5 ways health plans can improve member engagement

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AdobeStock_86786058-1Member engagement has been a priority for Medicare and Medicaid plans for years. The strategies used to improve it have had to adapt to changing times. The pandemic, greater adoption of digital channels and shifting member expectations have all played a role in a new horizon for member engagement. 

These emerging impacts and paradigm shifts should inform your member engagement strategies. In this post, we’ll look at the challenges and opportunities.

The pandemic affected member engagement.

The pandemic forever changed the member experience and health care in the U.S. There are positive and negative takeaways. On the positive side, the pandemic offered an alternative option for care access with telemedicine and telehealth. Additionally, the constant presence of COVID-19 made many people rethink their health and commitment to better behaviors and lifestyles. 

On the negative side, constant misinformation swirled, impacting fundamental trust in the health care system. The system was also stretched beyond its limitations, revealing the cracks in the foundation. The pandemic kept many people from seeing providers for regular visits or having screenings, and plans are trying to get members back into preventive care. 

All these impacts still impact engagement, so plans are using multiple communication channels to get their messages out. How members wish to receive information is now an important focus of outreach.

Consumer patients have higher expectations. 

Health plans need to see their members as consumers to improve member engagement. That requires understanding their needs, building trust and creating personalized communications delivered in the channel and cadence the member prefers. It’s as simple as ensuring they understand their coverage. 

A study from Wellframe looked at what consumers want from their plans. A chief complaint was that information received wasn’t personalized. Many respondents (43%) said they didn’t understand their coverage and benefits. The data revealed that members want support around chronic conditions and guidance when finding a provider. They also struggle with access to care linked to social determinants of health (SDOH). 

Members engaged more in digital channels in 2021.

According to the J.D. Power 2021 U.S. Commercial Member Health Plan Study℠, digital contact with plans increased in 2021, with 32 percent of members adopting this option. The Wellframe study also looked at digital engagement, with 57 percent of members expressing positive sentiment. Digital contact is so impactful in engagement because it provides a single point for members to get the information they need, according to Wellframe research. 

The use of digital channels isn’t just for younger generations. Seniors are using virtual health tools as well. They want to use these resources to find providers, schedule appointments, review explanations of benefits (EOBs), receive medication reminders, condition monitoring and access digital health coaching. 

In response to these member engagement trends, Medicare and Medicaid plans should retool their approach. 

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

Learn five ways to improve member engagement.

Here are some strategies your plan can activate now:

Expand access to advocates to improve health literacy.

As noted above, many members don’t understand their plans or benefits. Overall, health literacy is low, and the information is often complex and difficult to understand. A Medicare Advantage literacy study found that 74.5 percent of members don’t understand their coverage

For the entire U.S. population, the Center for Health Care Strategies (CHCS) reported that 36 percent of adults have low health literacy, with disproportionate rates found in lower-income people eligible for Medicaid. 

By expanding access to advocates, you can increase your members’ understanding of their plan and health. The first layer can be human-focused, building one-to-one connections. Start with disengaged members, overutilizers or those with high SDOH risks. 

To scale this to all members, you can also use friendly technology that educates and informs in simple ways. Your members likely don’t know insurance and medical jargon, so make messaging more accessible. 

Prioritize the most critical actions regarding member engagement.

As discussed, the pandemic kept people from their providers and delayed screenings. You can characterize this as disengagement. Telehealth helped some here, and many of your members may continue to use this option for convenience. 

Regardless of how members connect with providers, plans should make connections easy and prioritize them with communications. Consumers have identified that they want plans to help them find clinicians and schedule appointments. That’s the kind of engagement to prioritize, as it will move the needle on outcomes. In this way, members perceive plans as helpful and supportive, which can further engagement. 

Identify and address SDOH needs.

SDOH needs are often associated with Medicare and Medicaid members. For those that qualify for Medicaid, many SDOH needs are apparent — but Medicare members deal with these too. According to a report on the subject, Medicare members tend to have needs around social isolation, transportation, housing and food. In response, plans have increased activity to address them.

However, with either type of member, meeting SDOH gaps must begin with understanding and screening for them. Being data-driven in your approach enables more personalized responses to those members. When you know a member’s barriers, you can better engage them with relevant communication and resources. 

Improve digital channels to support a better user experience.

User experience is a huge consideration for any platform. Your plan has a portal and possibly an app for members, but how optimized are they for the user experience? Are they easy, friendly, relevant and intuitive? 

Look at what your technology offers. Having technology that is tailored to members and their needs — and provides quick access to resources and plan benefits — is vital. Redesigning or revamping these online tools for members could make a difference, and you’ll be able to measure this.

Introduce new programs that tackle loneliness.

Loneliness is a condition that impacts people mentally and physically. It’s a leading cause of disengagement, and isn’t just about having no one around you. A lonely person believes they are the only one who understands their situation. They also tend to lack social connection, which can not be resolved by companionship or an antidepressant. Instead, it takes a combination of approaches and interventions.

Evidence-based interventions that blend scalable technology with a human connection could boost engagement. The technology screens for SDOH needs and loneliness in a less-taxing way than calls or in-person conversations. When members have better engagement and participation in their health, it improves their outcomes and reduces costs. 

Explore more ways to enhance member engagement by downloading our resource, “Member Engagement Conundrum: 5 Issues in Medicare and Medicaid Plans and How to Solve Them.

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