Why healthcare complexity shouldn’t hurt member experiences

Managing process complexity to deliver strong healthcare experiences

There’s a growing need for comprehensive healthcare cover across the US. 

More people are living longer: the number of Americans aged 65+ is projected to nearly double from 52 million in 2018 to 95 million by 2060.

And there’s an explosion of startups seeking to address this increasing dependency on reliable healthcare.

But comprehensive cover is complex, dispersed and fraught with potentially life-changing risks. 

A single healthcare provider can contain multiple points of contact across vastly different departments—each with different call centers. And that poses a threat to a consistent and valuable service for your (equally varied) patient base.

So how can newer healthcare call centers manage this complexity to create strong and secure member experiences?

Complexity is an opportunity

Complexity gets a bad rap. At its worst, it’s synonymous with frustration, inefficiency and human error. And when the going gets tough, and mistakes happen, those accusations can be fair.

But here’s the thing.

The vast majority of the time, complexity is inevitable in healthcare. It’s a complex system of interlocking payers and stakeholders that—when working in harmony—can deliver some of the best patient experiences in the world. 

Complexity is what enables healthcare providers like yours to deliver the full gamut of care—from appointment reminders, to transportation for less mobile patients, all the way through to treatment plans.

Healthcare call centers have a critical part to play in wrangling this complexity towards outstanding member experiences—so everyone gets the treatments they need.

And that’s good news.

The bar for success is higher in healthcare than anywhere else. By embracing accountability to outstanding care at every customer-facing edge of the operations, we can have a direct say about the standard of care we deliver to our members. We can craft experiences that rely on something other than traditional metrics. 

While KPIs like fast Average Handle Time and Net Promoter Score are often strong indicators of call center performance, they don’t tell us enough about the actual patient experience.

Let me explain…

The power of value-based care

A lot of today’s healthcare call centers need a change in mindset and approach.

Strong patient experiences aren’t marked by fast resolution times. They’re built on consistent empathetic experiences—that adapt to patients’ changing needs.

It’s what we call value-based care: fulfilling KPIs that are unique to each and every member.

Say you have a member suffering from diabetes, with impaired mobility and poor literacy. How can you ensure their needs are met, and obstacles to treatment removed?

Traditional call center metrics do little to answer these questions.

Advanced customer agents are trained to triage the removal of these challenges—often undergoing weeks of training and mastering potentially hundreds of scenarios per client.

A healthcare call center operating on value-based care will find a suitable subsidy program for those struggling financially; arrange special transport to treatment for a wheelchair bound person; and even door-to-door transport if a member can’t operate the wheelchair.

Value-based care helps call centers consistently meet and even exceed members’ expectations by moving the emphasis away from traditional metrics and towards a more holistic way of measuring success.

Compliance means competence

Today’s successful healthcare providers don’t just cater to individual members’ needs: they constantly operate in ever-shifting bounds of statewide regulation.

That means implementation never ends for healthcare call center agents. Competence doesn’t stop with value-based patient care. It’s equally dependent on advanced agents who can adapt and deliver the same level of empathetic and effective service, no matter the regulatory context.

For instance: the system for applying for a subsidy in your state may change—the onus is now on your call center agents to help eligible members navigate a new and unfamiliar system. 

We need to be comfortable with continuous adaptation, while still delivering reliable and personal experiences for members.

And help is at hand: at Ubiquity, we have a dedicated team of adult educational trainers that ensures healthcare agents constantly meet their compliance goals.

What’s more, day-to-day interactions and business contracts and scripts can change quickly—which is why value-based care demands a deep level of dedication and industry knowledge from your call center agents.

For that, you need a certain caliber of call center agent. We talk more about that here.

Comprehensive and trusted healthcare outsourcing

There’s an opportunity to lead the charge towards comprehensive, empathetic and value-based healthcare—and it starts when you pick up the phone.

We’re Ubiquity. We help startup healthcare call centers deliver trustworthy member experiences through dedicated QA, operations, training design and delivery.

If you want to lean on years of experience creating and owning strong patient relationships, we should talk.