Geisinger Health System’s ProvenExperience refund program

  • Insurance

In November 2015, the Geisinger Health System in Danville, Pa., introduced its ProvenExperience program in which the health insurer and hospital system promised refunds to members who were dissatisfied with their care. At the time, Geisinger stated that its goal was to ensure the best customer experience in health care and the best customer experience in any industry. One year later, Geisinger executives reported first-year results in an article in the Harvard Business Review. In the article, the executives reported a 23 percent increase in communication between patients and patient experience advocates. Of these, 71 percent were complaints, 24 percent were requests for assistance, and 5 percent were compliments. Among the complaints, 20 percent related to trouble patients had making outpatient appointments and accessing care, 8.7 percent related to financial issues and billing, 8.4 percent involved difficulties accessing results or medical information, and 7.7 percent were complaints about provider behavior or attitude. Each month, the health insurer gets an average of 122 refund requests, averaging $464 each, amounting to about $680,000 such requests annually, they wrote.

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