10 Things to Evaluate Before Choosing a Member Engagement Solution for Your Plan

The pursuit of better member engagement lies in identifying a solution that solves what many consider unsolvable. How do you engage members so that they take an active role in their health? If you can increase engagement, both you and your members will benefit. They will have better outcomes and possibly a better quality of life, and you can reduce service utilization by those members.

So what is this core component that can significantly impact engagement? Medicare and Medicaid plans have had an epiphany, realizing loneliness could be that core factor.

Loneliness is a devastating and pervasive problem. It’s not just a feeling or consequence of isolation. However, you may not know that loneliness negatively impacts your member engagement strategy. 

As a health condition, loneliness requires treatment with evidence-based programs that holistically address member needs. If you can identify loneliness and reduce it, you may achieve greater engagement with your members.

The impact of loneliness

Experts have classified loneliness as a public health emergency. More research connects it to adverse outcomes. It’s a high-risk factor for mortality, and lonely people are at higher risk for heart disease, chronic inflammation, dementia and other health conditions.

Loneliness also costs the U.S. health care system nearly $7 billion annually, mostly related to unnecessary emergency department (ED) visits, avoidable hospitalizations, readmissions and other overutilization. 

Because loneliness plays a defining role in your members’ health, you’ll need to devise strategies to prioritize it. To do this, you will need a member engagement solution that confronts loneliness from a scientific, technological and human angle.

When formulating your loneliness plan, you’ll want to evaluate several aspects before deciding. The following questions will help you build a checklist:

If your plan is ready to rethink member engagement and deliver solutions to identify and address loneliness, use this checklist of questions:

1. SDOH needs and screening

Does the program screen for and identify social determinants of health (SDOH)?

• SDOH needs contribute to and exacerbate loneliness. 
• A solution that screens for SDOH provides more data on each member to offer a clear picture of which factors affect engagement. 
• In most cases, the ability to use both technology and humans in your screening is most beneficial. 

2. Onboarding

Does the solution expect members to engage with the program?

• Proactive outreach and onboarding are vital to get members to use technology and resources. 

3. Identifying and treating loneliness 

Can the solution identify those who are lonely or at risk for loneliness?

• Evidence-based solutions score members to determine if they are currently lonely or at risk of becoming lonely. 
• This information allows you to allocate the right programs and resources to improve engagement. 

Does the solution address loneliness as a chronic condition or just a problem solved by companionship?

• Chronic loneliness involves much more than the need for social interaction. It’s a disease that impacts how members make decisions and use their health plans.
• Science reveals that a lonely brain has differences in regions that impact reminiscing, imagining, thinking about others, future planning and more. 
• A program that focuses on the science of loneliness is more impactful than one that only provides companionship. 

4. Resources and channel options

Does the program allow members to contact care team members who offer them access to companionship and coach them on wellness?

• Most member engagement tools don’t have a human element. 
• To support lonely members, you’ll need this component for connection. 
• Providing a solution with no limit to interactions between care team professionals and members makes it more accessible and inclusive.

5. Ease of program

How easy is the program to understand for members across demographics and literacy levels?

• Member disengagement and a propensity for loneliness are not issues that only impact seniors. These issues impact people across demographics and age groups. 
• Disengaged and lonely people may also have lower literacy levels, both generally and around health topics. 
• An ideal solution will consider these factors and provide a friendly and easy member experience. 

6. Technology

How does technology integrate into the program? Is it inclusive, intuitive and user-friendly, regardless of technical aptitude?

• Technology is pivotal in engaging members and addressing loneliness.
• Virtual health tool usage is growing, and even seniors are adopting digital channels. However, it still comes down to whether the user experience is inclusive and not intimidating. Apps can be a good technology touchpoint for screening and engagement. 
• Apps must be easy to use and navigate for any user, requiring minimal tech literacy.
• To gauge this, ask the program provider about its technology engagement statistics. 

7. Intended audience 

Is the program personalized for different member segments, such as those over 65, under 65, and children?

• The ability to segment members enables your plan to provide the most relevant communications and resources. 
• With greater personalization comes the opportunity for deeper engagement. The reality is that loneliness can impact people of all ages, from teenagers to senior citizens. 

8. Type of solution

Is the solution evidence-based and data-backed?

• There’s no shortage of member engagement tactics and platforms, whether sophisticated or rudimentary. 
• Some programs even offer a “buddy” to inspire engagement and “cure” loneliness. However, those programs don't rely on data- and evidence-based strategies, are not scalable and have inherent risks related to sending people to members’ homes. 

9. Data and metrics

Does the solution provide actionable member data and measure improvement?

• Data is everything for plans. It’s the most valuable asset you have and informs decision-making. Thus, you need a solution that collects actionable member data. Metrics and key performance indicators (KPIs) are critical to understanding program performance. 
• Ask questions about how the solution measures improvements to discern if it aligns with your plan’s goals. 

10. Efficacy of the program

Does the solution have proven results?

• Before investing in a member engagement platform, you should assess its track record. 
• Ask questions about the program’s documented ability to reduce loneliness and depression, increase member connections and decrease utilization costs. 

All these components will impact the solution you choose for your members. Because loneliness is a new area of health care, the landscape of loneliness programs for Medicare and Medicaid plans is small. Once you define your ideal program by reviewing and answering these questions, you’ll want to compare your potential options. 

Use this comparison matrix to compare Pyx Health’s solution with other programs. Assign a score for each feature or capability with robust (2), adequate (1) or missing (0).

When evaluating member engagement solutions to address and treat loneliness, you need to choose one that recognizes loneliness as more than social isolation or a need for companionship. It’s a complex condition that requires multi-faceted interventions based on science. Further, Medicaid plans need a solution available to more populations than just seniors. Loneliness impacts all age groups, not just older members. 

Finally, the solution should offer a blend of technology and human connection. Pyx Health designed its solution based on all these points. When plans implement Pyx's program, they achieve an 11% per member per month (PMPM) reduction in ED and inpatient spend. On average, Pyx saves plans $5,083 per member over six months.

Want to learn more about our loneliness solution and how it can drive engagement and better health outcomes? Contact us today.