Usability & Net Promoter Benchmarks for Health Insurance Websites

Jeff Sauro, PhD

HealthCare ReportSigning up for health insurance might have been a nightmare for many, but managing your health insurance once you get it, it turns out, isn’t that easy either.

In conjunction with our panel partner, Op4G, we asked five hundred participants to reflect on their most recent experience with their health insurance provider’s website.

In total, we collected data on 13 provider websites, with most participants coming from four: Aetna, United Healthcare, Kaiser and one of the many Blue Cross & Blue Shield companies. More details on the study are available in the report; here are some highlights of what we found.

What People Do on Health Insurance Websites

We asked participants to describe what they were attempting to accomplish on their most recent visit and then coded these open-ended comments into categories. Here were the three most common tasks.

Checking Claims & Getting Plan Information: “I was looking up mental health care services covered by my provider”, checking premiums, checking to see if they had paid my flu shot
Refilling Prescriptions: “I was refilling a prescription through their online pharmacy for them to mail my order to me,” “Checking on whether my prescriptions needed to be refilled.”
Searching for a Doctor: “Looking for a specialist,” “verifying doctor’s address and directions to office,” “Looking for local physical therapists.

Participants had generally high self-reported success rates, with around 89% of tasks being accomplished. Kaiser Permanente subscribers reported a higher success rate at 98%. This better user experience was also seen across all metrics.

Usability

In general, users don’t find provider websites easy to use–the perception of usability across all websites falls at the 31st percentile (below average). Users had hard times locating functionality, and terms that are basic to insurance insiders like deductible, out-of-pocket expense and co-pay, are confusing to many users.

Of the top-tasks reported, many users complained that they were hard to accomplish, especially on Aetna, with participants reporting a paltry 50% success rate when trying to find a doctor.

Trying to figure out how to determine if a doctor is in network or out. That is way too hard.” Aetna User
“The only reason I use the website is because I have to; it’s WAY TOO cluttered & it’s difficult to navigate.” United Healthcare User

Kaiser Permanente had the highest usability score at the 70th percentile, providing a good benchmark for this class of websites.

Features Users Like

Locating a doctor and checking the status of a claim were the features participants reported liking the most. Kaiser Permanente has a different operating model than most insurance companies, and this is reflected in features their subscribers like: refilling prescriptions, emailing a doctor and making appointments—all online.

Loyalty

Most participants don’t have a choice, or feel they don’t, with their health insurance provider. This is especially the case when insurance is provided by an employer. Nevertheless, when the online experience is poor, users are likely to tell others, including their employers, about the bad experience.

The average Net Promoter Score for the Industry is -2%, meaning there are slightly more detractors than promoters (33% vs. 31%). That’s compared to around 24% for the retail industry and 21% for consumer software. The Kaiser Net Promoter Score is substantially higher at 28%, a likely consequence of an easier online experience and one with more functionality.

In fact, 41% of Kaiser users reported making a positive recommendation to a friend or colleague in the prior year. That rate is more than 3-5 times higher than that for the typical provider. In estimating the value of a promoter, Kaiser needs around half the promoters to generate a new customer relative to the other providers we examined.

What to Fix

Overall, the biggest suggestion on what participants wanted fixed was a common one: improve the navigation and the ability to find the most common features. Users know that functionality and information exist but they have a hard time locating them, even on Kaiser.

“Make it more user friendly instead of burying items in embedded links making them difficult to find” Aetna

“Navigation is clunky in places – may be due to the hierarchy of the Kaiser institution – there are different departments for all the parts of the body.” Kaiser

Having intuitive navigation is essential, as most participants aren’t logging into their provider website very often. On average, participants reported visiting their provider website 1-2 times per month. Kaiser participants visited about twice as frequently—likely a consequence of the additional online functionality like emailing doctors and making appointments.

When users can’t accomplish their top tasks on websites they will often call the customer support lines, which results in a much higher cost to providers, and likely a more frustrating experience for users (who wants to sit on hold, provide your account information, and get transferred just to accomplish a basic task?).

Improving findability and the overall ease of use will make not only make users more satisfied and reduce costly support calls, as the Kaiser example shows, it may also increase their likelihood to recommend.

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