Part 1: Building a Personalized Patient Experience Takes Time
This is the first article of a series called Lessons From 1 Year Of Experimentation.
Cedar was founded in 2016 to improve the healthcare billing and financial engagement experience for patients. In the first few years, we developed solutions to enable patients to clearly understand their charges, engage directly with their healthcare providers and resolve or pay their bills. Once we had our initial clients on board, it became clear that we had additional opportunities to improve the patient experience; so we built features like digital self-service insurance capture, allowing patients to enter their new health insurance information without having to make a phone call, and claim denial messaging, explaining why the patient’s insurance only reimbursed a portion of the bill. With our intuitive product and innovative features, we were able to significantly improve the financial experience for patients (and our healthcare provider clients were thrilled, with better financial results and happier patients).
As we grew and interacted with more patients, we soon realized that it didn’t make sense to interact with a patient who had an annual check-up the same way as one who had unexpected knee surgery. We developed the hypothesis that we can improve patient engagement by creating an experience that is tailored to the individual. This hypothesis will look familiar to people who come from industries like ad-tech or retail (an area where much of the Cedar team has significant experience). Co-Founder Arel Lidow, for instance, previously was a VP of Product at AppNexus, which optimizes programmatic online advertising.
However, the parallel with online advertising stops here. In healthcare, we can’t use the same tactics that will encourage you to buy a new pair of sneakers or tickets to Paris. We need to build a relationship between the healthcare provider and the patient — a relationship of trust that endures over time.
For our patients, our clients and ourselves, it’s become clear that meaningfully building this type of trust means taking a long-term view, having patience and keeping our guiding principles top of mind.
Prioritize what matters in the long-run.
Focusing on long-term indicators (that cover patients over multiple visits) allows us to make decisions that improve the patient experience over the long run, as opposed to vanity metrics that reward quick-wins. For instance, Cedar communicates bill reminders via text message for relevant patients. In the short term, we could be tempted to increase the frequency of bill reminders via text messages because it leads to higher engagement, which in turn leads to higher collection and resolution rates. But this has a negative long-term effect: it creates high unsubscribe rates and an understandably negative patient experience; not having the option to text a patient has a negative impact on collecting future bills. Hence, we would be sacrificing long term value for short term gains.
Be patient (for the sake of the patient).
Consider another example of the importance of timing (both for us and for our patients). Patients usually have 120 days to pay their bills before a provider might send a bill to collections. We never want a patient to experience this — having a bill sent to collections can harm their credit scores and it’s overall a difficult, unpleasant experience. As a result, we consistently try to lower the number of patient bills going to collections. It’s tempting to analyze the effectiveness of a new feature as soon as the number of users tops the minimum number of patients to detect “statistically significant results”. But this can give us misleading takeaways because patients’ behavior can change based on the time they need to resolve their balance. Some patients will engage upon receiving one email, while others need more time to contact their insurer or save some money to pay an unexpected bill; these patients will engage with us later during the billing cycle. Therefore, it’s crucial we have the patience to give patients time to go through the process before deciding if one variant outperforms another.
Of course there is no reason why an experiment shouldn’t focus on reducing the time that it takes a patient to pay. Actually that is at the core of what Cedar is trying to do overall by making the payment process easier and flexible (with e.g. discounts/payment plans etc.). Earlier payment often is an important experiment metric in the same way as collection rates are.
Know your users and take the time to do it right.
Through a cycle of data analysis, brainstorming, design, and experimentation, we release workflows targeting specific populations. Our latest work was about helping Millennials better engage with their bills. You can read a series of blog posts that the Design and Data Science teams have co-written on the topic here. Building personalized experiences takes time and a lot of cross functional work. It can be surprising to see that experimentation operates at a different speed than the rest of product development. We are working to optimize our processes to make sure we experiment at a high velocity but we also realize that the nature of the patient experience often forces us to operate at a different speed. To be as impactful as possible, we need to ruthlessly prioritize our experiments.
This year, the Data Science team defined the three values that guide our decisions.
- “Love Thy Teammate” emphasizes the importance of cross-functional collaboration for product development.
- “Impact Patients, Meaningfully” is reminding us to focus on improving the patient experience deeply and meaningfully.
- Finally, “Take Your Time (Do It Right)” is about going the extra mile. Experimenting effectively and building a better patient experience require that we take these values at heart.
In this first article, we talked about the importance of taking the time to focus on long term metrics, which ties to our 3rd value. In a second article, we will discuss the importance of our collaboration with other teams and how building a culture of experimentation is one of the keys to establishing a strong experimentation framework.
Cedar is a healthcare financial engagement platform for hospitals, health systems and medical groups that clarifies and simplifies the financial experience for patients. If you’d like to learn more about Cedar, visit www.cedar.com or click here to join the mailing list. You can view our open roles at www.cedar.com/careers.
