Salesforce Member Connect Healthcare Payor Solution Partner Training (July 29, 2014)

1. Optimizing the Member
Experience for Health Plans
Version 4, July 28 2014
Alan Lindsay
alindsay@salesforce.com
Healthcare/Life Sciences Partner Leader
Kim Arnold
Healthcare Solution Leader
@in/kimsarnold

2. Today’s Agenda for Member Connect Solution Review
• Case for Change
• Solution Overview
• Solution Demo Video
• Solution Components
• Customer Success Stories
• Target Buyers
• Where to Access Resources
Feedback Survey

3. Individual Demand Is Surging…They Are Costly & Dissatisfied
Source: Congressional Budget Office
25 million
uninsured Americans
will be covered
69%28%
7%
18-34
0-17
35 and
over
pre-existing
conditions = 8.5
times average
claim cost
Centers for Medicare
and Medicaid
8.5x
claim costs
Individual members contact
call centers more than
employer group members
6X
Newly insured members
more likely to go to ER
than continually insured
32%
2012 Accenture Healthcare Consumer Survey
cumulative
8M sign up
HHS in Modern Healthcare, April 17, 2014
Health plans have the
greatest opportunity to
improve their customer
experience
–Forrester, The Customer
Experience Index 2013
Employers say insurers
efficiently engage members
12%
Consumers say they trust
health plans to provide
guidance for their health
1/4
2012 Accenture Healthcare Consumer Survey
>50% age 45-64

4. Today’s Members Get This…
I have been on hold for 2 days
for 2 to 3 hours each day to only
be disconnected every time.
limited support access
unanswered questions
slow multi-channel responses
Every time I call, I get disconnected
within 1 minute. You terminated
my family’s coverage and I do not
understand why.“I left an angry message on
Facebook and within less
than an hour, they actually
tried to call me...
*Jan 8, 2014 Member quotes from Health plan Facebook pages
I did email the address you sent me
and got back a resounding silence.
Thanks for the assistance.*
”

5. … A Disconnected Member Experience
membership
claims billing
wellness
social
self service
mobile
email
face to face
eCare
communities

6. New Prescription for Unprecedented Change…
=
Social  Mobile 
Community
New
Ways to Engage
+
New
Customers
New
Expectations
Everyone
Accepted
Simple  Easy 
Personalized

7. Imagine Engaging Members Throughout Their Journey
Select a Plan
Sign Me Up
Teach me about
my Health
Track My
Health StatsSolve My
Problem
Connect with My
Care Team
Pay My
Claim
Insurance
Claim
Form
Find a
Doctor
Find a
Pharmacy
Get Support
renew
enroll
engage
Track My
Spending

8. sign me up
teach me about benefits
teach me about my health
enroll me in healthy programs
know who I am
show me my spending
answer my questions
help me find the best docs
Imagine If Members Got This…
…a personalized and seamless experience
anytime, anywhere, any channel

9. Systems of RECORD
Optimized for Transaction Processing
Enrollment
Product
Master
Provider
Master
ID Card
Fulfillment
Benefits
Administration
Claims
Processing
Medical
Management
Rating
Member Connect: Member Engagement & Service Solution
Single Platform of Engagement Across All Channels
Member Connect ENGAGEMENT Platform
Optimized for Front Office Interactions
EmailPhone Self-serviceMobile CommunitieseCare Social CareFace-to-face
Connected
Member

10. Member Connect: Member Engagement & Service Solution
EmailPhone Self-serviceMobile CommunitieseCare Social CareFace-to-face
Connected
Member
Member Connect ENGAGEMENT Platform
Personalized Marketing
and Member Nurturing
Experience
Member Self Service through integrated Web/Mobile portal
Omni-channel Service Console integrating backend Member
Sales, Service, Wellness, Claims & Billing
For sales, enrollment, service and exchanges

11. Personalized Drag & Drop Marketing Campaigns
Mobile-Ready, Personalized Content, Connected Devices
360 Degree Member View for Responsive Service
Member Connect: Responsive, Personalized and Connected Experience

12. Member Connect Demonstration
https://www.salesforce.com/form/conf/demo-
industries.jsp?videoId=RBMUoDe3qFE

13. Member Connect Components
Member Self-Service through
single Web/Mobile Portal
2
• Multi-Channel Contextual Service
• End to End Member Experience
• Call Deflection/Lower Cost to Serve
• Member Satisfaction/NPS
Increase Member Loyalty
Mobile Web Social Producers
Omni-channel Service
Console integrating Sales,
Service, Wellness & Billing
3
• Next Gen Social Service
• Increased Efficiency Across
Member Interactions
• Agent Productivity
• Call Handling Times & FCR
Streamline Operations
Personalized, Proactive
Member Marketing &
Nurturing Experience
1
• Personalized Experience
• Targeted Member Enrollment
• Pre/Post Health Event
Engagement
• Potential Member Conversion
Attract New Members

14. Member Connect Benefits
55% Find experts faster
37% Case resolution time decrease
34% Service and support cost decrease
36% Customer satisfaction increase
40% Customer retention increase
Source: Salesforce.com Customer Relationship Survey conducted from October 2010 to March 2013 by an independent 3rd party Confirmit Inc. Survey respondents were over 1,567 business executives/project
sponsors and system administrators from life sciences and healthcare companies worldwide, randomly selected.
36% Lead conversion rate increase
Member Self-Service through
single Web/Mobile Portal
2
Increase Member Loyalty
Mobile Web Social Producers
Omni-channel Service
Console integrating Sales,
Service, Wellness & Billing
3
Streamline Operations
Personalized, Proactive
Member Marketing &
Nurturing Experience
1
Attract New Members

15. Member Connect for Private Exchanges
Member Self-Service through
Web/Mobile Community
2
• Enable Personalized Member
Self-Service experience through
web, tablet and mobile interface
• New member or renewal plan
comparison & enrollment
• Provider/Knowledge search
• ID card and Benefits review
• Spending/billing/claims
management
• Care coordination/pre-auths
• Community engagement
• HRA/connected device data
• Profile management
Increase Member Loyalty
Omni-channel Service
Console integrating Sales,
Service, Wellness & Billing
3
• New Member lead conversion
and sales reporting and
analytics
• Existing Member contact center
service experience and analytics
• Social media service
• Live chat
• Email/web Q&A
• Triage for Benefits/Enrollment;
Eligibility; Care Coordination;
Claims; Appeals & Grievances
• Integrated responses across
channels
Streamline Operations
Personalized, Proactive
Member Marketing &
Nurturing Experience
1
• Attract/Identify New Members
through:
• Social Listening
• Web Inquiry
• Targeted online advertising
and lead nurturing campaigns
(healthy lifestyles)
• Engage and Retain Existing
Members through:
• Member journey campaigns
based on preferences, health
risk or self-identified priorities
Attract New Members

16. Customer Success
Stories

17. CO HealthOP Provides Affordable Healthcare for Thousands
• Deployed member-focused websites with educational tools and self-service
• Integrated CRM, contact center, marketing solution generates 3K leads in first 3 months
• Created an iPad app in 8 hours for grassroots marketing campaigns
• Improved lead to member conversion; reached 10K new members in 5.5 months
Everything is integrated: our website,
our call center, our portals, our internal CRM
app. Everything revolves around our members.
–Dave Abernethy, Director of IT, Colorado HealthOP
“
”

18. Colorado Health Op Solution Details

19. Salesforce Helps HCSC Commit To Industry Changes
• Custom service cloud used to support multi-channel marketing, sales, quoting
• HCSC transforms telesales in quickly to support 700% increase in call volume
• Increased major medical sales by 60% and short term plans by 200% YOY
Salesforce changed our processes, changed
how we operated, changed our ability to sell
and improved agent morale.
–Jack Orsinger, Dir. Retail Sales, HCSC
“
”

20. Regence Makes Choosing a Health Plan Easy
Created insurance e-commerce site with full rating, quoting & enrollment where
members track enrollment status online
3,000 employees, 1500 agents using partner communities to track individual
book of business
Eliminated paper applications and increased member satisfaction with easy
online shopping experience

21. Imagine If Employees, Employers and Brokers Got This…
Enrollment
Product
Master
Provider
Master
ID Card
Fulfillment
Benefits
Administration
Claims
Processing
Medical
Management
Rating
Email
Phone
Self-service
Mobile
Communities
eCare
Social Care
Connected
Employee
Connected
Member
consistent access
to all info and
interactions
Connected
Broker
BOB, commissions,
contracts,
literature,
education, reports
Connected
Employer
benefit, member, risk,
billing & wellness
management

22. Target Buyers

23. Member Connect Target Buyers
Personalized, Proactive
Member Marketing &
Nurturing Experience
1
Attract New Members
Chief Marketing Officer
Chief Consumer Engagement
Questions:
• How to create awareness
with prospects?
• How to differentiate
experience to attract and
retain members?
• How to leverage social
media to engage prospects
and members?
Member Self-Service through
single Web/Mobile Portal
2
Increase Member Loyalty
Chief Consumer Engagement
Customer Service Leader
Questions:
• On what channels do you
engage prospects/members?
• What tools do you use to
manage the member lifecycle?
• What are you doing to make it
easy for members to engage
with your staff?
Omni-channel Service
Console integrating Sales,
Service, Wellness & Billing
3
Streamline Operations
Chief Operating Office
Customer Service Leader
Questions:
• How do you differentiate your
member service experience?
• How do you engage &
respond to member questions
through social media?
• How are you scaling your
service operations to support
growing demand?

24. Member Connect ENGAGEMENT Platform
For CIOs: Rich Innovation Tools to Transform Member Engagement
Golden Customer Profile
social profile, contact preferences & frequency, demographics, health conditions, benefits, communications, claims,
usage
Integrated Platform Services
Recommend
Knowledge
Actions/
Notifications
Tools
Personalized
Content
Journey
Management
Partner
Portals
Enablers
Geolocation Identity
Search
Gamification
Social
EngagementEmail
Chat & Co-
browse
Channels
Engagement Roles
AGENT NURSE CASE MANAGERVIRTUAL ASSISTANT MODERATOR

25. • Customer Presentation
• Video Links
• Today’s Session Recording
Member Connect Resources Available
http://www.salesforce.com/industries/healthcare/
• Demo Video Links
• Customer Webinar Link
• Solution Brief (coming soon)
• White Paper (coming soon)

26. Today’s Agenda for Member Connect Solution Review
 Case for Change
 Solution Overview
 Solution Demo Video
 Solution Components
 Customer Success Stories
 Target Buyers
 Where to Access Resources
 https://www.getfeedback.com/r/TL0dzvzX
Feedback Survey

27. Member Connect: Supporting Your Most Precious Connections
For additional information, please contact Alan Lindsay at
alindsay@salesforce.com or reach us at http://bit.ly/SFDC4Healthplans
Questions?