How Flexpa converts 70% of user authorizations
Learn how 70.59% of all user authorization attempts through Flexpa succeed, where the rest drop off, and research we've conducted on member activation rates.
If you are new to our blog, welcome! Flexpa is the easiest way for any U.S. resident to access and delegate their electronic healthcare claims data.
Introduction
Flexpa’s product requires that every member individually consent to their data being shared. This individual consent requires inputting login credentials to their online health insurance portal. You might be wondering, as we were as well, the following two questions:
How many people have an online account anyways?
I don’t think users will remember their logins.
The underlying question here is: “What would Flexpa’s conversion rate be?”
We have been collecting industry data and analyzing our own results over the last two years to construct answers here. Today, we’re excited to share data on our conversion rates with you as well as how we think about those two questions specifically.
Flexpa’s conversion rates
Through user connections and our user testing program, we’ve devoted significant time to deeply understanding payer workflows and member pain points to decrease drop-off. We believe our conversion rates speak to these efforts.
70.59%
of all user authorization attempts through Flexpa succeed.
75.39%
of all Medicare and Medicare Advantage users authorization attempts are successful.
67.76%
of all users complete the Flexpa flow within 3 minutes. 85.29% complete it within 5 minutes.
Users have also attested to Flexpa’s ease of use:
"I was able to log in to my Blue Cross Blue Shield, app on the website and I was able to follow the directions from your web site without any difficulty."
- 74-year-old member from Tennessee
We aim to prevent errors before they happen but know there will always be users who need support. On the user side, we’ve developed patient guides to help users connect or troubleshoot their connections, and provided pathways to submit support requests along every part of the Flexpa workflow. Our users have complimented how quickly we turn around responses to them. For our customers, we offer joint Slack channels to provide real-time support on any development or user needs.
What causes drop off?
Where does the ~30% drop off occur? We monitor and internally alarm on nearly every error encountered across the Flexpa user experience. When a user abandons the flow, we track where and when that happens to glean insights on how we can improve.
25.21%
Of the users who didn’t succeed in the Flexpa flow abandoned it part way.
Where does abandonment happen? By far, our greatest drop occurs after redirecting to the payer’s login page. We have written extensively about this in the past, which you can read about here. Here the experience is controlled by the payer, but we do our part by funneling feedback and suggestions back to the payer. In two cases we are actively working with vendors to display improved error messaging that could impact up to 75 health plans. With each payer-nuanced learning, we add to our patient guides to continue empowering users and customer support teams with the ability to resolve errors on their own.
2.16%
Of the users who didn’t succeed in the Flexpa flow ran into an error. Where do the errors come from?
48.43% are payer side issues. These can range from faulty implementations where the configuration or data syncing isn’t functioning properly, to server errors, to eligibility issues where members on CMS-mandated plans are not supported.
22.14% are due to no resources being fetched. The majority of these errors actually have similar causes as the above payer issues. Data might be missing in the payer/vendor databases, FHIR resource calls may not be returning correctly, or there are faulty implementations of the Patient Access API
15.61% are sessions where the member rejected the consent. We are unsure why these members may not agree to share their data, but this is a valid contingent of people.
11.16% are members of commercial/employer-based plans. These lines of business are not mandatorily supported via the Patient Access API today.
2.67% are legitimate errors that Flexpa needs to fix. We have dramatically lowered this number as we alarm on all errors and work to rectify them as fast as we can. Some are technical and some are due to members’ inability to find a support carrier in our UI.
Customer-to-customer variation is also something we see. Flexpa’s conversion rate across the board is 70.59%. Segmenting by customer, our customer with the highest conversion rate comes in with a whopping 82.43% success rate, with the lowest at 27.77%. We find that the single largest contributor to the success of this number is a customer’s ability to express the value proposition to their users. Users need to feel like there is something in it for them, be it a better health outcome, time savings, cost savings, or other incentive. We’ve written up tips on onboarding and workflows for our customers based on our knowledge here.
Online account activation
Now that we’ve discussed our conversion rate and reasons for dropoff, let’s tackle those two questions in more detail.
How many people have an online account anyways?
I don’t think users will remember their logins.
We polled over a dozen of our payer partners on their online memberships to understand online activation rates. On average 19.68% of a payer’s membership base had logged in to an online accounts, with the highest payer hitting 60%. There are many reasons why this may be low at a population scale:
Infrequent healthcare system use: Many people, especially those in good health, may only interact with the healthcare system once or twice a year for routine check-ups, leaving little perceived need to engage with their insurance portal regularly.
Medicaid members' reduced financial incentive: Medicaid members generally have lower out-of-pocket costs, which could reduce their need to monitor claims or manage payments through a portal.
Preference for mobile apps: Many health insurance companies now offer a mobile app in addition to a web portal for users who might prefer the app and not create a separate web portal account. This stat does not capture those users.
Limited perceived value: Members might not see the immediate benefits of using the portal until they need to find a doctor or dispute a claim. If the features aren't compelling or don't address pressing needs, users may not be motivated to create an account.
In practice, our customers hit much higher conversion rates because in addition to having a strong value prop, they target a population that is more digitally native, and more engaged in their health.
To better understand this segment of the market, Flexpa independently conducted a 1,268 person survey asking whether people already had existing online accounts with their health insurance carrier.
89.70%
of respondents already had existing online accounts with their health insurance carrier.
The survey was limited to residents of the United States who were actively insured. The 1,268 respondents spanned residents across 49 states, and included people between the ages of 18 to 75.
This is the true baseline that Flexpa customers are working with. You’ll also notice that across age brackets, the percentage of respondents who already created an online account stays constant. Of the digitally native, while young adults and working-class Americans are largely considered tech-savvy, there is a long-held assumption that Medicare-aged populations may struggle. Our experience, with 75% of Medicare and MA members authorizing successfully tells a different story. But don’t just take our word for it. CMS published research in 2022 stating that
“Among Medicare beneficiaries living in the [community (i.e., not in a long-term care facility such as a nursing home)] in 2022, 62 percent ever used the internet to look up health information, 47 percent recently participated in video or voice calls over the internet, and 43 percent used the internet to communicate with a health care provider.”
Every year increasing percentages of the population become digitally native, and this is especially true in digital health.
Let’s say a customer targets a population largely without online accounts. Flexpa helps redirect and guide users through registration processes, thereby increasing conversion and payer activations rates. We have documented in great detail the registration process for the top 16 payers to assist with this process. In addition to adding more payers to this guide, we continue to request payers and vendors to add links to registration workflows on the login screens. With one particular vendor, our suggestions directly led to 8 payer implementations being updated with registration links and customer logos for improved user experiences.
Remembering logins
Evaluating the frequency of users remembering their online credentials is a difficult statistic to measure accurately. In the OAuth flow, once a member is redirected to the payer’s login screen, to protect the privacy and security of members, Flexpa no longer has visibility into user behavior or system logs. As such, there is no way for us to know quantitatively whether a user’s attempted credentials were correct and the payer’s system had an error, or whether the user made an error. However, we do know that password reset functionality is universally available, and easy for members to complete.
“As I went through the flow with the Medicaid and the different aspects of the website. I found it easy to log in. There was only the issue of When I put my email in, I used the wrong one and I couldn't remember which email address it was, but when it tried to send it, it said that there was no account with that email. So I just switched when I was using it and I was able to get the code very easily.”
- 34 year old member from Nevada
“When I try to log in originally, I wouldn't connect to the Ameri Health. And so, I actually changed my password to get in. And then it took a couple of times after I changed it and I got in.”
- 59 year old member from Delaware
In our moderated user testing sessions, we’ve seen many users work around the password problem in two ways:
They use a password manager to auto-fill their username and password
Some payers store session cookies in the browser. This means that a member who has recently logged in may be able to fly through the Flexpa authorization because the browser recognizes the user and automatically authenticates.
For these reasons, even if a member does not remember their password on the first go around, resetting their password is not a barrier to connecting their accounts. Password resets have been easily surmountable by our users.
What’s next
Our mission is to get our conversion rate as close to 100% as possible across all customers. We continue to track each step of the flow, monitor member requests, and perform payer outreach to increase these numbers. We believe in members’ right to freely access their data and provision that access to whomever they want. We remain committed to removing any barriers that prevent this in the Flexpa flow.
Authorization is the first step in the door. If members can’t get in, we can’t unlock their data and all the benefits that come after. Flexpa will continue to do our part with routine user testing and close payer collaboration. We’ve written extensively on our research of the landscape of payer login implementations here, and urge those with roundabout workflows to streamline the user experience. We are happy to help anytime - just reach out at interop@flexpa.com.