Before you ask: “How did that happen?” think about what happened: The past year whipped up waves of optimism in the world of customer experience. Those with their eyes open, paying attention to the latest developments, already know the coming year promises intriguing new opportunities for healthcare payers and providers.
We see a new healthcare ecosystem taking shape that puts people at the epicenter of everything. Processes and technology will revolve around the human, so consumers no longer are burdened to navigate tangled, disconnected systems. AI and people working in tandem form the linchpin of healthcare delivered with humanity.
Drivers of people-centered care
The top trends fueling this movement have been with us a little while and they continue to gather momentum:- Costs continue to rise due to inflation, wage and labor issues, drug prices, and the overall cost of doing business.
- Telehealth is still growing — and evolving. One projection puts the global telehealth market at $504 billion in 2030, up from today’s $143 billion.
- The shift from fee-for-service to value-based care puts pressure on organizations to improve coordination with other groups to ensure better health outcomes.
- AI and machine learning are producing intriguing new use cases and consumers are more receptive than ever to technology’s role in their care.
- Legislative changes affecting ACA marketplace access, the Medicaid and CHIP unwinding, and more guarantee uncertainty stays with us.
- Expansion, consolidation, and new market entrants like insurtechs exacerbate an already-fragmented market landscape that’s increasingly difficult for consumers to navigate.
AI-enabled connected healthcare
Numerous stressors make navigating the healthcare system a chaotic and disconnected experience for patients, not the least of which is the consumerization of healthcare, rise of value-based care, and workforce instability.In the wake of these swirling forces, we see four megatrends influencing the customer experience and employee experience and we explore them in our new strategy guide, “CX Trends 2024.” For healthcare payers and providers, the most noteworthy trend involves striking the right balance of AI technology and human processes.
As consumers get wiser and more demanding about their care and treatment options, AI helps healthcare advocates working in the contact center get better at what they do: truly advocate for consumers.
It’s already happening. AI trains and coaches healthcare advocates in the contact center so they can strengthen empathy skills; AI monitors live interactions and proactively fetches relevant information needed to assist consumers; AI even listens for vocal indicators of stress or erratic use of an IVR to alert a healthcare advocate that an incoming call will require patience, calm, and empathy.
This is not about AI resetting a customer’s password or updating a mailing address. Here are four ways AI goes much further to elevate the experience from chaos to connectivity and make healthcare more human:
Mitigate fragmentation across the patient experience. Conversational AI examines and analyzes the entire online enrollment journey, focusing on how a consumer interacts with the website and also live interactions with a healthcare advocate. AI then populates a profile of the customer, completes a health assessment, and proactively feeds relevant questions for the advocate to ask based on the patient’s specific needs.
Empower an expert, empathetic workforce via AI-enabled bots. Advocates in the contact center engage in role-playing exercises with AI bots to boost their knowledge and sharpen listening and engagement skills. Specialized bots like “objection” bots are programmed to train for challenging calls, such as when a caller is stressed or uncooperative. Through real-time feedback and coaching, AI bots help advocates flex that empathy muscle so it becomes stronger and every interaction is handled with compassion.
Successful calls build confidence and job satisfaction among healthcare advocates who feel they have the training and tools they need to perform at their best. As we all know, the first step in an exceptional customer experience has to be not only the right hire but an exceptional employee experience.
Respond to changing demographics and health equity dynamics. It’s here where AI-enabled bots come in again, simulating scenarios that new hires may not have encountered before in their own lives. Bots build awareness about demographic sensitivities to help healthcare advocates understand the needs of others outside their own cultural or socioeconomic circles. Combined with an enlightened curriculum, AI-based training enhances the experience, especially for those groups of people who have been marginalized in the past.
Expand the use of value-based care via AI-enabled back-office functionality. When providers move from fee-for-service to value-based delivery, a greater focus is on preventive care and AI is indispensable for managing agreements and claims processing across multiple health organizations. Better coordination across groups and data enables providers and payers to deliver more personalized care in the contact center, incentivizes patients to take greater ownership of their health, and ultimately saves needless costs for everyone.
Learn more about the fusion of AI and humans along with other megatrends influencing CX and EX in our new strategy guide, “CX Trends 2024: 4 megatrends shaping the future of customer and employee experiences.”
