Improve the Member Experience with Health Insurance Technology

In the late 1990s, as the Internet exploded, Yahoo was one of the most popular websites on the planet. The company offered services like email, news, and search to attract visitors. In 1998 Yahoo was the most popular starting point for web users. Its human-edited Yahoo Directory was the most popular search engine, receiving 95 million daily page views, triple that of rival Excite.

But that experience became more cluttered as Yahoo aimed to drive traffic to its web properties instead of delivering users useful search information. As a result, Google gained a foothold, offering a barebones search experience with better search results. Yahoo faded while Google exploded.

Why? Because Yahoo – despite having a significant advantage in the early growth of the Internet – failed to react to changing consumer demands. Consumers didn’t want an internet home page; they wanted to find specific content on a rapidly expanding internet.

A comparatively poor user experience led to Yahoo’s decline. But it’s not the only example of poor experiences harming an industry-leading company. Blockbuster was undone by Netflix’s user experience, MySpace by new competitors Facebook and Twitter, and Sears by Amazon. Even’s launch showed how a poor user experience led to millions of dollars in additional spending.

Health insurers risk losing market share by failing to understand the importance of the member experience. Insurers have shifted their thinking in the past decade, turning the member into the central figure in their growth strategy. Happy members lead to growth. Health insurers have begun to redesign the member experience using technology. 

What Elements Comprise the Member Experience?

Member experience measures member interactions with an insurer’s service. That includes the onboarding experience, the payment experience, the claims experience, the customer service experience, finding healthcare, and more. Many members don’t see their insurance experience as different than their provider experience. The member experience can impact how members understand and use their healthcare benefits. Insurers can use technology to augment that experience. 

Let’s look at why the member experience is so important and how insurers use health insurance technology to improve it:

Improved Engagement

Health insurers use technology to engage and educate individuals about their healthcare coverage. However, poor user experiences may fail to motivate individuals to use these tools and resources. By improving the member experience, health insurance technology can encourage individuals to use their healthcare benefits. The result is better health outcomes, as individuals are more likely to use preventative services and seek treatment when necessary.

Some health plans have turned to gamification to increase engagement. For example, UnitedHealthcare Motion enables members to earn money for out-of-pocket medical expenses by providing an activity tracker and a mobile app that tracks steps. Members can also join walking groups or teams and compete against friends. Gamifying the member experience can be beneficial to the bottom line; one employer that leveraged the Motion program saw 90% participation and cut claims paid by its healthcare plan in half.

Increased Transparency

Health insurance can be complex, with many factors influencing coverage and costs. Educated members are likely happier, healthier members. By leveraging health insurance technology, insurers can provide greater transparency to individuals about their healthcare benefits. Individuals understand their coverage more clearly, reducing confusion and frustration. 

For example, Blue Cross and Blue Shield of Minnesota’s mobile app includes an in-network medical cost estimator that compares the cost of various procedures at specific locations. It also breaks down plan details and costs like deductibles and coinsurance, helping members better understand their coverage. With this information on a phone app, members can quickly access information that helps them make informed benefits choices.

More Personalization

Healthcare is a deeply personal issue, and individuals have unique needs and preferences regarding their healthcare coverage. By improving the user experience of health insurance technology, insurers can offer more personalized tools and resources. For example, insurers can use data analytics to recommend services based on an individual’s healthcare history and risk factors. Personalized tools and resources can help individuals make better-informed decisions about their healthcare, leading to better health outcomes.

Alignment Health uses proprietary software called AVA to fill care coordination gaps for seniors. The technology leverages AI to anticipate and deliver care. For example, during the COVID-19 pandemic, a member with dementia failed to see his doctor on schedule. AVA was alerted to a rapid degeneration in his condition that required immediate attention. Within 48 hours Alignment helped arrange care for the member.

By leveraging AI-enhanced technology, health insurers can deliver better member experiences to improve satisfaction and retention.

Reduced Friction

The healthcare system can be frustrating to navigate, with long wait times, complicated billing processes, and other barriers to access. By improving the user experience of health insurance technology, insurers can help reduce friction individuals experience when accessing healthcare services. 

Insurers often overlook billing as part of the member experience. But offering members tools like premium billing payment portals and autopay or payment options like credit cards or retail cash payments can reduce payment friction and increase on-time payment rates. Plus, sending communications like delinquency notifications in multiple channels, like mail and email, can reduce member churn. 

The member experience is a critical factor in the success of health insurers. Improving the user experience with technology can increase engagement, provide greater transparency, offer more personalized tools and resources, and reduce friction in the healthcare system. Ultimately, a positive member experience can lead to better health outcomes for individuals and improved profitability for health insurers.


Certifi’s health insurance premium billing and payment solutions help healthcare payers improve member satisfaction while reducing administrative costs.

Member Engagement - A Health Insurer's Guide

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