Making it easier to sign up for health insurance: Transforming the Medical Services Plan

Context and questions

The Medical Services Plan (MSP) is British Columbia’s public health insurance. It covers the cost of medically-necessary insured physician services. New B.C. residents, existing residents applying for financial support through Premium Assistance, and residents changing marital or living status are all required to enroll or update their personal information with MSP in order to receive coverage.

In 2016, MSP received 130,000 enrolment and 147,680 Premium Assistance applications. Thirty percent of application forms were returned due to errors. As the applications were paper-based, citizens found the process frustrating-- especially new B.C. residents, 18-20 year olds, and seniors. Finding relevant information online or in print was equally frustrating.

To improve the enrolment and Premium Assistance application processes, the Ministry of Health wanted to introduce a digital self-serve product, an online enrolment form. The project was guided by the following objectives:

• Improve how MSP and Premium Assistance are delivered to the public online, specifically focusing on overall service awareness, enrolment, and communications.
• Provide recommendations to inform development of a digital enrolment solution based on the needs of B.C. citizens.

Our approach

Working together, the Ministry of Health and the Service Design Team took an iterative, citizen-focused approach to the development of online services.

The project included three key phases:

1. Desk and field research. First, a jurisdictional analysis of health insurance plans in Canada was completed. Then, the team spoke with 62 people across B.C. including First Nations health authorities support workers, Service BC frontline staff, HIBC customer service managers, third-party support workers, and residents.
    
2. Prototyping and testing. The team took an agile approach to design and development and engaged citizens and key stakeholders in prototyping and testing to improve the usability of the digital forms.
    
3. Implementing better services. Once basic working online forms were developed  MSP and Premium Assistance enrolment, they were released to the public without marketing or advertising. 

Outcomes that matter

Iteration is key. Even though the online enrolment forms were released without marketing or advertising, over 1,000 applications were submitted in the first week. The team tracked application error rates, which after launch initially dropped but soon bounced back up. The team identified the key issues, iterated a solution, and ultimately brought the error rate down to its current one percent.

Normalizing the conversation about data. The project focused on a data-driven approach to service delivery and prototyped and tested solutions based on statistical evidence and user research – even with limited government resources.

Improve the service, then improve delivery. A key insight from research was that before government invests in the digital delivery of services, they first need to improve the service itself. The project demonstrated the value that service design brings to digital transformation, both in healthcare and other government services.

Artefacts

MSP Online Enrollment Form

MSP Eligibility and Enrollment Information

@Work Blog “Making Digital Services Work” (Internal to BC Government Employees)

@Work Webinar “Making Digital Services Work” (Internal to BC Government Employees)