me the discount. If I was truly valued for my tenure, the discount or penalty waiving should have been automatic. Now that would have been impressive. I would have felt special rather than cheap.

Good Lessons here!

Healthcare Company Objectives: To Be Prettiest Pig On The Truck

A bit of disturbing research was recently published by Forrester showing that customer satisfaction of the health plan industry is poor and heading lower. Should that surprise anyone? No...not with prices rising, co-pays and deductibles increasing, and coverages more restrictive than ever. Here are some of the results from the Forrester research from Bruce Temkin in his blog "Customer Experience Matters":

In Forrester’s 2008 Customer Experience Index (CxPi), we ranked 113 companies across 12 industries. I recently published a snapshot of the health plan industry looking at the results from the eight plans on the list (Aetna, Anthem (BCBS), CIGNA, Kaiser, Medicaid, Medicare, TriCare, and United Healthcare). Here’s some of what we found:

--Experiences are “very poor” and getting worse. As a group, the eight health plans ended up with a “very poor” rating of 51%; the lowest score of any of the 12 industries we examined. Making matters worse, the industry dropped three percentage points from the 2007 CxPi results.

--Kaiser led the pack. With an “okay” score of 70%, Kaiser led all health plans. All of the other plans ended up with ratings of either “poor” or “very poor.”

--Medicaid is as bad as it gets. With a terrible rating of 38%, Medicaid was the lowest scoring plan. It also ended up in next to last place across all 113 organizations in our rankings.

--Only Kaiser improved. When we compared the 2008 results with those from 2007, only Kaiser showed an improvement. CIGNA and Medicaid, on the other hand, declined the most.
Some big shifts in CxPi components. There were five double-digit changes in the scores for the three underlying elements of the CxPi: Kaiser’s improvement in being easy to work with and enjoyability, Anthem’s decline in enjoyability, and both CIGNA’s and Medicaid’s drop in being easy to work with.

My view:

The Health Benefit industry is headed toward a cliff, with people paying a lot of money and not feeling like they are getting the service they are paying for. There are lots of reasons for dissatisfaction, many of which are not related to the service itself, but many are--such as the "easy to work with" category."

Service has not been a priority for these firms in the past. Controlling costs has been. I have heard management at healthcare companies say that their goal is to provide service that is just good enough, but not great, thinking it will be too expensive to provide service that makes clients/employees happy. The phrase "prettiest pig on the trust" describes their goal...not a lofty objective.

Further, health plans are viewed as marquee benefits for companies. Can you imagine spending millions on a "benefit" that no one is happy with? Companies will soon see that the money spent is not worth the aggravation, and look for other ways to provide coverage...like cheaper Consumer Directed Health Plans....or no coverage at all.

That is, unless a company, like Kaiser, steps up and shows you can provide service at a satisfactory way, and make the case that it benefits the company to have good service for its helathplans. There is clear opportunity for health benefit companies to step up here....and differentiate based on service....Perfect Service!

"The Role of Emotions In Buying Health Insurance"

Another expert has opined about the service experience in making health insurance decisions. McKinsey, in its latest quarterly newsletter, points out that a focus on customer satisfaction will drive customers to you. Here is the link to their website, but the research requires a premium membership: http://www.mckinseyquarterly.com/Health_Care/
Strategy_Analysis/The_role_of_emotions_in_buying_health_insurance_2352

The role of emotions in buying health insurance
Consumers shopping for health insurance today face more choice, complexity, and financial exposure than ever before. In an increasingly uncertain world, what they are really seeking is peace of mind in their choices. Insurers that address the emotional needs and biases embedded in the typical consumer’s behavior will be successful in creating and distributing effective products, earning the consumers’ trust, providing a more satisfying shopping experience, and, ultimately, helping consumers better manage their health.

Further, McKinsey points out that 140 million Americans have discretion in the purchase of health insurance, representing more than $750 billion in premiums. The key point of the research is that while companies view health insurance as an "expense" issue, consumers select based on "peace of mind."

My View
Service providers have an opportunity to step in, understand what will drive peace of mind, and then focus on delivering that service perfectly. I am not sure whether insurance companies will ever be viewed as the honest broker in the information/service delivery, but intermediary service providers can. And there is a lot of opportunity to take marketshare and find profitability in doing it well.

Retirement/Benefits Markets Suffering From Lack Of "Perfect Service"

There have been a number of articles in Plansponsor.com recently with implications about competitive positioning in the Retirement/Benefits marketspace. In each, I believe there are indications of a lack of overall servicing as well as opportunities to step up and dominate the space. To see these and other articles about the benefits market, link to http://www.plansponsor.com/.

-----------------

From Plansponsor.com on May 8: Interest in Integrated Service (TRO, TBO)Running Out of Steam
While cost savings and efficiency remain the most important reasons sponsors give for bundling (DC and DB plans) in 2008 (mentioned as the most important reason for bundling by 39% and 17% of sponsors, respectively), other key reasons vary by a plan’s bundled status. For example, fully bundled plans place great value on having a single point of contact, while semi-bundled plans place much greater emphasis on the opportunity to improve participant services, according to the report.

As a group, bundled plan sponsors question the ability of providers to deliver a consistent service experience across the bundled offering. Consider that bundled plan sponsors report considerably lower satisfaction levels with their DB providers in 2008 (63% vs. 77% in 2005), but higher satisfaction levels with their DC providers (85% vs. 77% in 2005). Intermediaries echo these sentiments, as only 13% believe that service quality is consistent across components of a bundled package.

From Pionline.com on May 12: Fewer DB execs looking to bundled providers
Fewer defined benefit plan sponsors are looking to outsource some or all of their plans to bundled service providers, according to a Chatham Partners survey.

My View:
This is a classic case of a failed value proposition due to a lack of execution. For years, there has been the promise of integrating retirement plans (DB and DC into TRO), then integrating all benefits (TBO), and then all Human Resource functions (HRO), and then all business service functions (BPO).

There is no question that companies want the simplicity and efficiency of a single-destination service provider. However, as these integrated solutions were sold, the services providers simply did not deliver an adequate product. The result is a blot on the entire concept.

The Opportunity:
Service providers that can fulfill the broken promise of excellent integrated servicing to companies and their employees stand to take significant share of the marketplace. I firmly believe that had companies focused their delivery on employee satisfaction, with the full commitment of a "Perfect Service" infrastructure, benefits integration would be the norm and those firms would be dominating the space.

-------------------

From PlanSponsor.com on May 12: Economic Crisis Accelerates Move To Consumer-Driven Health Plans
A recent study conducted by Workscape, Inc. and the Human Capital Institute (HCI) indicates that in the midst of the economic crisis...some employers are taking measures to mitigate increasing health care costs. Forty-four percent (44%) said they offer at least one high-deductible healthcare plan or consumer-driven healthcare plan (CDHP) to their employees.

My View:
The shift toward a consumer-driven healthcare plan model is inevitable (unless President Obama steps in with a massive overhaul). Shifting more of the "choice" burden to the employee, however, requires education, communication, and counseling/advising services that are just not there. Without access to vital information, employees will be unable to make critical choices that protect their health and wealth in the short-term and in particular the long-term. We have seen this pattern in the 401k plan where financial education and advisory/counseling services have evolved to meet the need...over 20 years!

The Opportunity:
Retirement and benefits companies can carve out an important niche by focusing on the needs of the employee of companies with HSAs and CDHPs. By servicing these employees in an extraordinary way, service providers will enable their company customers to responsibily achieve the utilization and then the savings these plans offer. Opportunity is there for the taking.

----------------------------

From PlanSponsor.com on May 12: Employees Need More Health Plan Information/Services
The 2009 UBA Employer Benefit Perspectives Survey found 81% of employers felt their employees were aware of health cost crisis and emerging trends. The survey also found 77% of employers strongly agree that employees need tools to help them choose the most appropriate plan option for them. Nearly 74% felt that the employer should provide education on health care costs and ways to manage those costs, including 68% who say employees should be given hospital/physician cost and quality info.

My View:
Employers are spelling out the types of service that will make their health plans successful. Not surprising, the views are about the services surrounding the plans, not the plans themselves. As above, the trends toward consumer decision-making is clear, but the information/tools are not available.

The Opportunity:
Understanding the client service need, and then filling it completely, is a way to effectively compete. There are those competitors who will design the plans with the best features, coverages, options; there are competitors who will compete with the lowest prices. I firmly believe there is ample room for a benefits provider to compete with services targeting employees who need help planning for and using their benefits optimally.

---------------------------

These examples show that companies that deliver extraordinary service, and develop a system that focuses on improvement of that service, can fill market holes. I believe it only takes a commitment and then a full-body resolve to develop this competitive advantage. And there is lucrative marketshare to be taken.