As I travel around the country, I continue to hear that the three biggest problems in employee benefits are healthcare cost, cost and cost. Then why in the world am I recommending a focus on the employee healthcare and health benefits experience?
The reason is because, at the end of the day, the healthcare cost problem is really our problem. It’s company management’s problem, it’s the executive team’s problem, it’s HR’s problem, it’s the benefit manager’s problem, it’s the broker’s problem, it’s the benefit consultant’s problem, and it’s the problem of health benefit partners like Compass; but it’s not necessarily the employees’ problem.
The employees’ problem is really around the healthcare experience for themselves and their family. It’s about efficiently and effectively navigating a complex system and getting the acute and/or chronic care they need. Some common employee healthcare experience problems include:
- “We’re moving, and my family needs to find a whole bunch of new doctors that are in-network in my new area.”
- “I just had a baby and I’m getting all these bills; what’s going to be covered and how’s it going to be covered. How much am I going to owe?”
- “I found the specialist I need to see but I cannot get in for an appointment for 6 weeks. I can’t wait that long because I’m concerned the condition will get worse.”
- “My husband is in the hospital. How is his stay going to be covered, and can we find a physician that is going to be competent to solve the problem so that we can go home.”
- “I haven’t been to the doctor in years. I know I need an annual physical but with my work schedule I don’t have time to find a good doctor and make an appointment. Plus most doctors I called a few years ago wouldn’t do a physical on the first appointment. I don’t have time for all that.”
- “It seems like every year my family and I are paying more and more for health benefits, but it seems like we’re getting less and less. What happened to the days of $35 co-pays!”
What employees really care about is the experience with their health benefits – how simple or hard it is to get the answers and care they need so they can focus on the things that matter most to them – their families, friends, personal interests and their jobs.
When employees are faced with a healthcare event, the first thing that pops into their heads is not “oh my goodness what are the financial ramifications to my employer.” No, that is NOT what they’re thinking; they are thinking about what their own experience is going to be like as they deal with this unexpected health event.
So, to solve the healthcare cost problem, we have to solve the healthcare experience problem first.
Why? Because in order to solve the healthcare cost problem, we’re going to need employees to change behavior. The famous definition of insanity by Albert Einstein is “to do the same thing over and over again and expect different results.” If we want different results for our health plans, we’re going to need to do different things. Employees are going to need to do different things, and family members are going to need to do different things.
If we’re going to expect employees and their family members to do different things, we have to solve THEIR experience problem before they’re going to help US solve our cost problem.
As an employee, why in the world would I ever help you solve your cost problem if you’re not going to help me solve my healthcare experience problem? That’s what we’re going to talk about over the next several blogs – best practices for creating Health Plan Moments of Magic.
Health Plan Moments of Truth
Customer service guru and New York Times and Wall Street Journal bestselling author Shep Hyken has a framework that he calls “customer amazement” by which companies can provide better than average employee experiences, every time. When an employee forms an opinion based on an interaction with your organization, it should be considered a Moment of Truth for your company. That interaction can result in a bad impression (a Moment of Misery™), an average experience (a Moment of Mediocrity™) or the desired outcome – a better than average experience (a Moment of Magic®). Sometimes experiences will be just a little better than average. Other times they will be truly amazing.

The Compass team used Shep’s framework to define the top 16 Moments of Truth for an employer’s health plan. Click here to download a cheat sheet with all of the 16 Health Plan Moments of Truth. In the next two blogs, I’ll use these Health Plan Moments of Truth to dive into the following topics:
- New Compass data about how employers rate themselves on their ability to deliver above average experiences for the critical Health Plan Moments of Truth
- Best practices from other HR professionals about how to create great employee health plan experiences


