Remarkable Leadership: Stacy Byers, Senior Vice President, Experience, Design and Digital

• By:  Don Bertschman
• Posted:  July 31, 2024
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Stacy Byers is Highmark Health's senior vice president, Experience, Design and Digital. The title barely scratches the surface of her impact — more than 20 years of evolving customer-centric capabilities and values that have become Highmark Health differentiators.

Customer experience (CX) is the heart of the organization's mission — to create a remarkable health experience, freeing people to be their best. And its Living Health model literally places the health experience at its center. Boldly proposing to align payers, providers, technology partners, and community organizations on improving the whole ecosystem around each person's health, the model shifts the focus from episodic coverage and care transactions to giving people the resources and support to engage in "living health" every day.

Byers generously took time for an in-depth interview on Highmark Health's CX journey, how CX and human-centered design shape its work, and insights on successful CX transformation.

Walking a mile in a member's shoes

Don Bertschman: Before we get into customer experience, tell me a bit about your motivations and how you got you into the health industry.

Stacy Byers: I started my career as an English professor. With teaching, you're very close to outcomes — you see where you make a difference in people's lives. That's always been important to me.

What's interesting is that while I was in the academic world, I had a complicated health issue and spent a lot of money — it nearly broke me. Years later when I joined Highmark, I learned that everything would have been covered — if I had turned in the right paperwork. I had an advanced degree in understanding and interpreting difficult texts, but my health benefits were so unclear that I took on unnecessary medical debt.

When I changed careers and joined Highmark, I saw the opportunity to help people avoid problems like I'd had. That's been a focus and guiding principle — how can we help people navigate the system and make it easier to understand? Leaving teaching, I expected to feel a loss around making a difference in people's lives, but I soon realized how much companies like Highmark can do to help people, and that I could be part of that.

An "eras tour" of customer experience

Don Bertschman: You have been part of an amazing CX transformation. Can you walk us through the different eras in that transformation?

Stacy Byers: Our CX "eras tour"? Sure. My first era was mostly improving our website. When I arrived, it was three pages of brochureware, so my job was to help create a database-driven, dynamic site that could solve problems for our members — starting with the basics like explaining benefits. Operationally, I was a bridge between business requirements and IT. This was maybe the start of approaching decisions through a Venn Diagram of feasible, viable, desirable. What is desirable for the customer, feasible in terms of technology, and viable for the business? Where do those overlap? Giving customer experience that weight in decisions is a big first step in any CX journey.

That first era was addressing those fundamental needs, mostly with existing resources. Around 2010 I would say we move into a second era, where we start prioritizing design and bringing in people who have training and expertise in user experience and human-centered design. With changes from the ACA, changes in technology, and changing consumer expectations, we saw that we had to change as well. To remain an industry leader, we had to invest in customer experience capabilities.

A third era, starting around 2016, transformed how we fund digital and see customer experience within the organization. Up to then, we're expanding CX expertise and making improvements, but it is project by project. Each project has funding and resource hurdles, you need to assemble people from siloed teams, and then the next project you do it all again. If we wanted to take on and accomplish more, that was unsustainable. So we created Atlas — a cross-functional team-based approach to digital. We blended design, development, strategy, and technology in one entity, with each area reporting directly to me. We funded it in a consistent way, annually, with a focus on specific outcomes. That structure helped us think about how to improve the ways we worked together. In this era, we're also building our customer archetypes and personas, our customer journeys, our human-centered design practice, metrics — by the time we rolled out the Living Health model, customer experience had become central to our business.

Don Bertschman: And that's a fourth era — Living Health taking shape up to now?

Stacy Byers: Living Health, and also expanding CX transformation throughout the company. When my team was in Marketing, the work tended to be seen as "a marketing project," right? To have a more fundamental impact, CX needed to move closer to product development, design and delivery. That's why we're now in the Product and Health Experience organization under Tracy Saula. We took experience people, research people, design people, and embedded our work in the product portfolios in a new way.

Don Bertschman: What might define the next era?

Stacy Byers: I am very excited about what's next. Internally, we talk about moving from a more traditional organization, where work sits in silos, to a product-led organization. That means you start with a customer problem to solve, and instead of funding one pocket of work here and another over there, you pool funding around the product that solves that problem. You have a cross-functional team that is accountable, together, for achieving the desired outcomes. My Highmark may be our closest, in-production example of what that looks like. Tying everything to the customer experience and product reduces the tactical redundancy and data debt of different functions each having their own road maps.

Living Health: Leading with the health experience

Don Bertschman: Can you elaborate on My Highmark as an example of CX capabilities in action?

Stacy Byers: My Highmark starts with a problem we want to solve for customers. People have a super-fragmented health experience because there are so many digital point solutions — sites for your insurer and providers, a site for your employer's wellness program, all these digital health apps. You have 10 different login IDs, but none of the solutions connect, and there is no data flow providing insight or proactively triggering an action or response.

We designed My Highmark to bring more of your health experience together. Let's combine what people expect on an insurer website with point solutions and information specific to your health. Let's use a cloud-based data structure and advanced analytics to turn the data you provide into personalized recommendations.

As an example, our employee wellness rewards program is now part of My Highmark. It includes an accredited questionnaire, and based on data from those questions, My Highmark might pop up a message that you're eligible for a certain program, or suggest resources in your area, or alert a health coach to reach out and help you.

We're still early in realizing our vision. As vendors and provider partners in our industry mature toward API-based systems, we will be able to provide a seamless experience that's more like your banking app. Your banking app runs off a significant number of point solution vendors, but with API integrations, you don't see or log in to anything other than your bank's app.

Don Bertschman: I like that framework of starting with a customer problem — any other examples come to mind?

Stacy Byers: Payment simplification and the digital solution with Cedar Pay is another good start-to-finish example. That began by looking at customer satisfaction data — billing popped hard as one of the most significant drivers of dissatisfaction in any part of the health experience. So we went to work identifying the specific problems, developed solution concepts, and tested them with consumers. Then, with Cedar Pay, we found the right technology partner to deliver a solution. Now you can get a text message when you have a bill, it's clear what you owe, and it's one click to pay. Payment plans are right there at the point of payment. The satisfaction on this solution is excellent, and the business benefit is that more people pay their bills on time. So that is a perfect example of desirable for the customer, feasible technologically, and viable for the business.

Don Bertschman: Many CX resources you mentioned are available on a site that team members can access. I'll quote something from that site (emphasis mine):

"a customer-first approach comes down to two basic principles: build trust with your customers, and meet them where they already are. We can't change who people are or expect them to learn complex health care concepts, but we can change the system we've created to meet their health and health care needs."

To me, that is Living Health — a human-centered, systemic model that starts with a realistic view of people, recognizes a whole ecosystem impacting their health, and then looks for ways to problem-solve and optimize within that ecosystem.

Stacy Byers: That language was inspired by work on our foundational customer experience strategy. Our industry tends to think about people as their "segment" — commercial plans, the ACA population, Medicare Advantage members. But people aren't their purchasing method for coverage, people are people. To get at the root issues for improving the health experience, and ultimately outcomes and cost, we have to understand people's different motivations, perceptions and needs. We did a lot of research on that and created six archetypes to help us match what we're working on to different kinds of people.

So, a solution to help manage hypertension has to be clinically sound, but we also have to understand who needs it, how best to inform different people about it and motivate them to use it, and what barriers stand in the way. Another example is annual PCP visits. Traditional outreach might be a mass email or letter basically saying "get your annual exam." That's fine for people who just need a reminder, but if someone can't get to a PCP office when it's open because of work schedule or transportation issues, no number of outreach letters will change that. If you're problem-solving for people like that, you might instead look at virtual PCP capabilities or at-home testing.

Insights on CX transformation

Don Bertschman: In terms of CX capabilities, how do we stack up against others in our industry?

Stacy Byers: Our level of foundational work doesn't exist in many organizations. If you look at third-party benchmarks, we tend to be toward the top of health insurance. Internally, we did a competitive digital assessment in 2023, and we were right at the top in many areas. But I would say that's not good enough — the benchmark should be retail and financial services. Relative to those industries, there is more to be done.

Don Bertschman: Acknowledging that — do you have suggestions for people at health industry organizations that are earlier in their CX journeys and would love to get where we are now?

Stacy Byers: You have to start somewhere — start small, but start. Looking back over a long trajectory, I can say, gosh, that's a big transformation, but it's built on many small changes. For example, when I saw the need to hire people with design backgrounds, which we had never done, I started by hiring two people. As leaders saw the value of design work, we were able to hire a few more, and eventually build specialized teams. But that was over years. If I had said in 2010, I need 50 people with specialized skills so we can do a CX transformation…nobody would buy into that.

I also emphasize developing and maintaining a clear focus. We didn't have much funding or dedicated staff to start, but we used a Forrester model for CX transformation and worked through all the components. We knew we couldn't do everything at once, but we established a clear focus with our vision, strategy and guiding principles.

People doing CX at other companies often ask me, how do you get money for experience initiatives? I always tell them, you don't. You never do just experience initiatives. You do initiatives that resolve experience problems while also resolving business problems. If you can't prove you can do both, you won't get the funding you need to make a difference. Also, there are business implications to every customer experience insight and recommendation. We can't just say, costs are a customer problem, so the solution is to make everything free, right? We need to create solutions that are customer first and financially sustainable.

Don Bertschman: This could be an entire article, but any high-level advice on measuring and socializing the impact of CX work?

Stacy Byers: Most people doing CX work are familiar with Net Promoter Score (NPS). In 2019 we began collecting NPS as a formal quant study — 10,000 members every year. The point I'll make is that NPS by itself is just a number, and people don't always get it. So we map NPS scores to the customer journey and use a framework, EVOKE, to understand what's driving scores. We assess Ease, Value (getting what you need), clarity on what you Owe, the Knowledge needed to understand and make decisions, and Emotion — feeling seen, heard and respected. That framework translates well to tactics — did this change we made improve Ease of use? Do members feel they have the Knowledge they need at this touchpoint?

As far as socializing CX — we use our CX resource center, we have a video reviewing NPS results, we do sessions with individual groups, and we're always looking for ways to make our data and insights more visible. I'll also mention customer immersion. One effective way to help people understand the customer is to have them live customer experiences. Karen Hanlon, our chief operating officer, invited us to do 15-minute customer immersion sessions as part of her leadership team meetings. At some point, Tracy Saula asked how I would do customer immersion on a larger scale, and I said I'd do something like I've seen in some retail organizations, where employees, regardless of role, have to spend time on the floor every year living the store associate's life and living the customer experience. So now we are piloting a customer immersion program within her organization — and remember, these are people who have the product portfolios aligned to Living Health. They have to earn a set number of annual credits, choosing from 15 customer immersion opportunities, like shadowing an associate at a Highmark Direct store, rounding at one of our hospitals, or observing member service calls.

Don Bertschman: On a personal note, I took Highmark Health's human-centered design training, and it really drove home the breadth of CX culture here — my training cohort included people from all over the organization.

Stacy Byers: Human-centered design has been an important part of our journey. In our first year, I think we trained 10 people. Eventually we worked with Luma to certify some team members as teachers, and now we have trained almost 700 people in human-centered design, and there is a community of practice that meets and has a Teams group to share insights and support each other. Human-centered design influences many projects, because people do the training and then go back to their area of the organization and champion the methods and mindset.

So that's another example of starting small and identifying people who have skills and passion and will take a run at something different. At one point we had a small core group of five and I kid you not when I say we sat down with an org chart and said, alright, which people will be our best promoters because of their scope, influence and interests? We each picked a couple people, and we committed to spending time with them, getting them on board, giving them the tools and information to share in the journey.

We have built a lot of capability and cultural momentum since then. People don't just say "customer first," they act on it. Karen Hanlon talks about CX in interviews and at industry events. David Holmberg, our CEO, has been a strong advocate for consumer-centric change in our industry. As I said, there is still work to be done, but I'm excited about what we've accomplished, I'm excited about our next five-year strategy taking shape, and I'm excited to continue the journey.