David Holmberg, chief executive officer, Highmark Health
Earlier this year marked the tenth anniversary of being given the privilege to serve as Highmark Health's president and CEO. A few months after starting that role, I contributed "Our Focus Is on Our Customers," my first article for Highmark Health Digital Magazine.
I'll lean into a similar "our focus is on our customers" theme in this article, but we are a very different organization than we were a decade ago. One difference I'm proud to highlight is that we've expanded and strengthened customer experience (CX) capabilities and deepened our customer first culture.
"The action we want to motivate isn't just purchasing coverage and care. A critical component of the Living Health model is to help people engage regularly in maintaining and improving their health"
DAVID L. HOLMBERG PRESIDENT AND CEO HIGHMARK HEALTH
For more insight on our customer experience journey, I encourage you to read this interview with Stacy Byers, senior vice president of Experience, Design and Digital. Stacy and her teams have led much of that journey, including introducing a human-centered design practice that has spread throughout our enterprise and influenced everything from our My Highmark app and integrated health experience platform to workforce programs to the layout of health care facilities.
In a real sense, our Living Health model is "customer first" in action. Instead of defending the status quo of how insurers and providers worked in the past, we asked ourselves what needed to change to align with what our customers value and remove what they find stressful. We made our mission customer-focused and personal: "to create a remarkable health experience, freeing people to be their best." And then we set about designing a simpler, more proactive and personalized model of health, coverage and care to help people "live health" every day.
That's not something we do for a year or two and declare "done." It's a commitment to long-term, ongoing transformation. In presentations a few years ago, our chief strategy and transformation officer, Mike Bennett, compared it to President Kennedy's vision of sending people to the moon. What I like about that analogy is that Kennedy's speech was just the first page in a thousand-page story of people coming together to do something that had never been done before.
Similarly, Living Health brings together teams across our organization, technology innovators like Google Cloud, League and Cedar Pay, digital health providers like Spring Health and Sword, community organizations like Thrive18 and Buffalo Center for Health Equity, and others to solve problems and innovate across the whole ecosystem that impacts a person's health.
Our "moonshot" work includes building better health insurance products, optimizing care delivery, advancing value-based care, finding the most effective ways to leverage technology and data, connecting people to community resources, and more. We also intend to continue proving that our approach is not only healthier and more satisfying for members and patients, it is financially sound and sustainable for our business and for employers and everyone else paying for coverage and care.
In almost any business, success depends on understanding what customers want and what motivates them to act. That's pretty straightforward in retail settings. You research what a given demographic wants from a product, and the action you try to motivate is "make a purchase.
"It's a little more challenging when your customers are millions of health plan members and patients who come from every possible background, have extremely different health situations and care needs, and define "better health" in different ways. Additionally, the action we want to motivate isn't just purchasing coverage and care. A critical component of the Living Health model is to help people engage regularly in maintaining and improving their health.
For all those reasons, we have to achieve an exceptional level of personalization. It's not enough to focus on "the customer" — we want to understand and serve each customer. Technological innovation, including advanced data analytics and artificial intelligence, helps us do that in ways that weren't possible a few years ago. My Highmark already uses the data a customer provides to serve up information and tools that are relevant to them and offer personalized "next best action" tips.
But as I've said in the past, it's not just technology that makes a difference, it's what we do with it. That brings us back to the importance of our CX research, expertise and capabilities. For example, our CX team did extensive research to create archetypes and personas that help us keep people's different perceptions and motivations front and center — and avoid one-size-fits-all thinking.
They also identified fundamental drivers that impact almost every person's health experience:
Putting the customer first means that instead of saying "figure out our system," we take responsibility for figuring out how our system can satisfy the customer across that EVOKE framework. You see that playing out in our one-stop-shop approach with My Highmark, our Cedar Pay solution to simplify billing and payment, providing extra support like care navigators or case managers or community health workers, and the SMPL literacy standards we developed to make communications easy to understand.
I would argue that to be a "customer first" organization, you also have to be a data-driven organization. You need steady, reliable quantitative and qualitative data from your customers to keep up with what they value and continuously improve your ability to deliver that value.
At AHN, that includes internal data and third-party validation to assess clinical outcomes, quality and safety, and patient experience. Led by Dr. Gene Scioscia1, chief patient experience officer, they have made their "caring people, caring for you" motto the standard across the network. Among many other validations, two AHN facilities have received Press Ganey Guardian of Excellence Awards® for patient experience, putting them in the top 5% of more than 40,000 health care facilities.
Turning to our Living Heath model, Karen Hanlon, our chief operating officer, has been relentless in keeping the focus on our members — what does the data say, and what do members say, about the value of our solutions? In addition to our CX experts, multiple teams and processes ensure continual collection and assessment of such data and make sure it gets to the right leaders and teams to shape decisions. Before we move forward with a program or solution concept, we do human-centered design work to investigate and understand the problems to solve and what will genuinely help people. That research helps executives make decisions.
Once a Living Health solution or service is available to members, our Solution Insights, Validation and Program Performance team does quantitative and qualitative assessment of business performance and customer experience performance, including percentage of eligible members using a solution, scores for satisfaction and ease, and verbal feedback. Multiple data analytics teams also measure health outcomes for given solutions. Taken together, this creates a feedback loop that guides us on what solutions stay or go, and how we can improve value from the customer perspective.
Earlier this year, referring to Living Health, I noted that "health plan members get the final say on how well we're doing." Although we have more work ahead and our model will continue evolving, the data and stories collected so far tells me we are moving in the right direction.
As one example, like businesses in most industries, we use Net Promoter Score (NPS) as a standard measure of customer experience and satisfaction. In western Pennsylvania, where our Living Health model has full payer-provider integration and risk-sharing, our overall member NPS score rose 46% from 2019 to 2023.
Scanning our July performance summary, I also see encouraging member survey comments like this one about My Highmark:
We'll pull even more of "everything" into one platform as we move forward. Since Living Health is about giving people what they need to be more engaged in their health, it's also good to see comments like these about condition-specific solutions:
These comments are backed up by quantitative measures. For example, 93% of members say the virtual physical therapy solution is easy to use. The mental well-being solution is delivering therapy and medication management access in less than five days on average, compared to a national average of 25 days, and the average provider satisfaction score is 9 out of 10. Cedar Pay's post-payment customer satisfaction rate is near 90%.
Given our emphasis on personalization, it's also good to see comments like these on care navigation and care management support:
People like Lee and Ashley put "customer first" into practice every day, and it is an honor to lead an enterprise where so many people share that mindset. That's what will power the Living Health model's continuous improvements in providing what each customer values and wants on their health journeys. But our customers get the final say — we're successful when it's them, not us, talking about "a remarkable health experience" and feeling free "to be their best."
By: David Holmberg
Originally Posted: August 20, 2024 on Highmark Health
David L. Holmberg is president and chief executive officer of Highmark Health.
This article was first published in Highmark Health Digital Magazine and is used with permission.
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