CVS & Aetna Merger: An RX for Healthcare CX?

The CVS and Aetna Merger: An RX for CX?

I doubt you’d be surprised to hear that the US healthcare system is not in great shape. News reports remind us often that the $3.5 trillion behemoth is the world’s largest and most costly—and yet far from the most effective. The US spends twice per capita on healthcare compared to other leading economies, even as its health outcomes rank below the top 10 nations on almost every critical measure. The situation has attracted the attention of Apple, Google, IBM, and other tech leaders who’ve dutifully set their sights on “disrupting healthcare.” To stave off these new entrants, industry stalwarts CVS Health and Aetna, Inc., announced last week they will merge in a dramatic step toward the same goal. It may not happen overnight, but we believe that by adopting a customer-centered approach, CVS-Aetna has the opportunity to systematically elevate healthcare customer experiences (CX) to levels consumers have come to expect.

A stated mission of the new CVS-Aetna is to improve patients’ access to care. The National Association of Community Health Centers estimates that 62 million people in the US have inadequate access to a primary care physician. Today, chronic conditions like diabetes and heart disease amount to more than 75% of total spending. With better access and improved healthcare CX, chronic conditions and the high costs that go with them can be better managed. CVS CEO Larry Merlo has said the merger will bring “10,000 new front doors to the healthcare system.” He hopes that his new vertically-integrated firm will be better at tackling these complex challenges and addressing CX issues, not as isolated problems but as elements of a cohesive and interdependent whole. Similar strategies have worked for other vertically-integrated organizations—notably Apple, Starbucks, Tesla, Target, Disney, and others—many of which are highly regarded for sweating the details of CX.

And so, the key questions the merger must answer are now clear. Will customer-centric vertical integration be an effective strategy in healthcare? How exactly will users benefit? And how might a combined CVS and Aetna actually pull it off? Using Perficient Digital’s seven-part CXIQ Assessment framework*, we explore some of what it will take for the new CVS-Aetna to create an organization with the capabilities to fulfill the promise of a satisfying and effective healthcare customer journey.

Customer Insight

Asked about the “future shape” of Aetna, company CEO Mark Bertolini highlighted a plan for personalized health featuring individualized treatments for patients. Said Bertolini, “We need to understand what they want.” Bertolini is right to note that the first step in personalization is gathering insight into consumers’ real needs and goals. Tapping into such insight will require removing operational silos that prevent sharing information between the two companies and across business units. Teams must develop tools to communicate user knowledge with one another. User personas and scenarios developed from the observational research will be vital tools for CVS-Aetna’s CX teams looking to bridge pharmacy and insurance experiences and develop a holistic understanding of customer needs.

Strategy

With insights mined from its extensive shared data repositories, CVS-Aetna can develop differentiating strategies that feature not only tailored treatment programs but also personalized insurance. Imagine enrolling in an individualized plan that’s built around you, based on your family’s unique health history, habits, and needs. Such a plan might include incentives and wellness coaching to assist in making smart choices in response to complex chronic conditions, delivered alongside in-store pharmacy services. Company leaders also hope such a strategy will allow them to fend off rivals such as Amazon before it can wield its UX, pricing, and distribution prowess across the pharmacy market.

Design Process

Designing robust customer experiences in the complex, highly-regulated environment of healthcare is hard work. Designers may be tempted to focus on easy, incremental improvements. But to achieve long-term success, they’ll need to unravel the systemic challenges endemic to end-to-end healthcare customer journeys. A recent McKinsey survey found that customer satisfaction with health insurance is “73% more likely when [complete] journeys work well than when only touchpoints do.” The recipe for success also includes training employees in design thinking methods (especially non-designers), staffing teams with individuals drawn from all parts of the newly merged business, and looking outside of healthcare to understand a broad range of customer expectations.

Enabling Technologies

Much has been made of the API economy and its potential to improve user experiences, especially in data-steeped industries like healthcare. CVS-Aetna and its partners can leverage APIs to integrate myriad data sources—electronic health records, radiology images, claims data, mobile devices, diagnostic tools, and reams of unstructured data. In the hands of an organization with such a vast array of data resources, APIs represent an opportunity to combine data to innovate new, more personalized experiences with truly transformative potential.

Operations

While numerous operational practices must work together seamlessly to support strong customer experiences, DevOps is worth special mention. Defined as a way “to improve the relationship of development and operations by advocating better communication and collaboration between the two business units,” DevOps brings continuous innovation and deployment, enabling fast response times as new applications are deployed and then later refined. With CVS-Aetna, we see a pair of technologically sophisticated giants coming together—a prime opportunity for leaders to imbue modern DevOps methods to help align their operations, instill a customer-centered mindset among engineers and operations staff, and drive change across the organization.

Measurement

On measurement, our advice to CVS-Aetna’s CX leaders is to listen intently to what BU counterparts have to say about which metrics they’ve found effective in informing CX decision-making. Given the considerable differences in current CVS and Aetna business models, we think there’s much to be learned through the process of comparing CX metrics. (As a retailer that owns outlets and channels for end users, CVS may have more to offer Aetna when it comes to consumer metrics.) But by working side-by-side we imagine the combined teams will be able to readily identify opportunities for improvement, determine how best to set and track CX progress, prioritize investments, and rally teams around shared goals.

Culture

One of the most effective ways to promote a culture of customer-centricity is to reward those who, 1) identify and enact processes that benefit customers and then, 2) work to scale those practices across the enterprise. CVS-Aetna will first need to paint a compelling vision of the future state CX (see Strategy, above) and then empower employees to act in ways that bring it to life. CX teams will need leadership support in the face of solving for complex customer journeys, especially as they address entrenched social and cultural attitudes amid a shift from disease treatment to prevention and ongoing wellness. When the job is done, leaders will need to encourage stories of CX excellence so they can be shared and celebrated.

For more information about applying Perficient Digital’s seven dimensions of customer experience to your company’s strategy, download our free guide.

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