Mind the Gap

Challenge— Increasingly, companies are switching to consumer driven health plans (CDHPs) as a way to manage their health care costs.* As a result, people often have negative experiences using their new benefits for the first time because they aren’t expecting to foot so much of the bill up front. Working with one other designer, my challenge was to develop better support services that a large US health insurance company could provide as a means to increase member satisfaction, understanding, and retainment – without altering how the CDHP itself is set up.

Process— This project gave me – a Canadian – a crash course on the US healthcare system and the complex world of CDHPs and Flexible Savings Accounts (FSAs)! After some intense secondary research to build an general understanding of our topic, my partner and I set out to do some primary research with the different key stakeholders involved. We recruited and interviewed not just members themselves, but plan designers and call centre agents at the company, primary care physicians, specialists, clinic admin (ex staff answering questions at the front desk, managing bills and claims, etc.), and hospital managers too. Our strategy was to understand what members were misinformed about and when, as seen through the eyes of the health care professionals they interact with throughout their journeys.

Our work was grounded by extensive research on the fundamental principles of behavioural economics, specifically as they apply to people’s mental models regarding decision making over time and insurance.

Insights— Redacted due to NDA

Solution— My partner and I presented a new model to help the company better understand the different touch points and moments leading up to first usage. We also shared use case scenarios that demonstrated how the company might add structure to this gap between initial enrollment and first usage.

*CDHPs generally have low monthly premiums and a higher deductible ($1,200 min for individuals), which means the employer pays out less over the course of the year.