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How Are You Elevating Your Health Plan Member Engagement?


As consumers shoulder a larger share of their healthcare costs, they’re expecting more from their health plan. The payers that succeed at keeping their members happy will be greatly rewarded.

In fact, satisfied members are five times more likely than unhappy ones to renew their plan, according to a survey conducted by global management consulting firm McKinsey and Company.

The survey also revealed that satisfied customers are often more savvy about how to utilize their benefits, which decreases both the plan’s administrative costs and its members’ out-of-pocket expenses.

When plans are successful at developing a solid relationship with their members, they can leverage this high engagement model to lower medical costs and improve outcomes, the consultants advise. A strong connection with engaged members enables plans to have a greater influence on their healthcare decision-making—for example, when it comes to selecting the most appropriate care setting or adhering to a prescribed medication regimen.

Research performed by clinical professionals, like Dr. Jennie Echols, Director of Clinical Solution Development at Carenet Healthcare Services, also shows the long-term positive impact of keeping healthcare consumers satisfied.

“In the research I’ve conducted, I’ve found that previous satisfaction with overall healthcare had a significant direct effect on patient empowerment, and empowerment had a significant total effect on patient satisfaction in a perpetual model,” says Echols.

In short, satisfied, engaged members mean stronger financial performance for payers and more empowered healthcare consumers.

Year-Round Interaction Key
Achieving a high level of satisfaction and engagement requires year-round positive interactions that elevate the member experience.

Sporadic, subpar member encounters will result in low engagement and adherence, poor clinical outcomes, low satisfaction levels and a high churn rate, ultimately putting a dent in a plan’s performance.

To help ensure plans deliver five-star member experiences, Carenet proactively connects with members multiple times throughout the year from the initial welcome call and health risk assessment (HRA) assistance to annual wellness visit scheduling and HEDIS® screening outreach.

“Not only do these multiple touchpoints ensure members receive the right support at the right time, they also serve as a constant reminder to members that their health plan is fully invested in their wellbeing,” advises Echols.

Plus, this ongoing interaction presents numerous opportunities for members to voice any concerns along the way, rather than waiting until a year-end customer satisfaction survey. This enables plans to address issues before they escalate and adversely impact clinical and financial outcomes.

CAHPS Survey Success
One of Carenet’s key touchpoints is conducting a preliminary survey before administering the year-end CAHPS survey to evaluate the member experience during the previous plan year.

If the findings reveal areas of improvement, Carenet initiates end-of-year outreach measures to address the issues, boost member satisfaction, and ultimately, improve the plan’s CAHPS scores and financial performance.

“Healthcare is highly complex and deeply personal, which makes delivering positive, memorable experiences that raise member confidence and trust in their health plan all the more important,” says Echols. “By taking multiple strategic steps throughout the year, we help ensure member expectations and needs are met, if not exceeded, and that plans are rewarded for taking good care of their members.”

To learn more about keeping your members happy, click here to contact us today.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).