IMPROVING THE CONSUMER EXPERIENCE ONLINE MARYLAND HEALTH BENEFIT EXCHANGE BOARD OF DIRECTORS MEETING SEPTEMBER 19, 2016
WHY “UX” (USER EXPERIENCE)? In spite of increased volume, private plan (QHP) enrollment up 33% and twice as many total enrollments processed as a year earlier, administrators were aware of ongoing user challenges with the website through conversations with consumers and consumer-assistance workers and through social media. Addressing those challenges is important for improving the experience of consumers and for reducing the volume of calls to the call center.
WHY “UX” (USER EXPERIENCE)? MHBE conducted User Experience (UX) research in January 2016, observing by remote webcam four new enrollees and four renewal participants . • The four renewals expressed an interest in exploring new plans with better pricing or coverage options for 2016. • The four new shoppers expressed an interest in finding an a ff ordable health plan with high quality coverage. All of the consumer interviews were conducted remotely by the firm gotoresearch during the final week of 2016 open enrollment Jan. 22 - Feb. 3, 2016 and lasted 60-90 minutes. Participants were compensated $200.
RECRUITING USERS
USERS To protect the privacy of participants, names and identifying details have been changed.
FINDINGS • Renewal participants were unsure how to start the renewal process or change plans. • Insurance terminology was often confusing to participants. • The “help with costs” section confused people as did household income and size questions. Participants interpreted the definition of “household” members di ff erently, and at times incorrectly.
OBSTACLES • One participant, who enrolled in a plan, believed that household income included everyone he lived with regardless of whether they file taxes together. He had an estimated annual income of $10K and files taxes independently. Had he only included his income, rather than both his roommates’, he would have qualified for Medicaid. Instead, he received no financial assistance. • Another participant who lives with his parents and files taxes separately only included himself. In contrast, another who also files separately included his brother and stepmother as household members.
ACTIONS TAKEN 1. Findings and video clips were presented to staff across departments. Consultants and IT staff began using findings to set priorities for OE4. 2. Password reset process resulted in significant user frustration and contributed to wait times and overload at the call center: Self-enabled password reset launched in April. 3. Design and content were streamlined, simplified to improve the informational part of the site. 4. Findings were cross-walked with other data, such as website analytics and call center data, to set priorities for improvements and changes.
SIMPLIFYING THE LOOK AND LANGUAGE Current design: Too many “doors” New design flow is less Users tested had mixed feelings program-oriented, more about home page, describing it as user-oriented. Fewer “doors” containing a lot of information and helpful, but also confusing.
● Anticipated Launch: First week of October 2016 ● Website will be organized in the following categories: ○ How to Enroll ○ Shop and Compare ○ Small Business (SHOP) ○ Find Help - How to receive in-person help ○ Get Answers ○ Enroll Now - Sends you to application
A TEMPLATE THAT’S EASIER TO FOLLOW
APPLICATION IMPROVEMENTS OBSTACLE SOLUTION In UX observations, users spent ● Fewer, clearer entry points. considerable time looking at available plans, without realizing they weren’t ● Application log-in buttons revised actually shopping yet. to “Get an Estimate” or “Apply for Coverage” Users browsing plan prices weren’t ● Application provides simple seeing reasonable cost and eligibility guidance on who to include in estimates because key information wasn’t your “household” when applying. asked. ● User also can choose whether each household member is/isn’t applying for coverage, to get a more accurate estimate.
APPLICATION IMPROVEMENTS HOUSEHOLD AVAILABILITY OF IMMIGRATION STATUS VERIFYING INFO COMPOSITION FINANCIAL HELP Applicants In testing, we saw several We clarified for applicants Made instructions advised to include consumers incorrectly at several key points that clearer about how to members of their answer “No” to whether people who aren’t see whether additional tax household they wanted to apply for applying for coverage verification is needed, (and specifying financial help, thinking this won’t be asked about and how to upload who not to include meant only Medicaid, so immigration status. documents. such as they weren’t found eligible roommates!) for tax credits even if they Improved explanations of And more urgency would have qualified. eligible immigration around needing to statuses, documents that confirm information Explanations clarify how could be provided to right away to prevent tax credits and verify each, and where to a change in cost-sharing reductions find important numbers enrollment or eligibility work to save the on these documents. for coverage or consumer money. financial help.
INTRODUCING THE “ENROLL MHC” MOBILE APP ● The mobile app features the online application, not the full website . Key Features: ● ○ Browse plans and enroll ○ Log into your account, view notices, and access your personal inbox ○ Submit verifications using your phone’s camera ○ It’s secure and has a setting to ensure that no personal information is stored on device ○ Conveniently reach call center
MOBILE ARCHITECTURE The Mobile Platform integrates with the Web Portals and other MHBE systems non-intrusively to provide a consistent customer experience Mobile Services are fully secured by the MHBE Security Infrastructure Customer Portal MHBE Systems JBoss Web Server HTTP Post Requests HIX Services (SSL) MHBE Customer BACKEND Portal SYSTEMS Worker Portal IBM WebSEAL Mobile App accesses the MHBE system like a Web Mobile Browser through the Service Adapter ISIM/ISAM Security Infrastructure JBoss EAP RESTful API – Account Creation, DB2 Database Enrollment, etc. Policy Secured by Server WebSEAL (SSL) SMS ▪ Implementing the mobile platform does not require any significant changes to the MHBE systems ▪ A mobile adapter will be installed in the MHBE environment and secured by the MHBE IBM ISIM/ISAM 15 security infrastructure
RELEASES The MHBE Mobile platform will be implemented in two releases that progressively add more functionality Screen and Shop for Benefits 1. Preliminary eligibility screening for benefits including APTC, CSR, Medicaid and CHIP ` 2. Provide financial quotes for APTC and health plan premiums Release 1: 3. Mobile optimized list of plans with APTC slider and plan filters 4. Detailed plan information, including Plan PDF from Carriers Aug. 19 on Android and Apple (iOS) Access Inbox and Verifications stores 1. Access Mobile Inbox including messages and PDF notices 2. Ability to upload verification documents using the mobile camera or gallery 3. Ability to access documents uploaded via both web and mobile Enroll in Benefits Release 2: 1. Secure customer account creation October 2. Application process and enrollment for QHP, APTC/CSR 3. Completing enrollment for Medicaid/CHIP on the Customer Portal 2016 16
REACHING TARGET AUDIENCES Groups that rely heavily on smartphones for online access: ● 15% of Americans ages 18-29 are heavily dependent on a smartphone to go online. ● 13% of Americans with annual household income of less than $30,000 are smartphone dependent; 1% of U.S. households earning $75,000+ per year rely on smartphones to a similar degree for their online access. ● Non-whites: 12% of African Americans and 13% of Latinos are smartphone-dependent, compared with 4% of whites. -- Pew Research Center, 2015
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