'Shoppable' Experience for Medical Procedures

insurance price for medical procedure _edited.jpg

Problem

Cost is significant consideration for customers while making healthcare choices. Being able to display accurate cost for healthcare services is becoming a market differentiator for insurance providers. Bogged down with data and system challenges Cigna was not able to keep up with disrupters in market. Thereby loosing significant business to their competitors. This project aimed at creating 'shoppable' experience for healthcare providers and procedures.

Process Overview:

Product Goals
Research Insights
We-analytics Data Analysis
Empathy Mapping
Crazy 8 Ideation
Rapid Prototyping
Interactive Prototyping
Concept Testing

Surprise expense

Customer who mention ‘surprise expense’ typically mean they had an unexpected out-of-pocket health care cost.

About 30% of commercial customers experience a surprise expense, when they do the impact is ginormous:

$3.5B financially responsibility
About 600K support calls
Negative impact on NPS

Variables in cost

Cost of a procedure depends on if it is preventive or diagnostic, the provider who is doing it and the facility where it is done.
There may be additional cost components added during the procedure which can't be estimated in advance.
Out-of-pocket cost also depends on where the customer is with their deductible.

frustrated middle aged lady with bill in hand.jpg

Cost transparency is good but it won't eliminate surprise expense

Colonoscopy was preventive and would have been covered at no cost to the customer, but polyps were found so the procedure was processed under medical/surgical benefit. The customer expected to owe $0, but instead was responsible for $1,250.

Goal:

Encourage users to lookup costs before availing care
Help user make informed decisions about their procedures and providers
Provide comprehensive cost estimate

What we learned

Our learnings from primary and secondary research

Design Thinking

After understanding the primary problem space, we conducted multiple sessions to collaboratively align on the goal of the project, map the primary user journey, sketch innovative ideas, and prioritize new experience features.

Frame

We used the LEAN canvas framework to collaboratively frame the business problem and desired outcomes. Collected inputs from multiple teams in the process. Presented the canvas at multiple instances to senior management in order to collect feedback and validate the our direction.

Empathize

Used the research data, insights from voice of customer and data analytics to map a typical user journey to understand the pain points and opportunities.

Ideate

We converted the pain points from journey map into improvement opportunities. Assigned priority to the opportunity ideas to perform a cost v/s benefit analysis. With prioritized ideas we conducted crazy 8 exercise. Conducted rapid user testing with the low fidelity mockups to collect early feedback. Iterated the flow and mockups based on user feedback and analysis from data teams.

Comprehensive search

Unified search experience fetching results for condition, provider, specialist, prescription based on the entered search query.

Procedure Guidance

Insurance websites (and even customer support) ask users for specific procedure codes in order to provide further information. Most of the times user may not have the code. This results in long wait time on the call or task failure.

We provided a procedure selection guidance - with a brief description in plain language along with statistics on the frequency usage of the procedure based on the logged in user.