The ROI of CX: 5 Steps to Drive Highest-Value Member Engagement

The ROI of CX: 5 Steps to Drive Highest-Value Member Engagement

In this first installment of our five-part series, The ROI of CX, Zipari CEO, Dr. Tabatha Erck presents five steps to ensure your firm derives maximum value from your CX efforts. Don’t miss the next installment: subscribe now or follow us on LinkedIn.

Across the industry, the word has spread: insurers that offer a consistently best-in-class customer experience (CX) grow faster and are more profitable.1 But why?

Businesses with bad customer service frequently pay a price and insurance is just like any other customer-facing business. Social media magnifies poor service. One mishandled claim or smartphone mistake can soon become a brand-damaging issue. This is one reason all insurers should prioritize great customer experience (CX).

Step #1: Establish a Goal-Based Engagement Plan

Best-in-class customer experience (CX) goes beyond decreasing member complaints and customer service errors. Internet, aggregators, and social media make shoppers more aware of coverage, prices, and services. A best-in-class CX program helps healthcare payers stand out in competitive markets.

Today, top healthcare payers across the U.S. are adapting their business models to improve member satisfaction. Healthcare payer CIOs and CX leaders must transition from claims adjudication to helping members stay healthy, get better when ill, and accomplish their own health objectives to succeed. Do this properly and your members will perceive your organization as a valued advocate in the congested healthcare marketplace.

Start With Solid Goals
As a healthcare payer, it’s critical that you establish and clearly communicate the goal-based engagement plan for your CX efforts.

  • Your goal-based engagement plan specifies the goals, steps, and metrics that must be achieved to improve your connection to your members, providers, distributors, and employees.
  • A goal-based engagement plan is a roadmap for healthcare payers to achieve a specific customer engagement (CX) goal.

According to Zipari CEO Dr. Tabatha Erck, “it would be shocking if most payers don’t have at least one of the following three goals inside their strategy:”

  1. Reduce costs
  2. Retain and grow our membership
  3. Improve member satisfaction

In fact, as Gartner found in their survey, 2023 CIO and Technology Executive Survey, these three strategic imperatives are common to every health plan.

By establishing a goal-based engagement plan for your CX efforts, you’ll ensure that the outcomes you deliver for your organization are best for your members and your bottom line.

  1. Maybe your firm’s CMS rating is two and a half stars and you want to get to three?
  2. Perhaps you want to go paperless with your EOBs?
  3. Or you might want more members to download their health insurance ID from your mobile app?

Make Metrics Matter
For example, when you think about your firm’s desire to cut call center costs while improving value-based care for policyholders with chronic conditions, such as improving the health outcomes of your members with diabetes, which department is championing that goal? Will it be your clinical team or your quality team?

It’s important to understand the cost drivers tied to each goal for your CX program. This is key to setting measurable goals.

Oftentimes, the goals you identify in your CX program’s engagement plan are to get members to use the tools you already have.

These are lofty and beautiful goals, and everyone in the room will wonder how they’re going to do this. The benefit of assembling your CX goals into a single document is that it forces you to prioritize a) what you want to accomplish and b) how you’re going to do it.

Invite Peers, Iterate Often
It’s nearly impossible to improve your member engagement rates when you don’t know what it is about your member engagement program that you’re specifically attempting to address. So where to start?
  • First, you’ll want to pull together a group of your peers responsible for member engagement, identify potential changes in member behavior that would benefit both members and your firm, and estimate the projected value to your organization if your member adopted the necessary behavior change.
  • Second, you also want to determine which member populations should be targeted with communications and prompts to elicit the behavior changes you’re looking for.
  • Third, once you’ve identified which member behavior, member population, and goal you’re trying to impact, reach out to solutions providers to explore your options to achieve the desired results. (A health tech organization like Zipari can work with you to help you add specificity to your goals and ensure you accomplish them.)
Armed with your Goal-Based Engagement Plan and the support of your peers, you’ll be able to shape your efforts around consumer engagement towards discreet changes in member behaviors and attach measurements to track these changes to demonstrate your ROI.

Don’t Delay, Start Today
Want to see how top payers are succeeding in CX?
Contact us today to request a case study or request a demo with one of our solutions consultants.




1 Source: McKinsey & Co. The growth engine: Superior customer experience in insurance.
Michael Vlasak

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