Zipari, along with research partner Ipsos, conducted primary, direct market research leveraging an online survey distributed to health plan members and health plan representatives across all 50 states. The survey sought data on member and payer perspectives of CX and digital CX in the health insurance industry. Zipari surveyed 3,000 adult health plan members aged 26 and over and 400 payer representatives, 80% of which were manager level and above.

The survey results showed that payers that orchestrate a consistent experience across engagement channels will see the biggest return on investment. While many see the heart of CX for members as digital self service (portals, apps), Zipari’s survey showed that most (43%) members prefer the call center as their primary health plan communication channel. Underscoring that finding, when members were asked what would increase their health plan engagement, 71% of members said shorter service-center hold times and 65% said they want service representatives to have their information available right away. But, digital self-service wasn’t far behind with 42% preferring these channels.

“While the call center remains a core pillar driving member engagement, digital member portals and apps are a critical, and complementary channel for payers to engage with members and maintain customer satisfaction,” said Mark Nathan, CEO of Zipari. “This creates a huge opportunity for payers. When members can accomplish basic tasks on their own with digital solutions, it creates less pressure on the call center, reduces hold times, and sets up opportunities for what health insurance leaders identified as a key competency: more time and empathy for members who are calling because of stressful health or financial challenges.”

Payer respondents that have made investments in digital CX report significant benefits from those efforts. Ninety-three percent of respondents that have made digital investments noted significant membership increases, with 73% indicating decrease in membership turnover.

Also interesting, while 73% of payers feel that they reach out frequently to members, only 24% of members share that sentiment. In fact, 63% of members said outreach in the form of personalized recommendations would increase their engagement. This highlights an opportunity for payers to improve communication orchestration and puts payers without digital CX platforms at a disadvantage. The need for sophisticated CX platforms capable of offering members personalized and consistent information across channels has never been more evident.

“The data clearly shows that mastering both the call center and personalizing digital offerings and outreach is going to be the golden ticket to attracting and retaining customers in this fast-changing, dynamic member-driven market,” added Nathan. “Essentially, what members want today is a human connection when they need it most, and digital self-access available around the clock.”


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