United Healthcare Gives Behavioral Analytics a Seat at the Table

The payer uses analytics to improve the call experience, increase customer satisfaction by 8 percent, and capture $47 million in savings.
Customer Service

It's no secret that health insurance representatives face numerous challenges in providing excellent customer experiences. Representatives often receive calls from members who are already irritated or concerned about a health condition, making it critical that agents provide efficient as well as compassionate services.

Health insurance companies also have access to reams of member and caller data that could help companies provide better services. The challenge is effectively leveraging the data and acting upon it. In an effort to differentiate its services, United Healthcare turned to behavioral analytics solutions provider Mattersight for help.

The caller experience is a crucial aspect of the health insurance business but it's fraught with challenges, notes Craig Howarth, senior director at Optum Consulting (a subsidiary of UnitedHealth Group). "Agents are dealing with callers who are going through a variety of emotions and we want to make sure members feel connected and comfortable with us when dealing with the complexity that is healthcare," Howarth says. "At the same time, agents need to be efficient, which can be difficult."

Prior to working at OptumInsight, Howarth led the implementation of Mattersight's Behavioral Analytics application at United Healthcare's contact centers for employer groups. In 2005, UHC began capturing and analyzing contact data to get insights into the performance style of agents and identify opportunities for improvement. Is an agent, for example, too rushed in speaking with members? After seeing positive results with a small test group of 20 agents, the application was rolled out to 3,000 agents nationwide in 2006.

Agents and their supervisors were aware that behavioral analytic technology was being used to analyze their performances, according to Howarth. "From a change management perspective, getting the agents involved to portray the message that this was a positive tool was crucial," Howarth says. "We gave several presentations and explained to supervisors why the technology was important."

Some supervisors were "a little apprehensive" about the data results, Howarth adds. While they were designed to improve the customer experience, such as by identifying low-performing agents, the results sometimes placed more pressure on supervisors to coach agents and resolve those issues. For example, if an agent continued to perform poorly, "I would wonder what was the supervisor doing about this?" Howarth explains. "The reports showed us that we were placing too much emphasis on meeting the metrics without making sure managers were also good coaches and this changed our hiring and training approach."

Within three years of using the behavioral analytics technology, United Healthcare saved $47 million by reducing operational costs and improving the efficiency of agents in handling calls. The company also lifted customer satisfaction scores by about 8 percent. About 5,500 agents now use the technology.

Looking ahead, Howarth says the next goal is to merge data from UHC's various entities like billing and enrollment with benefits to provide a more consistent member experience. The company could also use its insights into state-specific call volumes and other analytics to identify states that are receiving a disproportionate number of calls and offer its assistance to the state-led health exchanges. "We can create a relationship with the states to say 'we're seeing this about the calls that are coming from your state. Is there anything we can do to alleviate some of those calls?'" Howarth says. "At the end of the day, it's all about using the data you have in a unique and smarter way."