Is Your CRM Working Against You?
CRMs are essential to modern healthcare payer operations, but poor planning and implementation strategies could make customer experience challenges worse.
Customer relationship management (CRM) software has become an essential tool for health insurance organizations seeking a unified approach to superior customer-service initiatives.
However, CRM strategies that are short-sighted or poorly executed can actually make existing customer experience and service challenges worse, leaving in its wake dissatisfied members and costly administrative quagmires.
The ability to leverage a single solution across the enterprise to optimize service and benefit differentiators, increase organizational transparency, control costs and quickly scale for growth is critical to viability in a competitive and consumer-centric market. But CRMs are only as dynamic as the strategies behind them.
Here are five ways your CRM initiative may be sabotaging your organization’s ability to compete.
1. One-Size Doesn’t Fit All
CRM problems often start with vendor selection. The problem isn’t necessarily the quality of the solution—it’s that the CRM wasn’t designed specifically for health insurance. Industry agnostic CRM solutions require insurers to fit a square peg into a round hole through an arduous process called verticalization. This requires a significant investment in resources, time and money over the course of several months in order to customize the CRM to the insurers’ product, marketing and sales structure. Years(and opportunities)can pass before ROI is realized.
2. The Scale Fail
It’s not unusual for insurers to consider CRMs to be a one-and-done software investment for a single or small subset of departments. Organizations may select a department for the CRM as a proof-of-concept deployment, only to discover later that scalability has been compromised because the software was tailored too specifically to a niche unit.
3. Missing Connections
CRMs being isolated from other business units results in some units with CRM “super-users,” others that use it as a data dumping ground, and no real sense of what customer and prospect data is being tracked or how it is being used. Additionally, the lack of connectivity among product lines, legacy claims, and membership and billing systems forces departments to waste time double-entering data or closing information gaps. Instead of being a dynamic and valuable tool, the CRM becomes another administrative burden.
4. ‘Lazy’ Data
CRM software is supposed to help health plans better understand and manage their relationships with their customers. Too often though, it becomes a receptacle for unused dashboards and reports. Which members are likely to renew their policies? Who may need additional services or benefits? Do roadblocks exist that prevent members from completing a purchase? Insurers are floating on an ocean of member data, but it’s useless unless it can be made actionable.
5. Lack of Future Insights
Industry buzzwords are helpful shorthand for conversations, but can lead to misperceptions about how the concept actually works. “Predictive analytics” is a perfect example. You don’t plug in a CRM today and “get” predictive analytics tomorrow.
Predictive analytics are the result of a deliberate strategy of unifying actionable data, organizational transparency, and the ability to draw trends from historical information. If high-fidelity analytical models are desired at any point in the future, then an organization needs to make the collection of behavioral, purchasing, utilization and relationship management data a high priority now.
Achieving the Ideal Scenario
Ideally, CRMs help insurers achieve operational and analytical transparency, allowing teams across the enterprise to leverage actionable data to make better decisions, optimize performance and consistently exceed customer service expectations.
Organizations should begin by evaluating CRMs that are designed for healthcare insurers and can scale to anticipate both temporary and permanent growth.
Once a vendor solution is identified, focus should be on integrating the CRM with multiple front- and back-end systems to inform and accelerate the collection of all necessary data, which makes both the sales and service process more efficient as well as sets the table for future analytical capabilities.
For example, insurers can use sales and utilization information to design new offerings, provide additional buy-up options to consumers and make the most out of cross-selling opportunities. Sales and service data can also be utilized to drive the customer experience across the entire lifecycle; increasing and improving touchpoints with members provides opportunities to build loyalty. With a properly designed CRM, relationship data can be tracked, managed and leveraged from the initial shopping experience through enrollment, onboarding, service and renewal processes.
From an operations perspective, a healthcare-specific CRM can facilitate streamlined health plan set up, claims administration and member lifecycle management. All member participation information could be captured and integrated with multiple back-end systems to inform and accelerate the sales process.
Properly built, a CRM solution with seamless integration transforms traditional customer experiences into new, lasting and meaningful connections with current and prospective customers throughout the member journey.
Health insurance plans that embrace digital transformation of this magnitude stand to achieve substantial efficiency improvements in acquiring new members and providing services over the course of the customer lifecycle. That is the power of actionable information.