Guiding and supporting customers through complex insurance plans
Humana Reimagining Medicare Part D Plans (PDP)
Project Overview
Humana positions itself not only as an insurer, but also customers’ lifelong health partner. To help Humana explore potential service concepts, we reimagined future service offerings that will drive new customers to Humana while improving the existing experience. Over the span of 6 months, we conducted extensive research and co-designed with our research participants on 2 projects.
The Medicare Part D Plans (PDP) project aims to discover what it takes to engage Humana’s PDP customers digitally – to retain, upsell, and increase satisfaction and sales. Our approach is to build a close relationship with customers by thinking and acting on their behalf and changing their attitude towards insurances to a trusting one.
Team Structure and Responsibility
2 designers, 2 senior strategists, 4 researchers, 1 product manager
I worked on analyzing research data, turning it into service ideas with strategists, and creating mockups and prototypes. Our researchers surveyed across 220 insurance customers and worked alongside 20 of them to discover sentiments and opinions towards insurance plans across a number of insurance companies.
I helped mediate some interview sessions and synthesize the findings, both qualitative and quantitative, to develop an accurate understanding of customer pain points. Then, I collaborated with our strategists to distill research insights into actionable concepts and ideas that we can implement, and eventually created mockups across different devices to present to the client.
Survey Results
Our team fielded a survey of 220 respondents to better understand their digital behaviors and preferences in key areas. PDP customers are 65 years old and above. We found that 91% of our respondents are confident in their abilities to complete any task online. They engage digitally in many aspects of life, for example, 93% of them research information online with their digital devices. However, only 50% of them manage health online.
Sentiment-wise, most respondents feel very overwhelmed by the decision on a particular PDP plan. Many insurance companies bombard their mailboxes with marketing content. Once they sign up, they are left alone to navigate the services and feel helpless when they have questions about the plan. Also, cost of prescriptions always remains unknown. For those with complex health conditions and require multiple prescriptions, this is highly stressful.
Co-Design Plan
With a baseline knowledge about their digital usage, we worked with 20 participants for insight into a future digital PDP experience.
In Co-Design 1, we conducted individual sessions for 2 hours each to learn about customers’ PDP needs, objectives, pain points, and future opportunity areas. Based on learnings from Co-Design 1, we developed scenarios, use cases, and experience stimuli to test participants’ reactions to future state ideas, which were demonstrated in Co-Design 2.
Our 20 participants
Customer Value Framework
They ranked the importance of the five value areas and the intentions within them as it relates to participant’s relationship with their PDP. These are things to keep in mind while redesigning aspects of their insurance experience:
Understand my plan well enough to know there will be no surprises
Understand the value of my plan and that I am maximizing it
Find help quickly, easily, and in the moment
Get personal attention that reflects my past usage with my plan
Have a trusted source to guide my decisions
Storyboarding & Insight Gathering
Through a 36-frame storyboard, we narrated the crucial steps during the 4 phases of the PDP process throughout a customer’s journey: shop, onboard, using the plan, and renewal. Below demonstrates three steps in the “shop” phase. We walked each of the 20 participants through these scenarios and identified key challenges they encountered from their personal experiences.
Co-Design 1 Findings
We synthesized 40 hours of interview and distilled the below key points from the conversations:
Participants would like to know what they are supposed to do, when they are supposed to do them, and things checked off the list.
Help during onboarding and renewal would feel like PDP is cognizant of customers situations.
Keeping costs low is always a priority. They don’t want to always be surprised by high cost at the pharmacy.
Remember their interactions, have an archive. They would like support reps to see personal data and reference past communications.
Confirmation of pain point: language around coverage, phases, deductible, insurance is too complicated, and they don’t receive help with understanding it.
There’s value in knowing things in advance, with as much lead time as possible so action can be taken.
Need to know which medications are costing how much, and if they are close to the “donut hole”.
It’s not just about how much I paid, but what the plan has paid.
Co-Design 2: Defining Use Cases
We defined 4 use cases that center around the key findings. Offering clarity and support in these areas will greatly help them in reducing existing frictions and anxiety. Over the span of two weeks, we created wireframes for to validate our service concepts for Co-Design 2.
Lowest-cost prescription: we help users find and order prescription at the lowest cost from pharmacies in their vicinity
Prescription approval management: we take care of the complicated process of prior authorization and notifies customers know when Humana confirms coverage of their prescription
Mail order pharmacy: we offer prescription subscription and home delivery, which saves cost for customers
Coverage gap guidance: we provide suggestions throughout the PDP engagement around how to save money and avoid the “donut hole”, a stage where PDP covers a small percentage of total cost, which results in a sharp rise in the out of pocket cost for the customer
1) Lowest-Cost Prescription
Our customers don’t have any transparency into the cost of a particular drug they are prescribed. Therefore, we designed a flow where Humana guides the customer in finding the lowest cost for prescription drugs in pharmacies near them. Customers can then change the pickup location for that drug at the chosen location (in this case, Walgreens).
2) Prescription Approval Management
Prior authorization is the process used by some health insurance companies to determine if a prescription drug is covered within a certain plan. Due to the complexity of this process, prior authorization can take up to a month to be approved, and the customers don’t know what goes on during this time period.
We wanted to build a bridge of communication by assuring customers that this process is well taken care of. We would send notifications during each step and let the customer know if there’s anything they need to do. Customers can then get a realistic estimate of the approval date, which will reduce their concern associated with receiving the prescription on time.
3) Mail Order Pharmacy
We promoted the mail order feature so that customers can have their prescriptions delivered to the door at a lower cost with Humana Pharmacy. Mail order saves time and money especially for those who require refills of their prescriptions.
This features shows a cost comparison between picking up at your regular pharmacy vs. mail order with Humana. Checkout is easy since we collected the customers’ info upon signup, and once order is completed, we show the coverage chart to help customers understand where they fall in the 4 phases of the PDP with their recent order.
4) Coverage Gap Guidance
Customers usually don’t understand the out-of-pocket cost associated with each phase of the Part D Plan. Once the cost for drugs accumulates to $4,130 for the year, customers would be in the Coverage Gap (or “donut hole”), where the plan is temporarily limited in how much it pays for drugs. Drug cost can dramatically increase during this phase, often without prior explanation about why this happens.
We created a flow where we let customers know about the Coverage Gap and offer ways to manage their cost to avoid going into that phase.
Co-Design 2 Findings
With these use cases integrated into a customer-friendly experience that deliver new value, 90% of our participants expressed trust in an insurer that takes their needs seriously and takes action in improving the insurance experience.
Participants were very impressed by the amount of effort Humana takes in researching the existing obstacles of PDP to create a better experience. These are the most desired services that we distilled from their insights and anecdotes, and we wove them into new service offerings that customers believe can truly help them in navigating the complex Part D Plans.
When asked about sentiments towards PDP prior to the co-design sessions, our participant Helena expressed her frustration with her existing insurer, “You’re paying them, they should handle it for you. Instead, you have to do it yourself.” Two rounds of Co-Design sessions later, having seen the four use cases above, she said “This would make me feel so supported. I know I’m taken care of, they are acting in my best interest.”
One of Humana’s main goals of this project is to increase customer engagement and retention by building a relational partnership with customers rather than a transactional one, and our PDP work has validated this goal to be one that customers truly want and will invest in.