Close this search box.

Even in a Digital World, Human-to-Human Phone Engagement Remains Critical in Healthcare


The health plan member experience is high stakes in healthcare right now—whether it’s heightened Medicare Advantage Star rating measures, ACA marketplace competition or the need to keep employers and their employees satisfied. That’s why smart payers are taking time to rethink how they communicate with their members. In some cases, they’re even completely reorganizing their customer support teams around the delivery of outstanding experiences.

A key part of that retooling involves communication channels. Consider that by next year, experts estimate that 70% of all customer interactions in the U.S. will be via some sort of digital channel. That list of digital channels keeps growing, too: SMS/text messaging, app use and chatbots with conversational AI capabilities, among others. For the record, those channels are valuable and necessary.

But in the rush to serve changing digital health and customer service needs, we can’t, as an industry, forget the power of a personal phone call.

Here are just a few of the reasons we’ve been talking about lately at Carenet Health.

01      First and foremost, healthcare is personal—and compassion and optimism are difficult to convey digitally. Sometimes, you just need to hear the inflection, empathy, hope and warmth in a voice-to-voice conversation. Stacie Stoner, Carenet’s Vice President of Client Success, sees firsthand the value created in live interactions. “We know that one-on-one phone connections between a health plan and a member make it easier to establish credibility … easier to ask insightful questions. And it’s easier to provide answers that are complex and multifaceted.” (Read more insights from Stacie here.)

02      A call stops the scroll. As Pamela Cone, Carenet’s Senior Consultant, Business Solutions, says, “Phone calls are still one of the best, most cost-effective ways for gaining and maintaining an individual’s undivided attention.” This is particularly significant when you’re asking a member to take a certain action, like closing a gap in care, enrolling in a mail-order pharmacy program or taking the next step in chronic care management.

 03      Not everyone has the tech (or tech know-how) for effective digital communications. Broadband infrastructure is advancing and should continue to improve over the next several years. But until changes occur, the number of Americans without high-speed internet is still around 40 million. Those impacted are disproportionately in rural, low-income and medically vulnerable groups. Other studies indicate that 30% of low-income households and 20% of Medicare beneficiaries may lack a smartphone, with higher percentages among Black and Hispanic beneficiaries. We also know that when it comes to using apps and portals, technical utilization skills are an issue. That’s why our multichannel outreach plans almost always include a live outreach component to ensure effectiveness.

04      Conversational AI algorithms are getting better, but often still fall short. Despite growing sophistication, chatbots still have a lower rate of problem resolution than human-to-human interactions because they simply can’t go as deep as a human. Exchanging messages with an AI-based bot or SMS solution can be convenient and helpful, but it doesn’t always make it easy to reach a member’s or an organization’s end goal. These solutions are highly efficient (and we often recommend them) for basic requests, but more involved dialogue situations require an authentic, human-driven connection. A health plan’s use of phone calls also entails a lower level of tech capital and investment than, say, a natural language processing solution.

05      Phone call outreach, enabling meaningful two-way conversations, can be implemented quickly. In fact, it can be as simple as giving Carenet a target list. We’ll develop a custom contact dialing strategy, then hit “go.” Deployment can be fast and painless. (For more information on what happens behind the scenes to develop a successful outbound healthcare engagement contact strategy, download our infographic.)

06      You only get one chance to make a first impression. Building trust at the beginning of a member relationship is important. The first time a member interacts with your plan will begin to shape their satisfaction and loyalty right away. We encourage health plans to be cognizant of how they want to orchestrate first-time communications and those early consumer communications needs. For instance, are welcome communications the right time to risk a digital interaction with a new member or is a phone call the more engaging way to start? The answer may be either depending on your goals, but this is something that needs to be strategically considered as a part of the health plan member experience.

07      Digital can mean patient privacy concerns. Protecting patient privacy is paramount, and there are a lot of moving parts when it comes to personal and sensitive healthcare data. Consumers can have their own concerns, third-party apps’ privacy policies aren’t always straightforward and healthcare organizations (or their partners) must continually invest in best-in-class technology and processes to ensure data safety. As D.J. Toms, Carenet’s VP of Information Technology, says: “Phone calls remain secure and are proven to be a bridge from privacy worries to consumer assurance.”

08      Phone calls are successful, regardless of target audience. Chatbots, email and text can be appropriate for some audiences and for some health-related interactions, but not all. But live phone interactions? They work for all populations and a variety of member support needs. Lisa Policano, Director of Business Solutions at Carenet, put it this way: “There are just times when a personal touch from a live person is needed, regardless of the market segment … Medicare, Medicaid, Marketplace or Commercial. So keep in mind that the type of interaction should really drive the choice of channel.”

 09      The argument that “no one answers the phone anymore” doesn’t stand up to the data. A typical successful yield at Carenet from a live phone outreach campaign can range from 30% to 50%, with some hitting even higher thresholds. That success rate depends on a lot of factors, such as the reason for the call, quality of the list, number of call attempts and calling windows. “There are a lot of variables,” says Dave Dreggors, VP of Business Development at Carenet. “The key is to leverage advanced technology and contact management strategies, along with team managers that have years of experience in healthcare. With a dedicated team of professionals, we can efficiently provide a one-on-one, premier experience on a large scale.”

10      Convenience doesn’t always mean digital. Consumers today expect to be able to engage with your health plan at any time, across multiple devices and channels. But preferred convenience in many industries, including healthcare, can mean speaking to a person first. Plus, a recent study found that one-third of all consumers, of all ages, who started in chat, regardless of whether virtual or live agents, still needed to go elsewhere to get the help they required.

11      Three-way calling for appointment scheduling is easiest starting with a live outreach call. There’s something about a call, with actual human voices, shared among a member, their plan and their provider’s office that helps individuals agree to close their gaps in care.

The health plan member experience: Wrapping it all up

Member satisfaction and the consumer experience should always be a driving influence in strategic communications planning. Digital channels and tactics will absolutely continue to be vital as healthcare evolves. But keep in mind that technology should be implemented in context and that great conversations with your members build brand capital and rapport and create value. An outstanding healthcare experience still requires voice-to-voice touchpoints. And there are many ways to make digital and live phone interactions work well together, so you can reach your goals.

If you’d like to discuss your member experience touchpoints, please reach out to us today.