Member Engagement: A “Must-Have” for Health Plans Today

As Health Reform is constantly unfold, the eye rate of change is acquiring speed, as new kinds of reimbursement, care delivery and access take shape.

These shifts round the provider side should represent very good news for numerous Americans that need better support within the healthcare system, especially since several of people with chronic disease aren’t presently getting recommended care. Combined with the truth that many sufferers don’t stay with their medication and treatment regimens or recommended lifestyle and health behavior changes, and you can convey a couple of from the challenges ahead.

Here’s where the payer side, particularly health plans, can help.

Health plans have ready utilization of claims data as well as other relevant clinical information plus a direct line for his or her people for targeted messaging and clinical interventions. Although not really a conventional proper imperative, health plans have a substantial opportunity to assist drive behavior change, reduce risk, and provide positive health outcomes for people.

Most plans already provide member portals as well as other helpful sources, and a lot of have began to focus on enhancing these activities and initiatives to improve their value and impact. But, to compete effectively, in this particular rapidly shifting market, they’re going to have to re-orient their mindset and approach to be more consumer-centric.

Consumer Power

Carrying out a decade of slow growth, Healthcare Consumerism has began to think about hold. Participation in high deductible health plans (HDHPs) reaches accurate documentation level with 23% of people with employer-backed insurance now subscribed to an HDHP. Other emerging factors for instance cost comparison tools, quality ratings, and retail health alternatives continuously put more power to the hands of customers.

Health plans need to resolve this trend and elegance proper solutions or use best-in-class providers for member populations. This puts a bigger burden on member engagement outreach and interactions that are positive, relevant and trust-building.

This will not be simple. Scientific studies reveal an in-depth trust gap between insurance firms in addition to their people. The KMB Group survey of 34,000 consumers, uncover that just 22% of individuals identify their plans just like a “reliable source.” This comes even near to 80% for physicians.

Which year’s American Customer Happiness Index (ASCI) report ensures that customer happiness with health plans declined between 2013 and 2014, stating, “There is no area where medical insurance companies produce an outstanding experience.”

Member Engagement

Member engagement is completely new territory for a lot of health plans, with Condition state medicaid programs programs expansion, the rise old-in Medicare people as well as the lately insured, it’s increasingly more crucial that you provide consumer-oriented communications interactions, and interventions.

As Star Ratings as well as other quality metrics rise in prominence, and consumer brand preference and loyalty become important elements, health plans will uncover themselves going after excellence in buyer experience, though outstanding member engagement.

We view numerous areas that needs to be addressed in developing a powerful member engagement strategy:

1. Understand how consumers think and operate in their own personal health insurance healthcare world.

Health plans need to do an intensive and honest summary of the outreach which matches to individuals, along with all on-going interactions, the customer service function, and related areas. This really is really the fundamental beginning point for significant change and could help uncover insights in regards to the consumer decision process. In addition, areas for instance behavior overall costs provides many important learnings and is an excellent guide for creating a messaging method to people.

2. Adopt an affiliate-centric marketing system designed around their concerns and interests.

Employing a consumer marketing mindset in allowing the communications strategy and identifying measurable actions, health plans need to become be described as a valued partner. Proper messaging should be built-into all member touch points and areas of outreach. Lots of health plans still rely on dated letters utilizing their Chief Medical Officer since the review of a number of health enhancement initiatives. Scrap them and uncover ways to really make the content significant, relevant, and credible for the recipient.

3. Strategically align and integrate all health improvement service choices.

Most health plans can check all the boxes in compliance using their service choices in wellness, care management, disease management, pharmacy coordination, and a variety of other services – but providing them with altogether in the seamless option is what individuals truly would really like. By offering an overlay of measurement and feedback, plans may help ensure people receive what’s most critical on their behalf.

They’re ways health plans can consider evolving their abilities toward being member-focused and engagement-oriented. There’s lots they could do today to really change member behavior, lower risk and result in greater general health outcomes – which will produce more effective margins and returns.

Health plans can learn and adopt many consumer marketing strategies off their industries, which could more create positive encounters in healthcare. In the consumer health plan market, the winners that emerge will most likely be people who stick out in member engagement.

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