Gartner reviewed 15 U.S. healthcare insurers' websites to evaluate their ability to provide members with an online experience comparable to those received in online shopping, banking and other industries.

• Initial launches of healthcare insurers' member portals offered just enough novelty to attract early adopters. However, adoption has stalled at less than 10% of many insurers' memberships.
• Users have become accustomed to polished and compelling user interfaces among top websites, and healthcare insurers' member portals have not kept pace.
• Few healthcare insurers have taken advantage of new technologies to improve usability, interactivity and navigation. CIOs need new tools to get their member portals going again.
• The experiences that members have with their portals affect their impressions of the portals as well as the sponsoring organizations.

IT leaders at U.S. healthcare insurers:

• Align your member portal strategies and measures of success with your corporate strategies and key performance indicators (KPIs).
• Seek new technologies, such as rich Internet applications (RIAs), to give your members better online experiences. Analyze your vendors' efforts to incorporate new portal functionality, such as Web 2.0 features, into their products.
• Experiment with social media to begin to understand the nuances and needs of collaboration. Enhance your member portals with interactive agents and healthcare reform blogs, and encourage your members to comment on new benefit options.
• Look beyond your peers for an understanding of consumer expectations. Actively monitor consumer-facing websites, such as Amazon.com, to best understand expectations of compelling online experiences.

The ongoing consumerization of healthcare is driving people to the Web to search for information about healthcare concerns and costs. A member portal can provide a faster and more accessible entry point to healthcare insurers and should be a strategic point of contact with their customers. However, despite nearly a decade of existence, interaction by health plan members with their healthcare insurers' member portals (as indicated by healthcare insurers) remains less than 10%. In December 2008 and January 2009, Gartner conducted a Web-based survey of 4,010 consumers ages 18 and older in the U.S. (n = 2,003) and the U.K. (n = 2,007) on attitudes and behaviors related to media, retail, utilities, healthcare, insurance, and government services. The U.S. results for healthcare insurance were compelling. While 85% of participants indicated high use of the Internet, 37% expressed an active interest in their health and 37 % stated an intention to use their healthcare insurers' websites to perform health-related Internet activities. Less than 15% of those surveyed acted on these intended behaviors (see "Consumers Prefer Non-Healthcare Insurer Web Sites When Performing Health-Related Activities").

Healthcare insurers have an opportunity to change these behaviors and increase the portion of their memberships who interact with their member-facing websites. However, first they must create a compelling user experience for their members that meets consumers' heightened expectations for a satisfying online experience comparable to their interactions with online banking, shopping and social networks. Healthcare insurers that value their member portals as differentiators must keep pace with the generalized online experience and be prepared to continue to innovate and invest. This will challenge insurers to embrace new technologies, forms of interaction and style of content.

In early April 2009, Gartner reviewed the member portals of 15 U.S. healthcare insurers in three general categories:

• National companies (Aetna, Cigna, UnitedHealthcare and WellPoint)
• Multistate companies (Coventry Health Care, Health Net, Humana, Kaiser Permanente, and Regence Group Blue Cross and Blue Shield [BCBS])
• Regional companies (BCBS Kansas City, BCBS North Carolina, Dean Health System, Harvard Pilgrim Health Care, Health Insurance Plan [HIP] and Highmark BCBS)

Our focus was to review the "state of the industry" relative to five attributes common in successful consumer websites. We used the Google Internet search engine and member-portal-provided search capabilities to locate examples of the stated points of interest. We did not contact companies before or after the survey. Special login or identity creation procedures were not used.

To meet member and prospect expectations about attaining a satisfying online experience, healthcare insurers must adopt these four attributes common to successful member portals:

• Support new navigation models
• Incorporate social media
• Provide for transparency
• Create a compelling customer experience

Support New Navigation Models

Healthcare insurers' member portals were developed under the assumption that the home page would act as a virtual "front door" by ushering customers into a logical, linear experience. For example, a member might want to know if the health plan offers a personal health record (PHR). Traditional navigation models would expect the member to go to the insurer's home page, select the member tab and then receive introductory content on the PHR, followed by a login process and, finally, access to the PHR.

However, consumer embrace of search engines is making this linear approach obsolete. Today, consumers are much more likely to use Google or another search engine, keying in the name of the healthcare insurer and the term "personal health record" or the acronym "PHR." As a result, any page has the potential to be a landing spot based on customer-created search strings (see "Web Site Usability: Rethinking Navigation").

Gartner used Google to simulate search navigation with the 15 healthcare insurers, seeking a direct link to the company's PHR tool or associated landing page in the top-five search results. Of the 15, only a search for "Aetna's PHR" produced a result that led to a landing page customized to introduce the insurer's PHR tool through content associated with two key questions: "What can it do for me?" and "How does it work?" (www.aetna.com/showcase/phr ). Most of the other search results produced press releases or presentations that described the offered PHR, and a handful made no mention or provided search results to other entities that supply PHRs.

Recommendations for Supporting New Navigation Models

• Identify the key attributes of your website that you wish to promote, such as health and wellness tools, enrollment, or controlling healthcare costs.
• Create the landing pages you would like to associate with these attributes, providing appropriate content and links.
• Optimize your search strategy and tags to provide access from commercial search engines.

Incorporate Social Media

Social media spans a range of online communications using Web 2.0 technologies — for example, social networks (such as Facebook, LinkedIn and MySpace), blogs and microblog tools (such as Blogger, Twitter and WordPress), podcasts, wikis, mashups and widgets. These technologies can help healthcare insurers — and their customers — communicate with each other in a personalized manner.

Social media can enable healthcare insurers to extend their brands, connect their customers in a community environment and spur them to take part in creating, for example, new products and marketing materials. However, healthcare insurers — not known to be early and aggressive adopters of technology — have been slow to use social media. Delayed adoption may have helped insurers avoid the failures experienced by early adopters in other industries. Nonetheless, consumer demand is growing so fast that insurers must respond.

With websites such as ehealthinsurance.com offering interactive channels for sales, marketing and customer service, healthcare insurers' websites will fail to differentiate themselves with members and prospects if they continue to ignore social media. Healthcare insurers must also be aware that social-media-enabled collaboration is not limited to what they choose to offer. Facebook, Google and Twitter may soon become more powerful as sources of information about an insurer's business than its own website.

Of the websites that Gartner reviewed for this report, not one provided direct access to blogs, interactive communities or chats on home or member-facing pages. Using search navigation, Gartner found some fledgling initiatives in 27% of the sites, but they had low visibility (although 40% of the insurer sites reviewed had a corporate presence on Twitter). In our review, almost all were mentioned on other blogs, chats and collaboration sites.

Recommendations for Incorporating Social Media

• Master the art of user-contributed content and communities, including monitoring of responses, accepting and handling negative responses, and dealing with troublesome members.
• Be aware of the risks of negative reputation events online. Implement a process to identify new reputation posts and create mitigation plans.
• Adjust content management systems to integrate unstructured content with internal structured data and with information outside the enterprise.
• Recognize that loss of control and the potential for bad participant behavior can occur. Create a working group and a plan that will help ensure that enterprise reaction to the risks of participation does not overwhelm the promise.

Provide for Transparency

Consumers and healthcare providers have a high level of distrust for healthcare insurers. This is abetted by the veil of secrecy that some healthcare insurers wrap around themselves. Healthcare insurers must recognize that regulators, employer groups, unions, chambers of commerce, and other stakeholders are likely to begin efforts to support transparency and disclose information relative to their interactions with healthcare insurers that may not correspond with the insurers' versions. Healthcare insurers should provide for disclosure or transparency of their processes and policies.

Gartner searched insurers' member portals for the term "transparency," followed by site navigation for other relevant content. Although most member portals offered some form of content related to healthcare reform or healthcare trends, only a few used the term "transparency," and only Humana provided a space dedicated to transparency. Humana gives a link to transparency through navigation of Member/Tools and defines transparency as "access to data that help you make decisions." However, the tools, tutorial and content focus only on the ability to select doctors or hospitals. Healthcare insurers may have components of a transparency program scattered throughout their member portals, ignoring the spirit of transparency by forcing members to hunt for information.

Recommendations for Providing for Transparency

• Act now to prepare your member portals to support the disclosure necessary for transparency by assessing them for the ability to work with unstructured data, multiple communication devices and interactive sessions.
• Recognize that the public will use multiple online channels to access and provide feedback to healthcare insurance information. Examine how your business intelligence (BI) and e-discovery tools and approaches capture, analyze and use unstructured data that will continue to grow in volume and importance as a result of the openness reforms.

Create a Compelling Customer Experience

First impressions matter. Healthcare insurers must recognize that their member portals are extensions of the overall brand experience of their members. Although the imagery, content and tools are the face that the customer experiences, the healthcare insurer's decisions about technology, usability and design, and context determine whether the customer has a compelling experience — and whether a customer will return for a second try.

Technology: Based on their interactions with Amazon.com and other popular websites, consumers have set their online expectations high. Ajax and RIA technologies enable creation of user interfaces that are more responsive than those found in the typical healthcare insurer's Web applications. To accommodate the new collaborative capabilities associated with Web 2.0, healthcare insurers need to migrate to Ajax or RIA (see "Key Issues in Rich Internet Application Platforms and User Experience, 2009"). Risk-averse insurers face a quandary — balance the need to satisfy Internet-savvy customer demands while coping with the still-maturing Web 2.0 technologies. In our review of their member portals, most healthcare insurers offered scant opportunity to collaborate, provide product reviews or establish a community presence.

Usability: The usability of a healthcare insurer's website is measured by the member's ability to complete self-service transactions, find relevant content or engage in useful dialogue. Good usability ensures that a user's movement happens quickly and efficiently. It is affected by a user-centered design as much as by technologies and products. Insurers can improve the usability of their member portals by focusing on external needs that will help them discover blind spots in their design and business processes.

Context: Context-aware computing aims to deliver content, services and tools at a user's "moment of need." Although application capabilities have improved greatly, most users must discover content themselves by browsing or downloading and executing applications. Gartner believes that the next great challenges in computing involve the leveraging of information to provide context-aware, personalized interaction with users that eases the discovery of content and applications, and maintains this context awareness dynamically as users move among the sessions, applications and endpoints.

Recommendations for Creating a Compelling Customer Experience

• Align your member portal strategies and measures of success with your corporate strategy and KPIs.
• Seek new technologies that give your members a better online experience. Analyze your vendors' efforts to incorporate new member portal functionality, such as Web 2.0 features, into their products.
• Experiment with social media to begin to understand the nuance of collaboration.
• Actively monitor what is being said about you on the Web, and prepare a response toolkit.

IT leaders at U.S. healthcare insurers:

• Align your member portal strategies and measures of success with your corporate strategy and KPIs.
• Seek new technologies such as RIA to give your members a better online experience. Analyze your vendors' efforts to incorporate new portal functionality, such as Web 2.0 features, into their products.
• Experiment with social media to begin to understand the nuances and needs of collaboration. Enhance your member portal with interactive agents and healthcare reform blogs. Encourage your members to comment on new benefit options.
• Look beyond your peers for an understanding of consumer expectations. Actively monitor consumer facing websites such as Amazon.com to better understand the expectations of a compelling online experience.

"Consumers Prefer Non-Healthcare Insurer Web Sites When Performing Health-Related Activities"

"Web Site Usability: Rethinking Navigation"

"Key Issues in Rich Internet Application Platforms and User Experience, 2009"