How Bupa is transforming healthcare as we know it

The Business Issue

Bupa Australia has a simple mission – to help its customers live longer, healthier, happier lives. As a healthcare payer and provider, Bupa faced the industry-wide challenge of meeting ever-rising customer expectations. Their diverse service offerings – spanning private health insurance, dental, optical, hearing, aged care, and primary health centers – required a unified approach to customer interactions. With customers comparing their experiences to digital-first companies beyond the healthcare sector (like Google and Spotify), Bupa knew it needed to be able to deliver equally exceptional and tailored experiences – all while maintaining compliance.

Additionally, Bupa's growth through acquisitions had resulted in a patchwork of legacy systems, complicating efforts to deliver a cohesive and personalized customer experience. The onset of COVID-19 further accelerated the need for digital engagement, as traditional in-person interactions were disrupted.

With this in mind, Bupa Australia embarked on a journey to become the world’s most customer-centric healthcare company.

The company commissioned research to identify the essential aspects of its customer experience that needed improvement. They discovered 11 key areas of focus. These moments ranged from basic hygiene factors, such as transparent payment processes and effective claims management, to more exciting and personalized experiences based on customer history and preferences.

The Solution

Bupa Australia implemented the Pega Customer Decision Hub™ to achieve its vision of personalized, two-way customer conversations, enriched with empathy and emotion. Bupa initially focused only on outbound communication but quickly expanded to create a 360-degree view of each customer.

First, they mapped out a target state architecture to unify customer data, serve enriched audiences, and distribute personalized content across multiple channels. This included integrating Pega Customer Decision Hub™ within Bupa's existing systems to create a seamless, omni-channel customer engagement engine.

Bupa adopted an agile delivery model, forming cross-functional squads that included marketers, product owners, solution architects, and testers. This collaborative approach ensured rapid iteration and alignment across teams.

Pega Customer Decision Hub proved to be an effective tool for scaling Bupa's ambition of hyper-personalization. It analyzes billions of data points to determine the right course of action, for a one-to-one experience as unique as every customer.

They automated multiple processes with Pega Customer Decision Hub, including:

1. Personalized sales pathways: By personalizing the customer journey for visitors to their website, Bupa achieved a response rate for abandoned cart campaigns that surpassed the industry standard by 60%. This initiative generated an annualized incremental revenue of $5.2 million, making it a promising revenue driver.
2. Optical referrals: Bupa improved the efficiency and effectiveness of its optical referral campaigns by leveraging real-time data and micro-segmentation. This approach doubled response rates and demonstrated the value of simplified and targeted messaging, while generating $2.4 million in annualized incremental revenue. The success of this use case led to valuable insights that could be applied to other areas of Bupa's business.
3. Post-surgery recovery support: Bupa focused on supporting members recovering at home after surgeries, starting with hip and knee surgeries. By leveraging Pega Customer Decision Hub, the organization achieved engagement rates of over 80% with members. Notably, this initiative resulted in zero changes to contact preferences, a rare feat in marketing history. Bupa estimated near $5 million in annualized cost savings from this initiative and explored opportunities to extend similar support for other surgeries.

The Results

Previously, Bupa primarily communicated with policyholders, but now it can engage with all members, leading to a more inclusive and personalized approach. With automation and machine learning in place, Bupa’s employees have more capacity to shape strategy and value for the future.

Within the first six months of implementing Pega Customer Decision Hub, Bupa saw:

• More than 50% uplift in delivery efficiency
• More than $1M savings in partnership spend by reducing reliance on outsourced communication delivery
• More than 30% increase in customer responses to targeted conversations
• 0.7% reduction in customer opt outs
• More than 127 next-best-action recommendations live in Pega Customer Decision Hub

Bupa then continued their journey, transforming their customer engagement strategies and driving significant outcomes:

• Increased digital engagement: Post-COVID, Bupa observed a dramatic shift in customer behavior, with digital becoming the channel of choice. Implementing Customer Decision Hub enabled Bupa to process nearly 100% of claims digitally, achieving zero-touch interactions and streamlining customer experiences.
• Enhanced personalization: Bupa's personalized health propositions, such as mental health and maternal care programs, saw a 50% year-over-year increase in engagement. The ability to deliver hyper-targeted offers and suppress irrelevant messages helped Bupa maintain relevance in customer interactions.
• Operational efficiency: Bupa’s marketing teams leveraged Pega Infinity’s AI capabilities to enhance their workflows and deliver more personalized experiences – reducing time-to-market for personalized content by 20–50%.
• Unified customer experience: The successful integration of Bupa's diverse service offerings into a cohesive customer engagement engine is enabling them to deliver consistent, personalized experiences across all touchpoints – boosting customer satisfaction and loyalty.