Consumerization in healthcare: What it means for payers

Highlights: 

  • Healthcare consumerization has given members greater power over their healthcare experience
  • To retain members and create a better member experience, payers need to leverage healthcare consumerization
  • Unified communications platforms help payers deliver a better member experience by making it more efficient and personalized

The concept of consumerization might have started off in the realm of IT, but it’s moved into healthcare. Healthcare consumerization has an impact on the entire patient experience, including how members interact with healthcare payers.


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Read on to learn about the impact of healthcare consumerization on the member experience and how the right technologies can improve the member experience.

What is healthcare consumerization?

Traditionally, the medical establishment has been largely in control of decisions regarding medical care and patient wellness. Healthcare consumerization is shifting control over to the patient. According to analysts at UBS, healthcare consumerization refers to the trend of people influencing and controlling their medical care and wellness.

The following factors have spurred the trend toward healthcare consumerization:

  • Higher healthcare costs
  • An aging population with greater needs for healthcare services
  • Advances in technology that make it easier for consumers to access information and for players in the healthcare space to deliver products and services

Healthcare consumerization and the healthcare plan member experience

Healthcare industry analysts note that the global healthcare crisis accelerated healthcare consumerization. However, even before that crisis unfolded, payers faced pressure from consumers to deliver a better member experience.

In an interview published at the end of 2019, PwC analyst Ben Isgur explained that consumers have long been skeptical regarding whether large payers are acting in their best interests. The high premiums and deductibles they pay make it hard for them to see that the payers are working for them.

What do members want out of their experience with payers?

  • Greater efficiency
  • The ability to seamlessly navigate the care experience
  • Greater payer understanding of their needs, situation, and history

Greater efficiency

Today’s members want an efficient experience. They don’t want to wait on hold, nor do they want to be transferred over and over again while someone tries to help them. An efficient member experience has benefits for payer organizations in addition to members; McKinsey research shows utilizing self-service capabilities saves organizations money because members are able to find the answers they need to their problems on their own.

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Seamless navigation across multiple channels

In addition to an efficient member experience, consumers want seamlessness. When they contact their healthcare payers, they expect more than one channel of communication (and they should be able to switch between those channels during the same interaction). Those channels should be consistent, too. A member should have the same positive experience regardless of which channel they use.

Deeper payer understanding

Let’s take another look at the member experience from the member perspective. When members contact your payer organization, they want the payer to recognize their history as a member. Members also expect that the payer knows what’s going on with their lives. If they’ve put in a claim for physical therapy, the payer should know that (and why the member needed the physical therapy).

How can payers deliver a better member experience?

One of the cornerstones of a better member experience is improved communication. Improved communication, in turn, requires the right technology. A healthcare communications and collaboration platform improves the member experience by:

  • Streamlining communication
  • Increasing internal collaboration within the payer organization
  • Building stronger relationships with members

Streamlining communication

A unified communications platform brings together telephony, video conferencing, chat, and file-sharing capabilities into one place, which streamlines communication.

With a unified communications platform, members have more freedom in how they connect with the payer organization. In addition, payers can configure the communications and collaboration platform to route calls to specific agents in its contact center, so members feel a sense of continuity and have their issues addressed by the right payer employee on their first contact.

Increasing internal collaboration within the payer organization

To make clear the importance of internal collaboration within the payer organization, we’ll illustrate with an example.

Jackie submits a claim for a hospital visit for a broken arm. It makes its way to her healthcare payer. However, it gets stuck with one team member. That team member doesn’t have the right information to process the claim. More to the point, the team member doesn’t have a way to connect with the right people to answer the questions that would allow the claim to move forward.

A communications and collaboration platform solves that problem. It offers telephony, video conferencing, chat, and file-sharing, so team members can easily, quickly, and securely share information with one another to complete tasks more efficiently. A presence indicator shows when a team member is available to help.

Building stronger relationships with members

A unified communications platform helps build a stronger relationship with members by:

  • Routing them to a dedicated customer service representative
  • Offering self-service options so members can find the answers to their questions on their own and save time
  • Integrating trusted business applications such as CRMs so employees have a full picture of the member’s situation

Members want to feel that they matter to payers. They don’t want to feel like they’re just another number. Connecting them to a dedicated customer service representative who has information about them is one way to do that; offering convenient ways to find information is another.

Create a better member experience with RingCentral

RingCentral’s unified communications platform for healthcare helps build a better member experience with a variety of communication channels, robust collaboration tools, and self-service capabilities. To learn more, request a demo.

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