Voice is the Medium of Medicare
90% of Medicare enrollments involve a conversation between a beneficiary and an agent, either independent or captive to a carrier. About a third of these conversations occur in person. The rest happen over the phone.
After folks enroll in a plan, they have questions. "What's my deductible?" "Is Dr. Jones covered?" "I'd like to order a car to take me to the hospital."
Some of these can be answered online. Carrier online portals have come a long way in the last five years.
But if you've ever seen someone over 65 put on their reading glasses to use their iPhone or tablet at 130% magnification, it's obvious they aren't in their element. That's why most seniors still call whenever they have a question about their plan. And this is even more true for lower income folks.
That's why we think voice is the medium of Medicare. The vast majority of interactions between Medicare beneficiaries and health insurance carriers happen over the phone.
The problem, of course, is that for me, and probably for most people, calling your health insurance carriers is an experience unpleasant enough that it could be used as a minor form of punishment. Kids, if you don't clean your room, l'll make you call your carrier and figure out if my CPAP machine is covered!
But joking aside, we've secret-shopped many carrier support lines. On average, it takes five minutes to get to a human and then, if you want to use a supplementary benefit, you're transferred to the company that provides it. Twenty minutes and several transfers later, assuming your call isn't dropped, you've used the free OTC credit you were so excited to get when you signed up. But maybe you're less excited now.
The reason behind this bad experience is twofold. First, good human phone agents are expensive. Second, they use disjointed systems. The reason you're transferring to Wex to use your patient transport benefit is that the agent there has a piece of software to order one for you.
Those are the challenges on the member experience side. The enrollment side is even more complicated because most folks on Medicare can only switch plans in Q4, during AEP, and in Q1, during OEP. 75% of all Medicare enrollments during the year happen in these two quarters.
To handle the demand, carriers hire BPO's who hire hundreds of licensed agents, operate them during AEP and OEP, fire them, and start the process again in Q3.
Some of these agents are good, but many of them aren't. We have video interviews with hundreds of them who don't know the basics of parts A & B. And since they only have three to six months to make money, they are focusing on racking up sales numbers instead of getting Mom and Dad on the right plan.
In sum
Most seniors want to be able to talk to a human to decide what health insurance to enroll in and when they have questions about their health insurance Carrier phone experience are poor because:
Hiring human call center reps is expensive. As a carrier you can have high OPEX or high wait times. Pick one
Carrier reps often need to transfer members to vendor call centers because they don't have access to vendor systems of record. Transfers are inversely related to experience quality. The seasonality of AEP incentives sales teams to myopically focus on enrollment count instead of quality.
This is a classic problem. With a classic solution. Throughout human history, the most consistent way to increase access to a quality product by lowering its cost has been technology.
Enter Vox. Vox is an Al-enabled platform for Medicare distributors and carriers to analyze and produce voice, 10x'ing the outcomes generated by sales, member experience, and product design teams.
