In recent years, consumer expectations for digital self-service have evolved and become table stakes across various industries. To meet this demand and keep up with competitors, health plans rapidly developed member portals—often without setting an overarching strategy. This means that portals were often created without specific ROI goals set in advance. Now that most plans have a portal, it is time to retroactively adjust to meet plan-determined ideas of success. To optimize these investments plans must first ask “what is the point of our portal?”
Health plan executives commonly cite three primary reasons for developing a member portal:
1. Keep pace with other industries and plans
As mentioned above, consumer and market expectations spurred plans to set up their portals. This dynamic continues today as plans may add features because another plan has added that feature. Keeping pace with other plans may prevent disruption, but it won’t guarantee ROI.
2. Digital self-service for members
For all plans, a subset of members don’t want to ask the plan for help; they want to quickly find answers digitally. Self-service also decreases plans’ call center volumes and drives an immediate, calculatable ROI for the portal as every avoided customer service call saves the plan $6 to $10.
Portals should reduce the number of calls from members by fulfilling basic requests such as asking for a new ID card or checking the balance of a health savings account. In contrast, when members aren’t able to find answers on the portal, because the portal is hard to use or the information isn’t available, they will contact the plan.
When we asked consumers what they would do if they can’t find an answer on their portal, the top answer was to call their plan.
3. Increase member satisfaction
The third priority plans maintain for their portal is to increase member satisfaction. The hypothesis is that if members receive a seamless technological user experience then they will view the plan more favorably.
Plans use NPS to measure member satisfaction and select plans have even started measuring a portal-specific NPS. NPS provides another tangible measure for plan executives to monitor ROI for portals.
Our consumer survey shows that portal utilization correlates with overall plan NPS. The NPS is 22 points higher for members who have used their portal versus those who haven’t.
Furthermore, significant differences exist in NPS for members who had issues on the portal versus those who did not. Members who had an issue using the portal had an NPS similar to that of the average plan member— around 13. However, the NPS jumps to 32 for those who used the portal with no issues. To put this in context, popular retail company Nike has an NPS of 30.
This correlation was even stronger than the correlation between care utilization and NPS. A striking data point considering that members who seek care more often tend to score plans higher on NPS because they are receiving value when the plan covers their care.
Portals are worth health plan investments
Certain plans or executives may still think that portals are not worth the investment because of limited utilization among members. However, our data shows that when executed correctly, portals are worth plan investments of time, money, and strategic thinking—most directly as a means of decreased call center volumes and increased NPS.
More importantly, these are just the quick-win results. Ultimately, portals should aid plan goals of reducing medical spend, as discussed later in this report.