Highmark Capstone Sprint IV- An unexpected change of plans
Interview Round 2
Now that we had synthesized our previous round of interviews and developed a good understanding of the user, we wanted to shift our focus more on the employers and the medical service providers. We interviewed many stakeholders
Medical
- Dental Admin: to understand what the process looks like from the admin’s perspective
- Medical Resident: to obtain a view of the problem space from a doctor’s perspective
- CMU Health Services: to understand the pain-points and issues faced by a medical care providing clinic
Insights
Doctors don’t want to think about insurance
- “I don’t want to care about insurance, I just want to treat a patient”
- Insurance coverage does not stop me from providing a life-saving surgery
People prefer to pay less now, don’t think about the future
- Short-sighted thinking
- When they don’t know what they’re buying they don’t get the entire picture
Parents shield their children in a way
- Importance of children being prepared at 26
- Family discussions regarding insurance
- Parents thinking they know insurance and know what is best for their child
People just don’t want to understand insurance
- What are inhibitions to learning
Medical Admin consider themselves educators for insurance
- Tell people what is covered what is not
Employers
- Director, CMU Benefits: to obtain an understanding of how CMU decides on insurance and provides insurance to its employees
Insights
It’s easier to educate when people are shopping for insurance
- At this point, you already have buy-in and people’s attention
- More opportune time to interact in terms of healthcare literacy
Some people assume that cost = quality
- But this is not always the case when dealing with insurance
Brokers are a way for insurance companies to keep users at a distance
- Even if this isn’t true, it’s the perception to some people
“We have to have insurance”
- Treated as a necessary evil
- How can it be something people want, not something people need
People are slow to adapt
- If companies change policies, there is a long delay in employees understanding that their coverage is different
SMEs and Analogous Domains
- Root Auto Insurance: to get an understanding of how people understand analogous domains like auto insurance
- Abridge.ai: to get an idea of why they felt the solution they created was appropriate for the domain space
- Talk at Heinz on how medical insurance will affect the future election
Needs, Values and coming up with a “How Might We” Statement for our Conceptual Prototype
Once we reached this step, we walked the wall with all our artifacts and listed out the needs and values that we observed.
We then voted on needs we’d like to tackle for conceptual prototyping. The top ones are:
- Motivation to pay attention and learn
- Be prepared for the future/rainy day
Based on this, we came up with our “How might we” statement. We wanted to focus our conceptual prototype to try and get answers to this question
How might we reduce resistance to learn and prepare for a rainy day?
Crazy-8s, Storyboarding and Speed Dating
We then did a second round of Crazy 8s focusing on solutions to answer our “how might we” statement. We listed out all our solutions and voted for the ones we like the best.
Based on the result of our voting, we came up with five different ideas. We built them out into storyboards and speed dated them with participants.
Once we had speed-dated the storyboards, we came together and synthesized our feedback for the storyboards.
We realized that we had a luke-warm response for all the solutions and none of them really stood out as such to our test-takers.
We decided mutually as a team that it was probably not the right time for us to pursue research in this conceptual prototype and we should divert attention to furthering our research
Competitive Analysis- What have others done that works?
We looked at other insurance providers to understand what other health insurance companies are providing for their patients and members — both good and bad. We looked at whether these companies were an IDFS, how they’ve leveraged integrated care and finance, and what measures they’ve undertaken to improve their patients’ financial health literacy.
Some of the interesting things we observed were:
Kaiser Permanente
- Shared decision making: a process that provides patients with unbiased information in plain language about the evidence-based benefits and risks of treatment options.
Aetna
- 7 lessons learned from financial health literacy research
UnitedHealth Group
- BlueBook: internal guidebook for writing clear language
- Just Plain Clear: online glossary that translates insurance/medical terms in plain language
UPMC
- Estimate cost of insurance ahead of a procedure through phone call
- A webpage that explains the bill and how to pay it (link)
Oscar
- Strong digital presence: their app tracks insurance, prescriptions, and provides contact info for a concierge health team
- Most literacy help comes from their concierge service
Cigna
- A holistic approach to workforce health: physical, emotional, environmental, financial, and social health. Financial health is geared at helping members be prepared and have peace of mind
- My Secure Advantage program: provides financial coaching
Capital Blue
- Operate health and wellness centers where members can speak to a health coach, personal trainer, or take a fitness class
Reading the Highmark Insurance Plan- Building Empathy Round 1
Rita, our faculty advisor, mentioned that the CMU plan for employees was via Highmark, and she provided us a copy of the plan to go through.
Purpose of this research
Insurance plans are difficult to understand. That was the given assumption we started this journey with. This was further validated from our interviews with patients/members. However, we never looked at one (a plan) ourselves. Therefore, it was done for us to understand what a plan was comprised of and for us to build empathy for users.
Process
We divided the 107 page document amongst the five of us and took note of our understanding (or the lack of our understanding) of the content and our reactions to the document.
Insights
- Each section is very wordy, need to read a lot of things that don’t apply to you to get to the things that do.
- Very cyclic overall (need to read the Summary of Benefits to know which parts of the plan apply to you, but need to read the plan to understand the Summary of Benefits).
- Mostly Legalese
- Conflicting emotions, some parts made the reader feel cared for, while some parts were difficult to understand and seemed very unapproachable
- Cognitive overload to keep track of all the new terms
Visiting Highmark Stores- Building Empathy Round 2
Purpose of this research
Primarily, this research focused on understanding the store as a service touchpoint. We wanted to see what insurance shoppers would experience, how plans were explained, and what aspects remained confusing. Ultimately, it helped us build empathy for users.
Process
We conducted “walk-a-mile” immersion at two sets of Highmark and UPMC stores in Monroeville and in Mt. Lebanon. We told the representatives at the four stores that we were recently unemployed college students looking for insurance.
Insights
Store experience varied widely
- Explanation of plans and terms weren’t homogenized
- One store assumed we had FHL, told us to Google the terms
- Another store walked us through the plans and explained the differences between PPO, HMO, and the different network tiers
- Ultimately, uneven service contributes to high variance in customer experience
UPMC “pop-ups” lowered the user’s emotional labor, with tradeoffs
- UPMC stores, located in malls, reduced the barrier to talking to insurance; users could shop and visit
- However, the mall was a noisier and distracting environment
In the end, we still didn’t know what plan to choose
- Even if you know the terms and understand the plans, you still have to weigh your appetite for risk and your financial situation
- We felt like we had to be our own actuaries
- FHL is a necessary tool, but not a silver bullet
Building a Team Glossary
As a team we came across a lot of terms during all our research activities, we realized we need to be fluent in insurance terminologies to make sure we are able to understand what people are saying since there is a lot of expectation to be well versed with the terminologies. So we started an online glossary to keep notes of new terms
- HIPAA
- ACA
- Medicare
- Medicaid
- Power of Attorney
- HMO, PPO
🍷🧀 🎨 W(h)ine Cheese and Paint night🍷🧀 🎨
We decided to have a fabulous team bonding activity over spring break. We started with 1:1 discussions of peer evaluations and followed it up with w(h)ine cheese and paint night, where we whined about things, painted like Picasso, sipped on wine and munched on cheese. Perfect team bonding!
An unexpected change of plans
We had gone into spring break with grand plans of what to do once we are back. We had many in-person activities such as shadowing, contextual inquiry planned after spring break, however, certain developments took place during spring break which we could not have planned for. The Coronavirus which had started small, rapidly developed into a global pandemic, causing schools and offices to shut down, and people to quarantine themselves in their houses. The school decided to shift all classes online, and eventually shut it’s campus buildings off entirely. We had to shift our plans.
Concept Modeling
We decided to come together and model out our current understanding of the situations, throughout the entire interview and research process, we had been building out small concept models to understand smaller elements of the system
We combined all the elements of the concept model into a bigger concept model diagram
While we saw multiple players that we were aware of, we also saw new players come up which we hadn’t known of before, such as brokers, social workers, and case managers.
Reading up on Learning Theories and Designing Learning Experiences
We are in the process of doing a bunch of readings on different learning theories. We are reading up about various aspects of learning theories
- Who are our learners?
- Understanding conceptual blocks
- Learning Quadrants
- Defining the goal for learning
- What factors motivate students to learn
- How do you get learner’s attention
- Six facets of understanding
Covid-19 Survey
We also realized, as unfortunate as this situation is, it is a real-life implementation of our trigger-pod idea, albeit in a negative manner.
People are in a very triggering situation and anxieties are at an all-time high. We created a survey to understand how people are feeling about Coronavirus, how much do they know about their insurance and what to do in case they get ill, and if this situation has triggered them to revisit and understand their insurance.
Next Steps
While we wait out for things to return to normal, we have activities planned for the next sprint so that we can push ahead with our research and keep the project going and our spirits high. Some things on our to-do list are:
- Waiting for results of the survey
- Revisiting the Concept Model and playing around with it by adding or removing players
- Interview Round 3- medical admin, broker, users from other economic zones, users in the age group 18–26
- Online Health Communities
- Contacting Customer Experience and Sales teams in Highmark
We’ll see you all next week with more updates!
