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

As Health Reform is constantly on the unfold, the interest rate of change is obtaining speed, as new types of reimbursement, care delivery and access take shape.

These shifts around the provider side should represent great news for countless Americans that require better support in the healthcare system, especially because so many of individuals with chronic disease aren’t presently getting suggested care. Along with the truth that most sufferers don’t stick to their medication and treatment regimens or suggested lifestyle and health behavior changes, and it’s not hard to place a few of the challenges ahead.

Here’s in which the payer side, particularly health plans, can certainly help.

Health plans have ready use of claims data along with other relevant clinical information along with a direct line for their people for targeted messaging and clinical interventions. Whilst not a conventional proper imperative, health plans will have a substantial chance to assist drive behavior change, reduce risk, and convey positive health outcomes for his or her people.

Most plans already provide member portals along with other useful sources, and lots of have started to concentrate on enhancing these activities and initiatives to boost their value and impact. But, to compete effectively, within this quickly shifting market, they will have to re-orient their mindset and method of be much more consumer-centric.

Consumer Power

Following a decade of slow growth, Healthcare Consumerism has started to consider hold. Participation in high deductible health plans (HDHPs) reaches an archive level with 23% of individuals with employer-backed insurance now signed up for an HDHP. Other emerging factors for example cost comparison tools, quality ratings, and retail health alternatives continuously put more power in to the hands of shoppers.

Health plans need to reply to this trend and style proper solutions or work with best-in-class providers for his or her member populations. This puts a larger burden on member engagement outreach and interactions which are positive, relevant and trust-building.

This won’t be easy. Research studies reveal an in-depth trust gap between insurance providers as well as their people. The KMB Group survey of 34,000 consumers, discover that only 22% of people identify their own health plans like a “reliable source.” This comes even close to 80% for physicians.

Which year’s American Client Satisfaction Index (ASCI) report signifies that client satisfaction with health plans declined between 2013 and 2014, stating, “There’s no area where medical health insurance companies present an outstanding experience.”

Member Engagement

Member engagement is totally new territory for many health plans, with State medicaid programs expansion, the increase old-in Medicare people and also the recently insured, it’s more and more vital that you provide consumer-oriented communications interactions, and interventions.

As Star Ratings along with other quality metrics increase in prominence, and consumer brand preference and loyalty start to become key elements, health plans will discover themselves pursuing excellence in buyer experience, though outstanding member engagement.

We have seen numerous areas that should be addressed in developing a highly effective member engagement strategy:

1. Know how consumers think and operate in their own individual health insurance and healthcare world.

Health plans have to conduct an intensive and honest overview of the outreach which goes to people, together with all on-going interactions, the client service function, and related areas. This is actually the essential beginning point for significant change and may help uncover insights concerning the consumer decision process. Furthermore, areas for example behavior financial aspects provides many important learnings and could be a great guide for developing a messaging technique to people.

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

Utilizing a consumer marketing mindset in creating the communications strategy and identifying measurable actions, health plans have to become be considered a valued partner. Proper messaging must be integrated into all member touch points and facets of outreach. A lot of health plans still depend on dated letters using their Chief Medical Officer because the summary of a variety of health enhancement initiatives. Scrap them and discover ways to help make the content significant, relevant, and credible towards the recipient.

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

Most health plans can check all of the boxes in accordance with their service choices in wellness, care management, disease management, pharmacy coordination, and a range of other services – but getting them altogether inside a seamless option would be what people truly would like. By supplying an overlay of measurement and feedback, plans might help ensure people receive what’s most significant for them.

They are ways health plans can consider evolving their abilities toward being member-focused and engagement-oriented. There is lots they are able to do in order to really change member behavior, lower risk and lead to higher all around health outcomes – that ought to produce more powerful margins and returns.

Health plans can learn and adopt many consumer marketing strategies using their company industries, which can more create positive encounters in healthcare. Inside a consumer health plan market, the winners that emerge will probably be individuals that stand out in member engagement.

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