Oftentimes, our smaller or midsize clients feel that to get the contract terms and clinical programs they want, they have to sacrifice in other areas, and member services are often that area where they decide to sacrifice. However, the human implication of not providing the service to ensure employees are taken care of comes at a real cost. The good news is that sacrifice doesn’t have to happen. There are ways to get all of the things they want, just like Fortune 100 companies.
Measuring the cost of a poor member experience is a little bit tricky to do. It’s interesting because many times when we first work with a consultant, we also hear the concern from them about a diminished member experience with the health plans or PBMs taking more of a hands-off, more automated approach. And the folks who are expressing those concerns aren’t wrong, because if we look at, for example, the Net Promoter Score (NPS) for the PBMs, it’s a whopping zero. So things like complicated phone trees or canned correspondence are having an impact, and people are feeling it.
Those service issues are, of course, going to have a financial impact when they drive administrative issues that have to be solved. But there is also a human component in there. When people reach out for service or support when they are at their most vulnerable and don’t get the help they need, not only does it impact their health, but it also potentially impacts the trust they have in their employer.