With partner Blue Cross Blue Shield of Minnesota (BCBS MN), we presented “The NPS Halo Effect: Partnering to Engage Members During Moments That Matter” at the AHIP Consumer Experience & Digital Health Forum last month.
During the session, Grand Rounds’ Senior Regional Medical Director Dr. Todd Thames and Dr. Siupo Becker, Medical Director of BCBS MN, spoke about how our partnership continues to deliver meaningful member experiences through the COVID-19 pandemic via expert medical opinions (EMO) and care navigation, referrals to high-quality providers, significant cost savings and improved health outcomes.
Following is a brief recap of the jam-packed session, which answered questions such as:
- How did Grand Rounds help enhance BCBS MN’s offerings to delight and engage customers and members?
- What’s a good framework for how to assess new partnership models that can drive membership growth and retention?
- How does Grand Rounds’ expert medical opinions and care navigation services provide an innovative, virtual option to manage high-cost claimants?
The Halo Effect: Leveraging Partnerships to Meet Member Expectations
The COVID-19 pandemic has forced a transformation in healthcare delivery. BCBS MN has seen a 100–500% increase in telehealth services this year. This isn’t surprising as people get more comfortable using digital services and platforms, from fitness apps and online retail to streaming services such as Netflix and Hulu.
That said, members expect a data-driven and personalized experience that’s seamless and easy to navigate. According to PricewaterhouseCoopers, 59% of Americans say they’ll stop doing business with a company or a brand after several bad experiences. This puts added pressure on companies to meet customers’ rising expectations.
Health insurance companies in particular have an uphill battle when it comes to engaging their members. Their net promoter score (NPS), which is a standard measure used to determine the best-in-class experience, is just 19. (NPSs range between -100 and 100.) Only cable companies and internet service providers score lower than insurance companies do.
What this means is that organizations such as these have an incentive to forge partnerships that will help bring about the halo effect—in other words, relying on partners with a strong NPS to bring their own NPS up. This is in fact what BCBS MN has done. By partnering with Grand Rounds, BCBS MN was able to:
- Improve their member experience
- Address high-cost claimants
- Execute a solution quickly
Providing Members Continuous Support Through Their Healthcare Journey
BCBS MN’s mission is to manage healthcare spending by getting its members the right care at the right time with the right providers so that they can achieve better health. But it has been faced with challenges such as:
- 43% of members say they distrust their health plans.
- 75% of members don’t respond to calls from their health plans.
What Grand Rounds does for BCBS MN is it gives an almost friction-free experience for members across their entire healthcare journey, by putting a clinician in direct, ongoing and unlimited contact with them via expert medical opinions (EMO) and then surrounding them with a care coordinator who keeps them informed and a records team that does all of the heavy lifting of collecting their medical records for them. Connecting members with a local care team is also part of the winning formula, one that sees a 92% adherence to treatment recommendations based on EMO.
Meanwhile, though high-cost claimants make up just 1% of members, they drive over a third of spend. To help drive down costs, BCBS MN looks to Grand Rounds solutions including EMO—to ensure these members’ conditions are being managed and treated correctly—along with a customized provider matching service that finds in-network, high-quality providers for these members.
Grand Rounds’ Comprehensive Services Reflect Positively on BCBS MN
These are solutions that were easy to implement and have been proven to function well. BCBS MN says it’s now benefiting from a halo effect where members are happy with their experiences with Grand Rounds, and this, in turn, reflects positively on them. In addition, BCBS MN has recorded:
- An average savings per EMO case of $8,900.
- ROI that’s tracking at 1.7.
- A 69% change in treatment recommendations on average.
With Grand Rounds, BCBS MN has been able to add wrap-around layers of service, clinical guidance, financial tools, telemedicine and benefits routing in a high-touch, high-tech way that builds trust with its members. It’s been a successful partnership, one that will continue to expand to cover additional touchpoints, all with the goal of raising the standard of healthcare for everyone, everywhere.
About the author
Our Editorial Team is composed of our leaders, clinicians, and care coordinators, as well as other Included Health employees, all who are working to raise the standard of healthcare for everyone. Together, they combine decades of subject matter experience across all fields of healthcare.