Transparency for Variable Cost Healthcare

People feel more secure moving forward with healthcare the more they understand about services, procedures and costs. With this work, we strived to create an experience for members to grasp variable costs and move forward in confidence.

Problem

To wrangle a large-scale system serving millions of members with varying roles and plan types. To distill a complicated financial picture and to advocate for a human-centered design practice within a layered and constrained organization.

Solution

Attacking the problem from multiple vantage points and sharing the entire cost journey by way of current state and future state costs.

Discover

Frontline Immersion

I listened to the actual voice of the member to build perspective and empathy. Grievances are exported and auto-sorted on boards, transformed to problem statements and opportunities.

Data Analysis

The Product Manager and I hold workshops to leverage business stakeholders’ knowledge of complex business rules. Then these rules need to be validated in the data to understand the true scope. The image to the right is an over simplication but this ends as a gnarly, living excel doc.

Plan Type

Define

Survey

Longitudinal surveys were designed and evolved to uncover problem-solving styles, pain points, and comprehension of terms and concepts.

We are designing for members who call for assistance and that have some cost constraints.

Problem Solving Styles


Cost Mentalities

Develop

Content, copy and user-interface iterations are ongoing throughout all phases of the project such as discovery and ideation.

Test

Iterative concept testing, moderated usability testing, and card sorting helped with things like content flows, language and placement and order of categories, respectively.

Unmoderated Testing was also conducted. Members were given a mock scenario and answered questions about costs and variables for themselves and their family members.

Key observations in testing allow us to be more concise and optimize the design and create jobs to be done for a supporting module/piece of content.

Single Entry

Collapsing two confusing entry points into 1 all-encompassing experience provides one path to a snapshot of member costs per plan phase with point in time estimation.

Modular

I created a drawer module for when member might want these metrics but when it is not primary.

Guided

Before we expect members to understand complex cost structures, some need foundational terms and definitions. While implementing this inline comes with challenges, it a fair trade-off knowing the alternative is not following through.

Extensible

Designs were created across various plan types and product structures.

Time Sensitive

The final solution focused on the most valuable and contextual information alongside the metrics.

Procedure Level

Members can search by procedure or service and see a breakdown of services with cost in terms of money and time.

Cross Functional

We added cost estimate input into the appointments flow as well as notifications when members check-in at the facility.

Deliver

Impact

Level 1

3% decrease in digital support interactions and complaints per 1L sign-ons

Level 2

Decrease digital complaints, grievances and appeals per 1K member sign-ons

YTD 0.062, ahead of target of 0.072

Level 2

Decrease MSCC web support interaction per 1K member sign-ons

YTD rate is 2.04 interactions per 1K sign-ons is above the target of 1.88

Level 2

Increase member containment for medical bill statements and payments

Target 95.8% currently 92.9% as of EOY