Blog : Consumer Centric Design

imagine.GO helped Dell Healthcare design & launch CRM+

imagine.GO helped Dell Healthcare design & launch CRM+

Dell Healthcare hired imagine.GO to design and launch a CRM solution for health insurance companies.

Dell Healthcare is one of the largest Healthcare Technology Services providers in the world. They provide the people, processes, and technology to help health plans and large health care providers create the healthcare of the future.

The goal of this project was to define the ideal approach for implementing as a CRM solution for health insurance companies.  We used our 15+ years of implementation experience to not just design and build a technical solution, but also define the best way to implement it for Dell and its health care clients. Our work included how to set client expectations, how to make key design decisions, the best way to set up user roles, and our expert recommendations for customizations to the core Salesforce system.

Our final product produced solutions for health insurance lead management, sales, onboarding, service, and even care management. A high-level view of a few of the features in the solution are shown in the images below.

imagine.GO provides Salesforce CRM implementation services for healthcare companies using our proprietary delivery methodology (Decision Driven CRM Design). We also develop our own Healthcare Applications, currently available on the AppExchange.

to your health,

The Team at imagine.GO

How to Explain Healthcare Reform to Your Customer

How to Explain Healthcare Reform to Your Customer

This is a tale of two customer conversations about healthcare reform. The first is conducted by an insurer and the second by a large consumer financial services company.  Guess which one tells a better story. Here is a hint, not the health insurer. This article is not about picking on one or the other. It is about trying to uncover why healthcare companies have such a hard time communicating about their industry in a manner that is simple, clear, and effective. I set out to make a fair and honest comparison, and was actually disappointed in how bad the insurer got it.

H&R Block Reform Conversation Header

Why Communication is so important to Win Health Insurance Business

The battle for healthcare communication must be fought and won. As we head into the first enrollment period under the new Affordable Care Act (ACA), most small businesses do not have a clear or accurate understanding of what will be required of them to “play.”

This is a problem. I advocate that small businesses have the most change thrust upon them, and make up the market that is most competitive in the health insurance landscape.

I am not talking about the U.S. Small Business Administration’s (SBA) definition of a small business, which includes operations with up to $7 million in revenue or 500 employees. I am talking about the ACA definition of a small business – those with 50 employees and under, which includes most of the businesses in the country.  To put this in perspective, according to the to the most current U.S. census data, companies with 9 employees or less make up 95% of small businesses.

Provisions in the new law present difficult new decisions regarding healthcare benefits for companies of this size. Some employers must cover insurance for their staff or face a penalty. Some employers are exempt from having to buy insurance for their employees. Some can even be subsidized.  Here are some examples:

  • A small business with 50 full-time equivalent employees is required to provide coverage for employees who average 30+ hours a week, or a penalty will be applied.
  • A small business with less than 25 employees that pays average annual wages under $50,000 may qualify for a small business tax credit of up to 35% (up to 25% for non-profits) to offset the cost of insurance.
  • A small businesses may be eligible to use the new Small Business Health Option Program (SHOP) Exchanges to pick a plan they want their employees to enroll in. In 2014, the employer selects the plans, and employees choose from the selected options. In 2015, this changes to the employers selecting an actuarial value level and the employees selecting any plan in that range.


Infographic on Employer Understanding of Healthcare Reform

Source: Docstoc

So you would think Health Plans would be beating the streets to get the message out to all small employers.  It stands to reason that the Health Plan that does the best job of explaining healthcare reform and its implications on small businesses (thus taking a burden of information off of the small business owner) will probably be the plan that the employer selects for his employees in 2014. Assuming the Plan does a good job in 2014, there is a strong chance that the employees will keep that same Plan Carrier in 2015 and beyond. Yet, according to the infographic above, more than half of the exempt small businesses do not understand the basics of the equation. Who will win this business? The ones that does the best job explaining it!

2013 a critical year to compete for the small business health insurance.

But, healthcare reform affects more than just small businesses. It affects many individuals who are not on employer insurance roles as well.  To put this in perspective, according to the World Bank the total US workforce numbers a little more than 158 million.  By 2015 there will be 70 million independent 1099 contractors. That means that almost 50% of the US workforce will be an independent worker by 2015.  What are insurers plans to win this growth market?

2014 is critical year to compete for the under 65 consumer market.

What is Considered Good Communication?

H&R Block understands this cause and affect and has already started its communications to both groups. After filing my taxes this year, I was prompted to engage with the following interactive explanation of how the new healthcare reform law will affect me and my taxes. I made a quick video of what I thought were the highlights.

You can try it for yourself here:

Now juxtapose this to a more comprehensive and confusing explanation by a major insurer. I was not prompted in the course of another action as I was with H&R Block, so I did what we all do to learn – I started with a Google search. This page is what came back, so I clicked the top result.

CIGNA Explains Healthcare Reform

As I was trying to make sense of the overwhelming amount of information, unprompted CIGNA asked ME how to make THEIR website better.   This survey was unbelievable to me. They actually interrupted a bad experience to make it worse.

CIGNA Values My Opinion

And to boot, the dialog that I did not want and had to click to get rid of had errors on the page. Look n the upper left corner and notice the infamous “image not found” image. And to really go over the top, CIGNA gave me instructions on something I did not ask for and did not want, which put the burden on me. I was not here to help them with their website – I was hear to help myself learn about healthcare reform and somehow I am now roped into giving them my feedback. But even that was not easy. Take a look at the actual instructions they gave me – “When you click “Yes, I would”, another browser window will open for the survey. Please return to your open window, complete your visit, and then return to the survey window. All input you provide is strictly confidential.”

I had to go somewhere else, to do something I did not want to do, to help CIGNA, and then they had the brass to ask me to return to the page I was confused on in the first place to complete the business I was here for – absolutely unbelievable!!!

CIGNA H&R Block Reform Conversation

When will the insurance companies get it right? If H&R Block can do it, I expect them to be able to as well.

To your health,

The Team at imagine.GO


How to Send a Personalized Bill to Your Customer

How to Send a Personalized Bill to Your Customer

I just received a new bill from AT&T – and get this – it was a personalized video of my charges.  Yes, that is correct, a video.  It was my actual bill, with my actual charges explained.  And it was cool. I watched it three times and then recorded it and made a video to share. Here is the short video I made of my experience:

An Old Dog with Some Cool New Tricks

To be sure, I am not a raving fan of AT&T but I respect their product offering, and they seem to be getting much better at customer service. In truth, their coverage where I live at the beach in Florida is terrible. But, for the most part, they are pretty spectacular anywhere else I travel for work.  I pay around $130 to $150 every month for their services. I know and trust and rely on their product.  But, historically speaking I have had two issues with their product – at least from the arena of understanding my bill charges and getting someone one the phone to help me get answers.   I can sympathize as they have a lot of customers to deal with daily. However, I am still the customer, and I pay them close to $1500 per year. I have the right to expect better.  Such is life.

I have upgraded my phone and service several times in the life of my relationship with AT&T. Invariably, I am always confused at the one-off charges I see on the bill and in many cases, I have had the need to call and clarify what they were. I dread this scenario because I know it will be several trips through their telephone prompt system, then saying the same thing to at least three reps that have a somewhat less than mastery of English.  One month ago, I upgraded my iPhone to the new 5 (my relationship with Apple is a story in itself, and someday I may let you know about it).

So imagine my surprise when I received an email from AT&T with a link asking me to watch a video about my new bill. The call to action was clear and the broadcast email was well done, so I obliged. It took me to a page at the AT&T site where I saw a video that explained my most recent bill, in clear detail – even the one off charge. It was very well done, and it was tailored just for me.  I can still get access to the regular online or printed bill as well – but I feel no need to now.

AT&T Video Bill Email

How did they do it? I am not so naïve to think AT&T chose to invest resources in the AV department to create a video just for me – so I have to assume this was done by some smart new vendor that can tie into their systems and use list data to create custom videos. Whatever the reason, the result was that I understood the bill, and I did not feel a need to call AT&T – this saving them the transaction cost.  I have to assume the economics are for the mass/custom video versus the support line.  Furthermore, they saved me aggravation and got me talking in a positive light about AT&T. Nice work.

AT&T Video Bill

One other thing, because this is new technology and a new experience (I am sure they tested it quite a bit), AT&T was smart enough to ask me some survey questions at the end to see what I thought about it. Thus, validating their efforts. Again, nice work.

AT&T Video Bill with Questions

If My Phone Provider Can Do It, Why Can’t My Healthcare?

As I said, I spend approximately $130 with my phone provider each month. By contrast, I spend $400 with my health insurance provider.  As bad as my old phone bill was, by contrast, it is like a new Harry Potter novel (FYI I love Harry Potter books) compared to the bill I get from my insurance company. Or should I say, the “THIS IS NOT A BILL” I get from my health plan.  Take a look at a sample Explanation of Benefits (EOB) below.

Firstly, I find it somewhat ironic that it is called an Explanation of Benefits – as it is neither a benefit nor a good explanation of what I owe. I am not picking on any one plan – I just happened to be able to find a sample EOB for them online. And not wanting to post my own, I had to have something to speak to, so they are the lucky winners. In truth, from what I know and what I have heard, all if not almost all insurance companies are this bad.

Here is what drives me crazy about this document. It gives me more than I need in a poorly laid out manner, so it guarantees my confusion. Thus, resulting in my need to call them. Thus, having to deal with the call center for the insurance company. Thus, ensuring I add anger to my confusion. This repeat cycle is a never-ending loop for million of customers across the country.

When will the health insurance companies get it right? If AT&T can do it, I now expect them can as well.

Explanation of Benefits with Notes

To your health,

The Team at imagine.GO


Applying Personas to Healthcare

Applying Personas to Healthcare

Do Healthcare Companies Need Customer Personas?

I just wrapped up giving a condensed version of my Workshop 1a – Claim your customer at the 4th Annual Medicare Advantage Strategic Business Symposium in San Juan, Puerto Rico. It was a fantastic group, and we all learned from each other. Participants ranged from major insurance plans to renowned hospitals, and everything in between.

We went through how to create personas specific for a Medicare market so that product developers at these companies will be able to create something that is meaningful for a specific audience. You can see my intro deck here.


According to John Pruitt, personas are “detailed descriptions of imaginary people constructed out of well-understood, highly specified data about real people”.

Every healthcare company should become familiar with and practice the discipline of persona development. This realization is a result of The Affordable Care Act changing the market from wholesale to retail. As I have said many times before – retail means a focus on the consumer’s wants, not your products. As consumers are offered a choice of competing products, healthcare companies need to create offerings that have a clear value proposition or risk losing share.  A standard method for persona development looks something like the following:

Healthcare-focused Consumer Personas

But person creation for healthcare, in my opinion, has some points to keep in mind, which I refer to as tenants.  I describe these in brief below, but I will focus on them in depth in future posts.

Tenant #1 – All of this Exists in an Ecosystem

All of this exists in an ecosystem, only some of which is in your control.  A good persona has detail about the user’s needs, attitudes, and behaviors, and a great one includes the most important and relevant influencers as well. Outside of the patients themselves (note: I did not say member or customer), healthcare influencers in my model are comprised of:

  • The provider – including all care providers and health information providers, such as doctors, family members, Oprah, Google, …
  • The payer – this is the insurance company and their intermediaries, such as brokers, employers, government, organizations, …
  • The purveyor – or those entities selling the products and tools we need to get and stay healthy, such as the pharmaceutical companies, Nike, gyms, trainers, …

Your personas must take into account the dynamic of this ecosystem and provide insight into how the person is influenced in a positive and negative way about their health and your product(s). This will help not only the product designers but also the product marketing team later down the road.

Tenant #2 – You are a Retailer Now

Dear healthcare company, you are a retailer now, get used to it and act like one. As I mentioned earlier, the healthcare market is being forced into a retail setting. This is not just for the payers but includes the care providers as well. Groups like The Cleveland Clinic and Mayo figured this out early on and established themselves as the Zappos of their trade.

It is important for companies new to retail to understand that retail has its own rules – and the customer has the advantage. According to Willard N. Ander and Neil Z. Stern in their book Winning at Retail: Developing a Sustained Model for Retail Success, a successful retailer will only try and sell to one value position, and customers who prioritize that value position will shop at them. This means you can be Wal-Mart, or Target, but not K-mart.

One of the axioms of direct-to-consumer business is that you cannot be all things to all people. This means no more talking about your Medicare market as Over 65. The diversity of people over 65, in their health, and health knowledge, and how they shop is varied. Lumping them into one market with one set of products means you will be meaningless to all.  It is time to pick a horse and commit to the race.

Tenant #3 – Customers Behaviors Vary

Your customers attitudes (may) stay the same, but their needs and behaviors do not. People do not think of their health holistically. Instead, they break things down into jobs-to-be-done, as described by Clayton Christensen.  A single person, based on their changing health jobs-to-be-done and knowledge specific to them, can change their behavior and attitudes.  This means that the same person you lump into one segment can have very different behaviors associated with the different aspects of their health.

Smart healthcare companies have to realize this. Infinite customization of health products is a pipedream at this point. But matching a product to a like grouping, and being flexible enough to modify interactions based on a current job-to-be-done is crucial for creating lifetime customers, and the resulting value a company gets from that.

To Thine Own Self Be True

Healthcare companies, as all good retailers must know what they are capable of and should optimize their capabilities to 1) create meaningful value exchanges with customers around a specific value position, and 2) capture all of the data involved in a consumer making a purchase decision, not just the outcome of that decision.

You cannot just have a traditional “enROLLment” system.  Instead, you need a “ROLLing” system that moves with the customer through their health decisions, capturing all of the nuances along the way – and then uses that data, and some logical inferences, to create relevant and reasonable predictions for additional consumer needs.

More to come on all of this soon.


To your health,

The Team at imagine.GO