Health insurers' biggest pain point? Personalization, CIO of Wisconsin health company says

During an America's Health Insurance Plans conference last year, John Church, vice president and CIO of Wisconsin health insurance service company NeuGen, heard consumers raise several complaints about lack of personalization and health insurance literacy.

Mr. Church, who helps oversee health plans covering 130,000 members at WEA Trust, answered four questions for Becker's Hospital Review about how payers can improve member engagement and overcome market challenges.

Responses have been lightly edited for clarity and length.

Question: How can health insurers succeed in acquiring members and retaining them?    

John Church: This is done through demonstrating you care. Health insurance literacy is a real issue in the U.S. We have to help our members navigate the healthcare system. We also have to address the issue of cost and quality. High cost does not equal high quality. We focus on medical management programs that deliver quality outcomes at the best rate possible.

Q: How do outside pressures, be they geographic, demographic or new competitors, complicate this?

JC: Given the rising costs of health insurance in the U.S., many competitors try to buy the business at a reduced rate. This is a short-term cost savings for the member, just to have rates rise at double digits in subsequent years.   

Q: How can health insurers overcome these challenges?    

JC: Both the insurer and member have to have skin in the game. Insurers have to work with members through medical management programs. By aiding the member in living a healthy lifestyle, we can provide members with sustainable increases in premium.  

Q: How do health insurers stand out to consumers and differentiate themselves from competitors?   

JC: Personalized service. Back in November, I attended an AHIP conference. There was a panel of consumers discussing health insurance. Their biggest complaint was that when they had an issue, they couldn't get anyone live on the phone to help. At this same conference, there was a presentation on health insurance literacy. It showed that 52 percent of Americans have little to no health insurance literacy. So … when someone has a health condition exposed, they will need help to understand their benefits.

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