Navigating the challenges of customer experience (CX) in healthcare is no small feat, especially in an industry as dynamic and complex as healthcare insurance.
Mike Brzozowski, Senior Vice President, Solutions Consultant at MERGE, brings over 15 years of expertise in digital strategy and customer-centric innovation to the table. In this insightful Q&A, Mike sheds light on how healthcare insurers can elevate CX to drive both acquisition and retention, leveraging advanced tools, strategic frameworks, and a deep understanding of member needs. Whether it’s creating personalized interactions at scale or rethinking their technology stacks, his expertise offers actionable solutions for today’s most pressing CX hurdles.
MERGE: Many view CX as a tool for retention, but it also plays a critical role in acquisition. How can CX strategies impact both acquiring new customers and retaining existing ones in the healthcare payer industry?
Mike Brzozowski: Effective CX starts with understanding the individual. Whether for acquisition, retention, or upselling, the experience must revolve around customer needs, not just the business goals or technological constraints. Too often, healthcare experiences are generic and fail to resonate emotionally, despite health being one of the most personal and emotional aspects of life. By addressing pain points and motivations through tailored, relevant experiences, we can create deeper connections. With advancements in technology from platforms like Adobe, Salesforce, and Sitecore, we now have the tools to deliver the right message to the right person at the right time, fulfilling a promise we’ve been chasing for decades.
MERGE: First impressions matter so much. From your perspective, how can health insurers use CX to deliver a seamless and engaging experience from the very first interaction with a prospective member?
MB: I’m not speaking out of turn when I say that health insurers lag behind other industries in creating experiences that truly engage and understand their members. This lag is due to the necessary complexities involved when working in this highly regulated industry, but our clients’ customers are unconcerned with the reason. They are focused on the impacts to them. To bridge this gap, they must move beyond process and regulatory constraints, which often stifle creativity and the prioritization of personalized, seamless interactions. People now expect healthcare experiences to match the ease and fluidity of using an iPhone or ordering an Uber. Health insurance is deeply personal, and insurers need to provide clarity, reduce surprises, and deliver thoughtful, supportive interactions across all channels—from mobile apps to physical communications. And with advancements like AI, delivering such tailored experiences at scale is no longer a lofty goal, but an achievable standard.
MERGE: What are the most significant ways you’ve seen technology enhance CX to improve both acquisition and retention efforts?
MB: I think healthcare can learn from industries like travel and entertainment and online retail, which excel at delivering timely, personalized messages based on individual preferences. A key area for improvement in healthcare is fostering two-way dialogue. Rather than simply collecting data during enrollment, insurers need to understand the unique circumstances of members, like a spouse’s chronic condition or a child’s special needs. I often say that life events are insurance events. And I know it sounds really silly, but it’s true. Think about it: the birth of a child, marriage, divorce, getting laid off from a job, finding a new job, moving—all of these huge events that happen in your life often necessitate an insurance response. These moments are opportunities for insurers to show empathy and provide relevant, reassuring communication, whether through digital tools or call centers. Advancements in AI are already transforming how call centers operate, making it possible to deliver personalized, empathetic interactions at scale.
MERGE: Personalization is often cited as a key driver of member satisfaction and retention. How can health insurers better leverage data analytics to create personalized experiences and address member needs?
MB: AI plays a pivotal role in delivering personalized member experiences, but its success depends on integrating data across systems, a challenge many health insurers still face. Siloed data, like claims, acquisition, and program enrollment, limits the ability to craft tailored interventions. A customer data platform (CDP) serves as a centralized hub, enabling a complete view of member needs and behaviors. By combining CDPs with AI, health insurers can generate data-driven recommendations that feel personal and actionable. However, a third component is required: you need a powerful delivery mechanism. While AI refines insights and even crafts compelling content, it’s the Digital Experience Platform (DXP) that actually gets those personalized messages and experiences to members, precisely when and where they matter most. Without it, even the most brilliant insights from your CDP and AI remain just that—insights, not impactful interactions.
MERGE: For organizations hesitant to migrate to new platforms, what advice do you have about maximizing the potential of their current technology stacks to improve CX?
MB: Maximizing existing technology starts with aligning business goals, customer needs, and a thorough tech audit. Evaluate what your systems—such as CRM, CMS, DAM, CDP, or mobile apps—can do, where they fall short, and how they integrate. It’s crucial to spend time in discovery, ensuring your technology supports seamless user experiences. Many organizations underutilize the power of the tools they already have, so this process is key.
Tools like Adobe Journey Optimizer and dynamic CMS platforms are game changers, enabling personalized, journey-focused content. Even during pre-enrollment, organizations must demonstrate they understand the unique needs of potential customers, setting the stage for strong, lasting relationships.
MERGE: MERGE’s partnerships with Adobe Workfront, Salesforce, and Sitecore help distinguish us. Can you articulate the ways in which these platforms specifically support health insurers in creating exceptional customer experiences?
MB: Health insurers rarely rely on a single vendor stack, instead opting for best-of-breed solutions across software providers. Platforms like Adobe Workfront enhance employee experience by streamlining workflows across teams and technologies—from creative to legal to delivery. This ensures smooth delivery of content and communications. It’s not about campaigns anymore; it’s about adopting a marketing systems mindset. With platforms like Salesforce and Sitecore, organizations can provide always-on communication that adapts to members’ evolving needs in real time, reflecting the dynamic nature of their lives and circumstances.
MERGE: Retention often comes with its own set of challenges, like member disengagement or disenrollment during AEP/OEP. What strategies or tools do you recommend to pre-emptively address these issues?
MB: Retention during AEP/OEP really hinges on two key factors: price and experience. While price-driven members may switch regardless, insurers can differentiate themselves by delivering seamless, personalized experiences. Members should never feel like they're starting from scratch during these critical moments of truth, whether via phone, mobile app, or website. Timely claims management and cohesive touchpoints build loyalty and reduce the likelihood of disengagement or disenrollment. This is especially critical for both Medicare Advantage and commercial insurance, where complex ecosystems make exceptional experiences the strongest differentiator.
MERGE: How can healthcare insurers evaluate and measure their CX maturity to identify areas for growth?
MB: First of all, if I could do a shameless MERGE plug for second, we have created a CX maturity model that asks a whole series of questions that allows clients and potential clients to see where they are and identify the areas that need improvement. Not surprisingly, evaluating CX maturity starts with assessing people, processes, and technologies to identify improvement areas. While technology is easy to upgrade, the real challenge lies in retooling employees and driving change management. Many struggle to move from a campaign-focused to a systems mindset, but the industry must adapt to meet rising consumer expectations. Learning from seamless, constantly evolving experiences like Amazon or Netflix, healthcare must balance innovation with privacy concerns to remain relevant. Change isn’t optional; it’s essential to thrive in today’s dynamic landscape.
MERGE: What kind of value can healthcare insurers expect when partnering with MERGE and working with leaders with the level of experience and expertise that we offer? What are the key problem-solving capabilities we bring to the table when addressing CX hurdles or pain points?
MB: One of the reasons I joined MERGE is the exceptional expertise across disciplines like digital design, technology, media, and creative development. Our team combines deep skills with a strong business focus, ensuring every decision drives results—not just aesthetics. We’re also able to bring a fresh perspective, leveraging experience from other industries safely adapted for healthcare, which means our clients benefit from cutting-edge strategies tailored to their unique needs. Equally important is the humility of our team; collaboration is at the heart of our process. We partner openly with clients to tackle CX challenges together, building solutions that truly move their business forward.
Let’s create solutions together! Connect with MERGE to begin transforming your healthcare CX strategy today.
