Understanding and Mapping out Complexities of a Medicare Advantage plan provided by a Major US Healthcare Insurance Company

Mapping out healthcare services through conducting 100 ethnographic interviews with patients and providers alike.

In this project, my role was to design (interview guides, workshops) and conduct qualitative research (semi-structured interviews, workshops with medical professionals) with patients and healthcare providers, as well as synthesize the collected data, which resulted in creation of two complex user journey maps.

Overview

Defining the Problem

The objective of the project was to understand the holistic experience of patients and medical professionals with a Medicare Advantage plan provided by one of the major US insurance providers. Through the research, my team and I were able to uncover moments that impede smooth delivery of care, causing gaps in care as well as healthcare adherence issues. These lead to increased costs of case as well as decreased patients' wellbeing.

Patients and providers both experienced a lot of impediments that prevented them from effective collaboration, sometimes leading to the creation of workaround systems. This systems decreased provider's capacity to provider care to more patients.

Understanding
the Problem

Ideation

In order to successfully conduct the semi-structured interviews, my team and I conducted problem definition workshops which informed the creation of question guides. Having conducted interviews, we then moved onto analysis and synthesis of the collected data.

The maps, as well as an in-depth presentation identified key painpoints which once addressed could vastly improve patients' and providers' experience, thus increasing overall ratings of the health plan.

Outcome

The creation of detailed user journey maps for both providers and patients allowed the company to identify moments that caused delays and unnecessary costs. They are currently working on employing internal teams to fix the identified issues. Additionally, the creation of a detailed presentation and report allowed the teams to focus on addressing the well-defined roadblocks in user journeys, allowing them to focus on prototyping actionable solutions.

Project Outcomes

Please click on images to learn more about the design outcomes