2-3 MIN. READ   /   STRATEGY   /   SERVICE DESIGN / DIGITAL

Redesigning Members’ Experience for Managing Healthcare Finances


We redesigned a key member touchpoint by applying an understanding of consumer needs to a operationally complex and highly regulated environment.

CHALLENGE
OUTCOME
Identify the biggest opportunities for a leading health insurer in a redesign of their EOB and to lead them through an engagement to create an improved version of the EOB built with the member experience at its core.
A business case, socialization materials, and a prototype of the redesigned EOB that was validated through consumer testing with overwhelmingly positive feedback on design and ease of use.
KEY ACTIVITIES
DISCOVER
– Current state assessment
– Competitive assessment
– Opportunities + design factors
DESIGN
– Ideation sessions
– Prototype development and iteration
DEVELOP
– Internal stakeholder interviews
– Future state service blueprint
– Strategic Roadmap
KEY DELIVERABLES
14
Competitive Assessments
8
Identified Opportunities
3
Prototypes
APPROACH

Over the course of 8 weeks, we worked alongside a client team consisting of representatives from customer experience, operations, sales, and legal/compliance to understand the current competitive context and member experience, ideate and develop an improved future experience, and develop a plan for implementation.

To begin, we completed a deep dive assessment of the role the EOB played in the current member experience and the pain points and frustrations it caused in its existing state. We also performed a competitive assessment of 10 other health insurers, and reviewed similar artifacts and experiences from 3 external industries (e.g. financial) as sources of inspiration.

INSIGHTS

From the research we discovered common themes of complicated industry language, visually cluttered layouts, and content lacking focus or relevancy. This all combined hindered the member’s ability to reconcile their healthcare finances and drove frustrated.  We identified 6 critical design factors and 8 areas of opportunity to guide a redesigned EOB specifically created to enhance the member experience. Armed with these insights, we led the client through a collaborative ideation workshop where we began creating new visions for the EOB through brainstorming and rapid prototyping activities.

RESULT

In a single week we turned the workshop output into three high-fidelity prototypes introducing simplified language and improvements to content, visual display, and associated operational efficiencies. The first prototype was built with feasibility in mind and would allow our client to make immediate, incremental improvements (less than 1 year). The second prototype overhauled the EOB and established an alternative delivery cadence that took cues from other industries. The third and final prototype was a customizable, fully digital-based experience that aligned with the organization’s long term digital strategy.

Finally, we developed a package of implementation materials, including a service blueprint identifying key people, systems and processes required for the future state, a short-term roadmap of next steps for advancing the prototypes, the outline of a business case, and socialization materials. Following the engagement, the redesigned EOB was validated through consumer testing with overwhelmingly positive feedback on design and ease of use.

No matter what barriers are hindering your innovation, we can help you accelerate through them.