Vulnerable Population Health Plan Revamp
User Research & Onboarding Redesign
A Major Health Plan in California
User Research & Design
Figma, UserTesting (formerly UserZoom), Microsoft Teams
This project was a 6-month engagement focused on increasing increasing plan profitability by increasing member engagement with their PCP, boosting risk adjustment payments, and improving the plan's operating income.
This health plan's HMO plan was losing $127 per member per month on members who weren't utilizing the plan (members with 0 claims), versus $88 PMPM on healthy plan members. Retention was also an issue. Members would enroll, but switch plans after the first year. I was tasked with finding out why enrolled Trio members were not using their plan, what they were unsatisfied with, and what strategic improvements could be made to increase member retention.
Per Member Per Month
6 point NPS drop
Net Promotor Score as it relates to member satisfaction
The plan strategy was developed during 2022 to address significant financial losses and improve the quality of care and the member experience by developing a new guided digital onboarding process. This was aimed at ensuring the appropriate plan selection and guiding members through their plan benefits at the start of enrollment.
I designed and facilitated surveys, interviews, and usability studies of our member population to understand plan onboarding and benefit pain points. I then collaborated with the health plan's Product Strategy team, and Covered CA Portfolio Team to create a product definition that outlined the necessary capabilities for a new digital onboarding process and virtual health risk assessment. Additionally, I supported my manager in making digital onboarding recommendations and design modification mockups.
To gain perspective on the current state, I conducted 10 45-mintute interviews with both the health plan employees and non health plan employees that reflected our member population. The interviews provided us with qualitative data on why members selected their plans, how they utilized their plans, their relationships with their primary care providers, their onboarding experience, and feelings around plan renewal.
I also conducted 8 surveys of California residents enrolled in health plans that focused on:
Overall member pain points
Their plan selection criteria
Their onboarding experience
Their primary care provider selection criteria
Their experience selecting a primary care provider
Their experience with the providers in their network
Whether or not they would reenroll, and why
Their ideal benefits
5 IFP Interviewees
5 Existing Plan Members
Example Interview conducted through UserTesting
We found that many study participants struggled with the HMO onboarding process, and the selection of a trusted primary care provider.
Based on the analysis of that research, I developed personas that represented the various types of plan members. I was able to use these personas in collaboration with the product strategy team and the health solutions team to make recommendations for plan enhancements that would drive the most benefit. This ultimately led to recommendations around onboarding and virtual risk assessment.
Due to confidentiality of designs that have not been launched yet, I have provided examples of our design mock-ups. The difference between existing digital onboarding, and new design mockups include:
Full-screen lightbox instead of partial window takeover for popup onboarding window
Improved and simplified messaging
Direct and simple calls to action
Adding a benefits needs survey to provide appropriate care management recommendations
Adding a post-survey screen to thank participants for completing the survey
Improved messaging around PCP auto-assignment
Improved call to action to schedule first PCP assignment with information about the associated $0 co-pay
Inter | Medium | 32px
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We aligned with the health plan's Covered CA Team on the recommended onboarding flow and associated virtual health risk assessment. Recommendations were approved by stakeholders, and awaiting prioritization and implementation. Projected cost savings are between $5-10M in by 2024 from risk adjustment and improved disease management.
My survey research was limited to the members and member size available through the Userzoom platform, so that data is not completely representative of the Trio plan's member demographics. Next time I would place more strict filters and screening criteria to ensure we are get perspectives that are representative of the member population. This project has taught me how difficult it can be to gain diverse perspectives through a limited research budget. I also realized how valuable quantitative data is to understanding member or customer motivations. Interviews allowed me to dig deeper into the things that influenced their purchasing behavior.