Health care is a balancing act of providing quality care, keeping costs low and maintaining appropriate utilization. Taken together, these efforts help your plan and its members. Discover why member satisfaction is so vital and how to improve it.
The importance of member satisfaction for health plans
You have competing priorities, but none so important as pleasing plan members. In fact, member satisfaction is so essential that a survey of 73 health plan executives identified it as their top priority. And it comes with a handful of major benefits too:
Higher retention
Keeping health plan members happy should be a priority because it makes them more likely to trust you and stick around. Besides, acquiring new members can cost between $400-$800 per member, which can add up quickly.
What’s also worth noting is that retention is impacted by different variables, from cost to coverage and beyond. One factor you can’t ignore is loneliness. That’s because retention issues are especially prevalent among the lonely. These members are inherently less likely to use available resources and may struggle to see continued value in their plan, leading to worsening conditions and more frequent use of costly health care resources.
Better CAHPS scores
The Centers for Medicare and Medicaid Services (CMS) agrees that member satisfaction is vital, to the point that they changed Consumer Assessment of Healthcare Providers and Systems (CAHPS®) scores to give more weight to member experience than health care outcomes.
Satisfaction and experience are intricately connected, as experience includes member interactions with a plan—from member service call centers to care management programs to plan communications. Whether those interactions are positive, negative or somewhere in between makes a difference in member satisfaction, impacting CAHPS scores.
Better engagement
Engagement is the cornerstone of plan success because it reflects how invested members are in their health and what you provide. When members are engaged, it becomes that much easier to understand their needs and personalize their experiences. As a result, these same members benefit from better overall health, health literacy and lower costs because they are:
- More knowledgeable about treatments and plan coverage.
- More likely to have regular follow-ups.
- Less likely to need expensive treatments.
How health plans can improve member satisfaction
The struggle is that member satisfaction has been waning. A study by J.D. Power showed that satisfaction was flat from 2021-2022 due in part to members’ unhappiness with customer service, coverage options and network providers. So what can you do to turn this around?
Expand access to advocates
One thing that can never steer you wrong in serving your members is offering helpful resources. This is especially important because 36 percent of adults have low health literacy.
Health care advocates—or support staff—can work to expand knowledge and guide members toward valuable care. Providing communication opportunities such as messaging between members, care teams, and plan staff improves member satisfaction and literacy.
Take an individualized approach
If you want to satisfy members, don’t be afraid to get personal. By providing surveys, articles, and health management tips, you can begin to personalize care programs to members.
Then, take it a step further by digging beneath the surface. Screen members for social determinants of health (SDOH) needs, from connection to transportation to housing, to further personalize their experience based on the barriers they face and elevate member satisfaction.
Implement user-friendly technology
Educate and inform your members on their terms. Today, that means in the digital space. Research shows that 93 percent of plans that implement digital member experience services see enrollment increases, while three out of every four reports decreased membership turnover.
Engagement apps and member care portals are both good places to start. Easy, friendly, relevant and intuitive tools help tailor experiences to member needs. And if you can centralize member data and plan benefits, members will always be able to access important information.
Get the tools to help your members
When you keep member satisfaction top of mind, it helps your plan across various fronts. Retention, CAHPS scores, and engagement can all improve while you refine and evolve to provide excellence.
Pyx Health is here to help. Our solutions improve member satisfaction by providing the right resources at the right time. The Pyx Health program pairs a dynamic 24/7 app with our supportive ANDYs (Authentic, Nurturing, Dependable, Your Friend), blending scalable technology with human connection to improve engagement. We aren’t a substitute for communication with your plan, rather we help connect them back to you with the needs we uncover and the trust we build with them. With Pyx Health, your members can:
- Screen for SDOH needs.
- Navigate plan and community resources.
- Engage in wellness activities.
- And more!
Make your members No. 1! Discover new ways to improve engagement and satisfaction with our guide, and reach out to discuss how Pyx Health can help.
