Challenge

Following a Star rating decline, BCBSMA needed to understand the root causes of poor member experience and identify strategic priorities for improvement. The organization lacked a systematic way to connect qualitative member feedback to quantitative CAHPS performance.

Approach

I designed and led a comprehensive mixed-methods research program that combined large-scale qualitative analysis with quantitative validation:

• Grievance Analysis: Conducted simultaneous coding of 1,000+ member grievances, building and iterating a structured codebook to ensure consistency
• In-Depth Interviews: Synthesized insights from 150 member interviews to surface emotional drivers and journey pain points
• Quantitative Validation: Mapped theme mentions against member-level Mock CAHPS ratings across eight domains to identify the strongest drivers of poor experience
• Pattern Synthesis: Translated coded data into decision-ready themes and problem statements

Key Insights

The analysis revealed that member experience issues clustered around specific journey moments rather than general satisfaction. The strongest predictors of low CAHPS scores were related to care coordination gaps and communication breakdowns during transitions—not the clinical care itself.

Impact

Deliverables

Executive-facing decks and talking points synthesizing behavioral insights for SVP and VP audiences, dashboards to track CAHPS-related initiatives, and a strategic priorities document guiding 2026 enterprise planning.

Challenge

BCBSMA's "Find a Doctor" tool wasn't effectively guiding members toward high-value providers. Despite having cost and quality data available, members weren't using this information to make informed decisions, resulting in suboptimal provider selection and higher costs.

Approach

I applied behavioral science principles to redesign the provider search experience:

• Behavioral Audit: Analyzed the existing interface for choice architecture issues, identifying friction points and cognitive overload in the decision process
• Choice Architecture Redesign: Applied principles of smart defaults, salience, and simplification to surface cost/quality information at key decision moments
• Personalization: Designed algorithms to deliver personalized provider recommendations based on member needs and preferences
• RCT Evaluation: Designed and implemented a randomized controlled trial to measure the impact of the redesigned experience

Key Insights

Members weren't ignoring quality information—they were overwhelmed by it. By restructuring how and when information was presented, we reduced cognitive load while increasing engagement with the data that mattered most for decision-making.

Impact

Deliverables

Behavioral audit documentation, redesigned interface specifications with choice architecture annotations, A/B test design and analysis plan, and post-launch impact report for stakeholders.

Challenge

Member dashboards and care navigation hubs weren't driving engagement with high-value preventive care. Despite having the right content, members weren't finding or acting on important health information, leading to missed opportunities for preventive care and early intervention.

Approach

I conducted a comprehensive behavioral audit to identify opportunities for improvement:

• Journey Mapping: Mapped member journeys through the dashboard to identify friction points, emotional moments, and leverage points
• Behavioral Audit: Analyzed the existing interface for attention allocation, information hierarchy, and call-to-action effectiveness
• Friction Identification: Documented specific barriers preventing members from engaging with preventive care content
• Redesign Recommendations: Proposed homepage changes grounded in behavioral principles to increase salience of high-value actions

Key Insights

The homepage was optimized for information display, not action. High-value preventive care content was buried below the fold and competing with lower-priority items. By restructuring the visual hierarchy and reducing competing elements, we could direct attention to what mattered most.

Impact

Deliverables

Behavioral audit report with annotated screenshots, journey maps highlighting friction points and opportunities, homepage redesign recommendations with behavioral rationale, and measurement framework for ongoing optimization.