How to motivate Medicare members and close gaps in care

Motivated and engaged members often have better outcomes and are less of a cost burden for Medicare plans. However, it’s not easy to cultivate this type of member. Without these components, gaps in care are an unfortunate consequence. 

There are ways to increase member participation, empowering them to take an active role in their health. When that occurs, satisfaction with your plan increases, as noted in the J.D. Power 2021 U.S. Medicare Advantage Study. When engagement was strong, member satisfaction rose 54 points. 

In turn, your plan can experience improvements in Star Ratings, Healthcare Effectiveness Data and Information Set (HEDIS) scores, outcomes and cost reduction. So, how do you motivate members and begin to close those care gaps? Consider these strategies and initiatives.

Communication and contact should be consistent and relevant.

If your members don’t hear from you, it’s hard to grow engagement. The J.D. Power report dug into communication practices, which was the lower-performing element within the study. Increasing touch points should be a priority of plans and can influence member behavior to close care gaps. Such a program could include:

• Onboarding communication. When members enroll, you can engage them from the start and recommend specific benefits that close care gaps, such as help finding physicians, pharmacies, mental health services and programs associated with a chronic disease. This is also when you want to urge members to register for and use your portal. 
• Regular check-ins with members using multiple channels (mail, phone, email, member portals and so on) relevant to the member.
• Interactions after major medical visits, especially at discharge. Personalized communications at these points can be critical to ensuring members follow treatment plans. That reduces the risk of readmission and ensures they have things in place (medications, follow-up visits, home health assistance) to not fall through the cracks of care continuity. 

One-on-one interactions make health care more personal.

Gaining the trust of your members isn’t easy. It’s been eroding over time, accelerated by the pandemic and social media disinformation. The 2021 Edelman Trust Barometer report revealed increased distrust in the U.S. government. Another study found that trust in the health care system in the U.S. declined during the pandemic. The findings also concluded that people trust physicians the most (84%), with government agencies much lower (56%).

One-on-one interactions can be a way to address and repair distrust. The more personalized they are, the better. When these interactions involve transparency, empathy and reliability, connections happen. 

You'll need two things to execute this:

• Member data about their conditions and health care activities as well as things that stand in the way of or create care gaps, such as social determinants of health (SDOH).
• Well-trained customer care staff that have compassion at the center of all that they do and use these personalized interactions to educate, inform and motivate.

By leveraging data and staff, you can rebuild and establish trust. When members trust your plan, they’ll be more likely to get preventative screenings, adhere to treatment plans and use your plan's programs.

Improving member health literacy is key.

One of the biggest issues with Medicare member engagement and motivation is a lack of understanding. The Centers for Disease Control and Prevention (CDC) reported that nearly 90% of adults struggle with this, impacting outcomes and costs. Improving health literacy could prevent almost 1 million hospital visits and save up to $25 billion a year. 

Making strides in health literacy should be part of your engagement strategy. It should be fundamental in your consistent touchpoints and personalized interactions. When members better understand medical terms, policies and benefits, they’ll be more motivated to make appointments, fill prescriptions or attend physical therapy. 

Beyond communication, personalization and health literacy improvements, what else is standing in the way of member motivation? Often, the problem is loneliness, and that’s a dangerously wide care gap.

Addressing loneliness is vital to motivation.

Chronic loneliness is a medical condition, not just a feeling of isolation. It impacts more than 42.6 million Americans over 45, according to one study by AARP. Chronic loneliness refers to how individuals feel about the quality and quantity of social interactions. 

The science behind loneliness shows that it can rewire the brain and cause members to disengage from any care plans. On average, at least 10% of your members suffer from loneliness, based on our findings. This group often has members with chronic diseases, mental health struggles and SDOH challenges. 

The key to reaching this part of your member population, who routinely incur the most costs, is to identify these members and execute a plan. So, how do you discern who’s the loneliest and launch a program at scale? 

You’ll need two specific components. The first is human connection between your members and compassionate staff. They should be available to members at any time to discuss whatever members need help with and allow them to receive support without judgment. The second is easy technology that allows for screenings, information collection, positive reinforcement and resources at their fingertips. 

Our solution weaves both elements together and is the first of its kind that uses evidence-based interventions. You can learn more about member engagement and loneliness by subscribing to our blog now.