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Embedding CX into
a Health Insurance Org
How might we further embed customer-centricity within a complex, siloed, and institutionalized health insurance organization?

Client: 

A U.S. health insurance company

Project outputs:  

2-day workshop and training

Customer journey research
Journey maps

Co-creation sessions

Service concepts
Service blueprint

Team: 

Noah Keppers, Researcher

Leeza Dennis, Researcher

Emma Stokey, Service Design Associate

My roles:  

Project Lead

Senior Service Designer

Researcher

Facilitator
Presentation Designer

A regional insurance health insurance company wanted to embed customer-centricity into their organization, so I led a Journey Operations (Ops) workstream to help them upskill around understanding their customer and activating customer insights from the strategic down to design. I led one other researcher and we worked in collaboration with a small client core team who were meant to walk along with us during the process and give us access to the greater organization. 

Discovery: Understanding the Current State 

We started with a very open-ended SOW, recognizing that we needed to develop our approach after a discovery phase to learn more about the client's current maturity in customer-centricity and where momentum already existed in the org. We started with several stakeholder interviews across the organization, from leadership to UX designers and developers.

 

What we heard was that the organization was really lacking in a common strategy. They were in the process of developing a new strategic plan that people were very excited about. However, the current state was that every functional area had its own goals and sometimes they were conflicting with one another, which led to more engrained silos. On top of that, there certainly was not alignment on customer needs, or even that customers should be centered unless you worked in the Customer Care department. 

Our team also embedded ourselves in the UX and CX teams, attending standups, performing an audit of what CX artifacts already existed, and having leads walk us through their current processes for gaining customer input and making strategic decisions. We saw a lack of maturity in their CX activities — journey maps made up of touchpoints and personas based on products.

The discovery phase culminated in a 2-day onsite workshop, where CX, UX, and IT teams came together to co-create a roadmap for CX in their area of the organization. I was the MC for the workshop and facilitated a very engaged session of discussion, activities, learning, and reflection.

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Developing the Approach

We decided to start with a grassroots approach. Since we had an amazing advocate in the head of CX at the organization, we decided to work with her to build skill and knowledge with their small core team as we learned about the customer. I developed a project plan that led the team through journey research and mapping, prioritization, ideation, concept creation, concept resonance testing, and a desired state journey. Our hope was that by walking along with our team, the client core team could see how customer insights get translated into action. We also hoped to instigate collaboration across the very siloed organizations and get other parts of the organization excited in driving more customer-centric change throughout.


In hindsight, I wish we have tried to engage with leadership at this point. Having sponsorship from someone on the executive leadership team could have cleared our path to enable the capacity needed to integrate CX processes, mindsets, and tools. We also would have had greater access to the in-progress strategic plan in order to align with the momentum of that rollout. We ended up trying to get this access at the end of the project, but the effort was not successful as we encountered gate-keeping and skepticism.

Starting with an Assumptive Journey

Before starting research, we had to choose a specific customer journey to focus on. Since this was their first foray into journeys, we held a short workshop with stakeholders and chose a high-level journey of that was centered around the mission of their insurance organization: How members get care for a medical need. 


I developed the project plan in a way that showed their team to use iterative loops to build upon their understanding of their customer. We started with an assumptive journey map where we contacted people from our personal networks to ask them to walk through their experience getting medical care. Once we had the assumptive journey mapped, we shared that with a group of stakeholders across the different business areas of the insurance organization, including claims, benefits, medical staff, and customer care. During two hour-long work sessions with different groups, we got feedback on the assumptive journey, adding their questions, steps they thought were missing, and insight into the backend of service delivery. This was our first chance to engage across those silos, and the teams were really engaged and receptive to working together.

Customer Research and the Current-State Journey

We then spoke with 8 customers during 90 minute 1:1 interviews. We recruited through the User Interviews platform and spoke with people who had frequently engaged with the medical system in the past year. We heard from people who had a medical emergency or illness, managed chronic illnesses, or needed more consistent care for various reasons. We did a quick form of synthesis using notes that were taken as we had participants create their own journeys. This allowed us to move quicker than a full synthesis of the transcripts. After speaking with customers, we were able to form a current-state journey map document that we shared with the client.

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Ideation and Concept Creation

I facilitated a workshop with the client to walk them through the journey map findings and to select an area to do some ideation workshops around. Once we prioritized an area, we did workshops with two groups of five insurance users to generate ideas around transparency in costs. The workshops were facilitated over Zoom, but we requested that participants bring a pen and paper to participate in an ideation drawing session remotely. We wanted participants to be able to generate freely and co-create with us and each other. We also held a client workshop where we generated additional ideas based on the journey map findings. After facilitating the workshops with both users and the client, we synthesized all the ideas into 6 concepts that would improve key moments of the journey.

Our team facilitated another prioritization session with the client to choose one concept that had momentum and aligned with current strategic goals to do some validation with users and have them help us flesh out the concept. The concept was around having an advocate, someone who could guide you through the messiness of insurance and do the heavy lifting so that you could focus on your health.

Developing a North Star Journey

We used the findings from the validation as well as all the previous research to build a desired state journey map. The goal of this map was to create a north star for each of the moments that mattered in the journey, so the client could align their service delivery with customer needs. We wrapped up the project with a larger share out with different stakeholders from across the organization to share not only our research findings, but actions the client could take to implement the desired journey. We also ended up developing four proto-personas based on the customers we interacted with to act as first drafts of personas that could be developed with further research and data.

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Reflections and Learnings

 

By the end of the project, the core team had a much stronger grasp of customer-centric thinking. They understood how to iteratively build on the customer journey, how to collaborate across departments in service of improving the full customer experience, and how to creatively generate and co-create ideas with your customer as well as different people across the organization. 


What was lacking at the conclusion of the project was that the core team didn't really have the capacity to enact these new skills on top of their current duties and mandates. While we were doing the project, leadership also rolled out a new strategic plan that really took priority and overshadowed the team's ability to drive additional change across the organization. For future projects, I would think critically about changes the organization was going through and try to integrate those realities more thoroughly into the project approach.

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