ACA Bumpy Rollout Learnings for Customer/Patient Experience

The Affordable Care Act (ACA) opened enrollment just two months ago and, while much has been said about the government’s implementation, little has been said about the consumer’s journey or the role the health insurance companies play—or not play—along the way.

The Affordable Care Act (ACA) opened enrollment just two months ago and, while much has been said about the government’s implementation, Latino Fam 3 generationslittle has been said about the consumer’s journey or the role the health insurance companies play—or not play—along the way. A recent assessment of State-based Market places1, State-Federal Partnerships2, and Federally Facilitated Marketplaces3, shows that many Hispanics, the greatest source of growth of eligible uninsured in key markets, have great challenges to engage through ACA. In order to capture the new market segments created by the ACA, the healthcare system needs to stand in the shoes of the uninsured Hispanic community on whose business it now depends to understand the landscape from the outside in and engage them with relevant outreach initiatives.

The assessment, conducted in June, September and November of this year, indicates that the Spanish language service offering is deficient. While call center IVRs were available in Spanish, calls were handled in English with the option to request translators, many of which never made it to the phone. Overall, the quality of the content provided is better online than it is via phone, as most reps seemed ill-prepared to answer questions and be a productive resource for callers. All websites assessed are bilingual, but some links and key features were not functional in Spanish.

It is no secret that the Government has its fair share of challenges with the implementation of the Affordable Care Act. However the rubber meets the road with insurers and other stakeholders in order to capture growth from newly created market segments. Santiago Solutions Group’s May ACA webinar outlined tips to capture Hispanics and maximize the ACA opportunity, including:

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1 California and New Mexico
2 Illinois; state conducting plan management and consumer assistance
3 Florida

About SSG
SSG is a strategy consulting firm driven by management P&L experience and predictive analytics. We develop fact-based business models, growth roadmaps, insights and segmentations for the Total Market and the evolving Hispanics, Multicultural & Millennial segments. We help clients focus  their limited resources where the highest market opportunities exist, and which strategies advance maximum, efficient Total Market growth.

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