Case Study
Optimizing Digital Member Portals: A Competitive UX Assessment Across Insurance Types
overview
Agile Qualitative Research to Benchmark and Improve PBM User Experience
As digital healthcare access becomes the norm, pharmacy benefit managers (PBMs) must ensure their online and mobile portals are intuitive, informative, and user-centered. A leading pharmacy solutions company sought to deepen its understanding of how Medicare, Medicaid, and Commercial plan members perceive and use competitor portals. This research explored what users expect, what frustrates them, and what opportunities exist to elevate the digital experience—ultimately guiding strategic enhancements to better serve all member types.
THE PROBLEM
Navigating Evolving Expectations for PBM Digital Platforms
As digital experiences become central to healthcare access and management, there’s increasing pressure to deliver user-friendly, informative, and seamless digital tools. With members turning to web and mobile portals for everything from medication tracking to cost transparency, the stakes are high for PBMs to meet evolving expectations.
However, challenges remain:
- Member familiarity and engagement with digital tools vary widely.
- Experiences can differ based on insurance type and medication needs.
- Competing pharmacy and health platforms are raising the bar with intuitive features and integrated services.
To remain competitive and relevant, our client needed a comprehensive understanding of how their digital experience compares to others in the market—and where the greatest opportunities lie to enhance usability, satisfaction, and long-term engagement.
OUR APPROACH
In-Depth Qualitative Interviews With Real Users of Competitor PBMs
Our research team conducted webcam-based interviews with members across key insurance types (Medicare, Medicaid, and Commercial) who were actively using portals from major PBM competitors.
Key Features of Our Approach Included:
- Lookbacks to observe real-time digital behaviors on both desktop and mobile.
- Task-based explorations such as accessing cost estimates, finding in-network pharmacies, and viewing medication lists.
- Segmented insights by insurance type and medication complexity to uncover nuanced needs.
- Behavioral and emotional drivers captured through qualitative depth and open dialogue.
This approach allowed us to observe natural portal use, assess usability, and identify unmet needs in context—not just in theory.
The result
Clear Guidance to Build a More Proactive, Personalized, and Integrated Portal
Our research uncovered actionable insights and strategic recommendations for our pharmacy solutions client to advance their digital roadmap:
- Promote Tool Awareness: Help members discover and understand key features.
- Simplify Navigation: Streamline access to essential information.
- Design for All Users: Address both simple and complex healthcare needs.
- Highlight High-Value Features: Make essential tools easier to find.
- Create a Seamless Experience: Better connect pharmacy, benefits, and insurance touchpoints.
By grounding portal development in real-world behaviors and competitor benchmarks, the client is positioned to offer a digital experience that not only meets expectations—but anticipates them.
proven experience
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