Less Is More

By Christopher Nicholson  |  Posted 2010-08-17 Print this article Print

New software enables Humana to communicate more effectively with members by using colorful, highly personalized documents to present individual statements of benefits.

With a clear view of who paid what, members can easily see what they are responsible for and what their plans paid toward the medical expenses. The SmartSummary also displays a detailed explanation of how plans work, so members can see what they’ve spent toward their deductible—both in-network and out of network—and what they have paid out of pocket for medical and prescription claims. 

We can also use one of our flexible design templates to communicate with members across a variety of plans, whether individual or group. For members with families, the household view within the SmartSummary combines family data in one statement for the current period and year to date, allowing families to view spending totals (in-network and out of network) and cost details by family member. 

On average, a family of five that was previously receiving more than 139 pages of traditional EOB documentation annually now receives 39 pages of SmartSummary pages over the course of the year. Even though the EOB has nearly 70 percent fewer pages, it provides more usable information in a format that is easier for our members to understand. 

With the flexibility of this solution, we also developed the SmartSummary Rx, a monthly benefits statement summary tailored to Humana’s Medicare members. As a result, Humana became the only company that does not use the traditional black-and-white EOB for Medicare beneficiaries. The SmartSummary Rx provides Humana’s 4 million Medicare enrollees with a comprehensive record of prescription claims that includes helpful information, such as full-color pictures of pills, dosage, previous refill dates, and prescribing doctor and pharmacy information.

With these tools, Medicare enrollees can more effectively communicate with their doctors and pharmacists about medications to help avoid potential harmful drug interactions and also receive guidance about lower-cost medications that their plans cover. SmartSummary Rx also gives an enhanced level of control to each member by helping them track how much they’ve spent on prescription drugs, enabling them to budget for future health care and prescription spending.

Improved Member Satisfaction

By personalizing and automating the production of customized EOBs for our 4 million Medicare drug benefits members and our 1.1 million commercial members, we are able to communicate more effectively with them. Our initial research compared retention rates of members who received the newly designed statements to a control group of those who did not. Members who received the new statements were 14 percent more likely to say they would renew their Humana plan. They also reported that they were 7 percent more likely to recommend Humana.

We also tracked calls to a dedicated member-service phone number for inquiries about our new statements. For members receiving the SmartSummary, calls to that number lasted 390 seconds, on average. That’s 15 percent less than calls from members receiving the older EOB statements, which lasted an average of 420 seconds. Decreasing the demand on our support center is significant because Humana’s member-service department receives about 80,000 member-service calls per day.

We also are managing white space and blank pages better in order to deliver valuable and relevant content. We are able to combine communications into a single document when it makes sense to do so, cutting production costs by up to $250,000 per month. If a prescription drug comes off patent, rather than mail a separate notice, we can now include the notice in our SmartSummary Rx. By integrating these types of communication in our EOBs, we’ve saved several million dollars a year, primarily in postage costs.

Today, we continue to transition other document-production workflows to the HP Exstream environment, as our business success depends on how well we communicate with our members. In five years, our SmartSummary statements have allowed for an industry-transforming innovation that changes decades of bland document delivery with a communication that is personalized, more informative and highly relevant to our members.

Our brand promise is to provide guidance to our members when they need it most. By transforming the composition and information contained in the EOB, SmartSummary and SmartSummary Rx not only deliver on that promise, they also redefine how we communicate with customers who for years have been requesting more personalized and actionable communications guidance from us.

Christopher Nicholson, director of strategic communications for Humana, has a background in telecommunications, retail and health care. He has an MBA from the University of Louisville, Ky.


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