Member Retention, Member Loyalty – Lessons from Amazon

By Yvonne Tso

Whether you have a high turnover in your enrollment or not, the Amazon way of serving its customers is a good lesson on enhancing member satisfaction and loyalty that, in turn, can raise the STAR rating on your scorecard for bonus payments (remember CAHPS?). Amazon’s customer obsession has propelled the company to being the second highest valued enterprise, behind Apple, with a $1 trillion market capitalization within sight.

The company has publicized their fourteen (14) principles for management. For our purpose, we will focus on five:

1. Customer obsession

Medicare beneficiaries don’t necessarily visit to find a health plan. They ask friends and family. How you serve your enrollees will be your best advertising medium. The place to start is your Call Center. We have helped many clients train their Call Center/Member Services staff and improve their processes. We are still witnessing staff members to be long on niceties on the phone but short on solving problems for the members or not providing the correct information. In every encounter with a member, your staff should ask himself/herself, “what would this member tell his/her family and friends about our health plan after we hang up?”

2. Deliver results

This is more important than on first glance. When you deliver results, you are building trust with your members. Trust is what drives recurrent purchases in the consumer market. When one shops online, one trusts the vendor, in this case Amazon, to deliver on time as promised, the merchandise matches what is shown online and returns are easy if you are not satisfied with the product. These experiences accumulate and underscore loyalty and member retention.

4. Invent and simplify

Simplicity is especially relevant to the Medicare population. Don’t write a lengthy member handbook; rather, create graphics (pictures) to illustrate how to access services, how to appeal, how to manage chronic conditions, etc.  Invent ways to educate the members. For the more dependent members, provide personalized support (“concierge service”) to walk the member through the experiences once or twice (“My ride is always late, so I am late for my doctor’s appointment” or “I am out of pills and I can’t get them at the drug store”) to show the easiest ways to access services. You will have firsthand experience during the course to find out if access is indeed easy or the process needs improvement.

4. Dive deep

Review the call log regularly and listen to recorded calls when you have questions about the issue description or the resolution of a call from a member. CMS auditors listen to recordings in a CMS program audit, as does Medicare Compliance Solutions when we perform a member service re-engineering or training project.  Until you have a good grasp of why members call, you cannot get at the root causes of their dissatisfaction or complaints. When you know, you can find ways to improve and minimize member calls! Yes, minimizing complaints and grievances via phone calls should be a business goal for your Call Center/Member Services.

5. Bias for action

Take calculated risks. Try new ways to conduct your business. Do not let excellence be the enemy of good. No experiment or initiative is perfectly executed the first time. Identify a way to put an idea into action, develop metrics to measure results and expand to your membership at large when the results meet your expectation.

Healthcare consumers may not have the same attributes as those who shop online but their expectations are the same – results, efficiency and one-click ease for their needs. When you meet these expectations, you will have their trust and loyalty (and enrollment) for life. And they will give you raving remarks in the CAHPS.

Medicare Compliance Solutions has helped managed care organizations evaluate gaps in their member services, provided training to bridge the gaps and improve their member retentions. To learn more about our expertise and solutions please contact us at 562-498-2218.

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