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Experience Design in a Regulated Industry

By Judith Weader posted 07-29-2014 03:50 PM

  
Typically, people don't put the phrases "experience design" and "health insurer" together in a sentence, but I'd like to see that become a more common occurrence. At Blue Cross Blue Shield of Rhode Island (BCBSRI), we take our customers' needs very seriously and we have spent the last several years developing more customer-centric practices for use inside and outside of the organization. As a health insurer, we run into the same challenges that every heavily regulated company faces, and we're not willing to let those challenges be excuses for inaction. 

In heavily regulated industries, the typical issue with trying to make customer experience improvements lies in all the rules and approvals that you have to navigate - the hurdles and hoops you have to jump over and through - in order to make even the smallest change. There becomes this confusion about who your customer really is: is it the regulatory body (or bodies) or is it the end user/consumer? I tend to focus on the regulator as a stakeholder, since they set up the guidelines by which you have to operate, but the person who's actually paying for and/or using the service is the one who's the customer. And, in reality, you typically have far more leeway than you might think when it comes to making changes, but a lot of it comes down to being willing to change how you approach the problem. As one example, when fielding a study about a specific form that we must send to the majority of BCBSRI members, we wanted to understand whether changes under consideration would meet our customers' needs better. So, rather than asking survey respondents directly, "Were you able to understand this form better?", we asked them to locate information on the form. By doing so, we were able to understand whether the proposed form designs were meeting our intended goal; variances in survey results for different designs helped guide us to an overall better solution for our customers. We also captured verbatims that we then categorized and analyzed, so the final product - due out later this year - will have the "member tested" seal of approval on it. 

This same form also has a number of regulatory requirements that must be satisfied, but we aren't required to say everything in "legalese". To that end, we're also changing lengthy, complicated paragraphs to more concise, plainer English, making it easier for members to understand what the regulators want them to know. After all, regulations are designed to be safeties - protections to help customers - and making language clearer and more understandable is definitely in the spirit of the rules. Even in the strictly controlled world of Medicare Advantage, it's possible to make changes to a portion of the "model" documents supplied by the Centers for Medicare & Medicaid Services (CMS). Making changes to model documents requires more time, because you have to submit your materials for a 45-day review by CMS, but improvements to the experience are typically applauded and encouraged. 

The important thing to remember with experience design in these "heavily regulated" industries is that not only is it not impossible, it's essential. As customers seek alternatives in every industry - switching out oil in favor of geothermal heating/cooling, changing from one health insurer to another, etc. - it's vital that companies in all industries remember that the experience you design for your customers will help determine how long you have them as customers.
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07-31-2014 03:44 PM

Your comments are right on target. Our industry needs to be much more consumer friendly and convenient. In the past, unequal weight and focus was given to being compliant with regulatory guidelines than being committed to providing a good consumer experience. So our industry needs to change the directional arrow to move from just being compliant to being committed to a positive member experience at every touch point.