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Typically, receiving a Net Promoter Score depends on the customer taking the time to complete a survey; however, CVS Health is now using its huge quantities of data to create predictive NPS, using the data that they have about a customer’s journey to infer their score.
The healthcare company receives an average of 18 million NPS surveys every year from a customer base of more than 100 million Americans, which includes customers of Aetna, CVS’ health insurance brand, and Caremark, CVS Health’s pharmacy benefit manager (PBM).
“In 2025, [we] will have about 250 million imputed customer scores … we are scoring call transcripts, digital engagement, store experiences – we know, and we can with high accuracy predict what we think you felt about the experience based on all the knowledge we’ve gleaned over the past few years having NPS as our north star,” explained Michelle Peluso, EVP and Chief Customer and Experience Officer.
Thanks to this analysis, Peluso said that CVS Health can quantify the elements of the customer experience that would lead to a poor NPS score for a first-time customer – without needing to send a survey.
“We know for certain that if you are a first [prescription] filler with us, if you pay more than $100 for your prescription – no matter what the reason … If you wait more than 20 minutes or if we send you a text that says it’s ready and when you arrive, it’s not ready, we know you are going to be a detractor.
“…We should get in front of that right away. …And we will outbound email somebody; outbound text them; outbound call them; and say, ‘Look, we’re sorry – we didn’t get it right.’ We apologise for that, and [say], ‘Here’s ten dollars to shop our store.’
“When we do that, in the next survey, we see a 30-point NPS bump. People are so appreciative.” Peluso pointed out that airlines do this when a customer experiences a severe flight delay.
“There’s so much more power in this [customer] data.”
Responding to every single detractor
Peluso was speaking to Jon Dick, SVP Customer Success at Hubspot, at the CRM’s conference, Inbound 2024 (September 18-20). The CVS Health EVP discussed why NPS data is a “north star measurement system” for the company, and how predictive analytics allows the brand to get in front of what dissatisfies customers.
When CVS Health set out to use NPS as a “north star”, Peluso said, “I and the team made a commitment – we had a whole executive session on this – we were not going to ask the Net Promoter survey question unless we were willing to do something about it.”
Any customer who rates the brand a 0-6 when asked whether they would recommend it to a friend or colleague is considered a detractor, and Peluso said that the team pledged that, “we would respond to every single detractor”.
“We get back to them with email or phone call saying, ‘We’re sorry this happened; here’s what we’re doing to improve it.’ In some cases we can intervene directly with the customer experience and make it right.”
Tying NPS back to financial outcomes
Another tangible dimension to CVS Health’s work with Net Promoter Scores has been the ability to tie the data to financial outcomes for the brand – particularly invaluable when it comes to making the case for optimising the customer experience to the C-suite or finance department.
Peluso noted that customers on Medicare have a high likelihood of churning within the first few months, but if they can successfully be moved from detractors to promoters, “They have a 3x less likelihood of churning. That is a massive financial impact – that is thousands and thousands of dollars’ lifetime value for us.”
Peluso also detailed that customers who are classed as promoters shop twice as much in-store, spend twice as much, adhere to their medications more successfully, and churn half as much as detractors.
“The ability to take that information and tie it back to the financial metrics of the company has been an unlock for us. We are working with the CFO, with the finance organisation to say, ‘How do we make the customer experience better? And how do we trace that in the P&L?’”
Creating “delight” in “moments that matter”
Peluso said that she encourages her team to “do the hard work to fix the problems [with detractors] – we can’t be the marketers who [only] look at the shiny object”. However, working to “create delight” for promoters and earn NPS scores of 9 and 10 is another major piece of what the brand does.
“The job is ‘both and’,” said Peluso. “Fix the problems, create delight.”
What this looks like in practice is training employees to go above and beyond: CVS Health has worked with the Disney Institute to create a culture of “delight” and train all employees on six service actions, such as giving the customer a warm greeting when they enter a store. Other personalised touches might involve a hand-written note from Aetna to congratulate a customer on the birth of their first child.
One of CVS Health’s newer subsidiaries is Oak Street Health, a network of primary care centres for older adults that was acquired in 2023. Peluso said that CVS has been “intensely” surveying seniors and “asking them for their feedback in open-ended ways about how they think about health and wellbeing”, which led to a lot of insight into the ‘moments that matter’ to them – such as moving across the country, or the loss of a loved one.
“When you talk to seniors, there’s these moments that matter to older Americans that we don’t normally think about … We don’t track those in our traditional system, and yet we know from seniors that it affects a lot of things.” Learning about the importance of house moves led to CVS Health sending customers an information packet when they’re preparing to move to help them change their prescriptions, along with welcome products – including a picture frame – and information on a local Oak Street Health community event.
“How do we get in front of these moments and provide something delightful?”
How CVS Health is using generative AI
As has become standard for major companies, CVS Health is experimenting with the usage of generative AI, although Peluso emphasised that the company wants to make sure “that we’re tying these [pilots] back to outcomes that we can measure” and that CVS is “put[ting] this in place in ways that can be trusted”.
Some of the key ways that CVS Health is using generative AI is to summarise customer calls in its call centre: this saves time that agents would otherwise spend summarising the conversation after a call, and also ensures that summaries contain less jargon than would normally be used by customer service agents.
“[As a result] we have a great record of what the customer said – you can imagine how good that is for finding root causes, to really understand what’s driving calls; what’s causing customer frustration.”
The technology also enables customer service agents to pay closer attention to the call as it’s in progress and be more empathetic; it also means that if a customer wants a record of a call, it can easily be sent on.
CVS Health has also developed a tool called ‘Knowledge Assist’, which aids in providing answers to health questions quickly – “that they can assess and decide if this is the right answer to pass onto the customer” – and reducing the time that customers spend on hold. Generative AI is also used to compose first responses to customers.
“So, both those benefits of being more present for the customer [and] reducing average handle time are financial benefits that we can really measure.”
As an industry, Peluso said that healthcare is “changing fast but it has to change faster … [We] know we have to pick up the pace. How do we remove barriers to care? How do we simplify experiences for consumers? … Even if we can’t solve every financial issue – how do we at least provide more transparency on what things are going to cost? How do we simplify options for you?
“…We have so much more to do to truly be an industry that puts the consumer at the centre. The work has just begun.”
