Clearly  the government wasn’t ready for the October 1 deadline for health care insurance change but there is an opportunity to get it right in future releases. Change on this scale isn’t easy.

Just think: A generation ago, most of us didn’t know what 401ks and IRAs were but now they play a prominent role in our retirement planning. All of us are on the cusp of having to learn about managing our health care in much the same way—with decisions moved from employers, doctors and hospitals into our own hands. However, the complexity of our health care system is far greater than that of Wall Street.  How can insurers help consumers while simultaneously achieving efficiencies?

This is a clarion call for simplicity in health insurance. Insurance is based on trust. Lack of clarity and confusion are the enemies of trust.  The solution lies deeper than merely increasing transparency, because transparency only lays bare a very convoluted, jargon-ridden maze of terms, conditions, exclusions and exceptions. Most insurers tweak and modify small moments of the customer experience but rarely step back and take a comprehensive, blank-slate approach. Companies that take the early lead in providing a new, meaningful approach to health insurance will own the space in business, brand and experience.

In my recently published book, Simple: Conquering the Crisis of Complexity, my co-author, Alan Siegel and I, focus on three principles as the key to achieving simplicity. These three principles, empathy, clarity and distillation are essential for simplifying health insurance. Fewer plans, with clear distinctions, explained in plain language would benefit consumers and the employees who must explain them. Greater understanding would beget increased trust and would strengthen the system overall.

Of these three principles, empathy is most critical. Customer experience is the culmination of myriad interactions. Every sight, sound and engagement is important. Merely noting the questions and impressions formed by customers during their journey from insurance shopping to medical claim can be remarkably revealing and lead to insights for improvement.

If you map this journey, invariably several ‘hassle factors’ will surface and the number of interactions will be staggering:

  1. Interminable waiting. Everyone hates to wait particularly when they are anxious and making a significant decision. Phone trees with myriad options coupled with the inability to access a person are a poor way to start a relationship as is a confusing website. Clear, intuitive, empathetic points of initial contact will go a long way to establishing consumer confidence.

  2. Annoying repetition. “I punched in my id number and now I am being asked again for the same information.” In addition to the annoyance of repeating oneself, repetition also plants a seed of doubt about the validity and accuracy of the institutions’ recordkeeping. Faith and confidence are critical in health care much as they are in finance. If my brokerage firm asked me to recite the history of all my stock trades every time I transacted business, I would feel mighty uncomfortable. Instead of asking again, telling the patient what you have already gleaned and asking them to verify the information might be more palatable.

  3. Uncertainty and fear of cost. “I don’t know how much this will cost me out of pocket.” None of us knows when a doctor prescribes a medication how much it will cost us out of pocket until we fill the prescription at the pharmacy. Unexpectedly high drug costs often lead to a cycle of patients phoning doctors seeking cheaper alternatives or worse, not complying. A more empathetic approach would be for insurers to facilitate doctors prescribing via I-Pad with immediate cost information on screen while simultaneously directing orders to the pharmacy.

  4. Jargon and verbosity. Jargon is overwhelming and intimidating. Health insurers bandy about HMO, EPO and PPO with basic and premium flavors of each as though such acronyms were common parlance. At a recent industry conference, one pundit used more acronyms in 30 minutes than one could write down: EMR, PHR, PBM, UM, CM, DM, PCP, IVR, NP and PA. Very few patients (and probably a surprising number of health care professionals) have a clue what any of these actually mean.

  5. Simplify before digitizing. There has been a lot of discussion (and some progress) lately about the liberating promise of information technology and the power of a single platform for electronic health records. We couldn’t agree more. However, unless we first address the underlying complexity in processes and communications, we fear that this will lead to incremental rather than comprehensive change.

We know empirically from our work with insurers, providers, pharmaceutical companies and government agencies that streamlining and simplifying how patients, doctors, scientists, managers and public health officials communicate, transact, and interact with each other can deliver dramatic increases in productivity and efficiency, while saving hundreds of millions, potentially billions of dollars each and every year.

Accept the simplification challenge
We challenge everyone in the industry to take a deep breath and remember what the mission of health care is – to treat patients.  A valuable first step in health care reform will be to adopt a truly patient-centric approach, by spending the time, effort and resources necessary to streamline, simplify and rethink communications.

With this in mind, we offer as a starting point seven guidelines we use to develop simplified, customer-centric communications:

Statement of purpose
Every touch point, whether it’s a website, application, letter or pamphlet, should clearly communicate exactly what its purpose is. Through both copy and design, the touch point must instantly communicate why it’s important.

Plain language
Everyone deserves simple, jargon-free language that improves the chances of comprehension and compliance, while building trust.  No acronyms should be used unless there are clear, accompanying definitions.  Simple and meaningful examples should always be given, since it is proven that this is how people learn and remember.

Content and graphics
Content should always be as short and concise as possible.  Next steps should be clearly outlined. Simple and useful tables, charts and graphics should illustrate complex information.

Structure and navigation
All formats should follow a summary-to-detail organizational format, which matches how people typically process information. Clear headings and labels should be used as signaling devices. Related information should always be grouped together so it’s easy to find. Documents, correspondence, phone trees , web sites and other touch points should be easy to use and easy to navigate.

As much as possible, content should be customized for the target audience. Relevancy increases comprehension.  Research proves that customized approaches achieve intended results better than form letters. Sending a six-year old child a standard wellness pitch advocating exercise and good nutrition comes across as disengaged and counterproductive.

Trust and relationship building          
Education, community, and value-added content that truly informs builds relationships.  Prominently displayed self-help options and customer service contact information anticipate questions. 

Visual appeal
Clear and intuitive design cannot be underestimated.  Plenty of white space, readable type, clear titling, and quality graphics all indicate that you value and respect your audience and have nothing to hide.

Breakthrough simplicity is as difficult as it is rare and goes beyond streamlining processes and redesigning communications.  True simplification starts from the bottom up and analyzes how people consume and process information. You must tackle the underlying economic incentives, organizational roadblocks, sacred cows, and entrenched systems and technologies.  We believe that simplification can be a tremendously empowering force in the health care sector, because it will increase comprehension, transparency and trust, while encouraging patients to take greater personal responsibility.  Understanding the pain of others never hurts.


Irene Etzkorn is Chief Clarity Strategist at Siegelvision in New York. She can be reached at ietzkorn@siegelvision.com. Irene has worked with many large, complex, insurance companies to cut through the clutter and develop communications that are clear and easy for the customer to use and understand, while achieving bottom line cost savings for her clients.

Follow her on Twitter @Irene_Etzkorn. Her book, Simple: Conquering the Crisis of Complexity, with co-author, Alan Siegel, is available on Amazon and everywhere books are sold.