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How Effective is Your Health Plan Member Engagement?


As individuals increasingly shoulder the cost of healthcare, they’re striving to become more active, informed and responsible healthcare consumers. With more of their own money on the line, they want to feel confident from day one that they are making the best choices for their health and their wallet.

However, it’s hard to make smart decisions about healthcare when you don’t understand it or lack support navigating it. By its nature, health insurance is much more complicated than, say, auto or homeowners insurance. With its complex jargon and confusing terms, like co-payment versus co-insurance, it’s easy to understand why nearly nine out of 10 U.S. adults have low health literacy.

Difficulties interpreting information, navigating the system, and obtaining support coupled with confusion over what to do deters members from taking action and instills a sense of powerlessness. It also makes them question if they’ve chosen the right health insurer.

Today’s healthcare consumers want and need to know that they are getting good value for their money and that their plan genuinely cares about their overall experience and well-being.

Health plans can avoid member disengagement and attrition by simplifying the healthcare experience and cultivating strong relationships with their members, starting with onboarding and continuing throughout the year. 

Keep it Simple

Simplifying the healthcare experience — from calling members to discuss plan benefits, available resources and preventive care measures, to helping them find a doctor, schedule health screenings and avoid unnecessary ER visits — creates an empowering, member-supportive environment that builds confidence and trust, promotes informed-decision making, drives engagement, and generates brand loyalty.

Starting with an onboarding welcome call and continuing with year-round navigation and advocacy support and proactive outreach (e.g., HEDIS® engagement), the health plans that meet their members’ needs for easily accessible, comprehensible information and support and personalized, seamless service will come out on top. In fact, according to the 2017 Global Brand Simplicity Index:

  • 61 percent of consumers are more likely to recommend a brand because it provides simpler experiences and communications
  • 64 percent of consumers are willing to pay more for simpler experiences

Connect Early and Often

Connecting with members immediately following enrollment via a welcome call is critical for establishing a solid foundation, communicating resources, collecting vital information, and reassuring them that they made the right purchase decision. A well-executed welcome call also helps get members onboard and engaged from the beginning making it easier to achieve desired actions and outcomes down the road. This applies to returning members as well as new members.

Staying connected throughout the year via multiple, cohesive touchpoints is essential for cultivating the relationship and maintaining a continuous feedback loop that promotes member engagement and compliance and eliminates gaps in service and care.

When members know they’re being looked after and that their needs are being proactively attended to, they’re much more likely to engage with their plan, and much less likely to go shopping elsewhere.

Learn More: New Ebook

As the healthcare sector shifts toward a more consumer-directed marketplace with individuals wielding greater cost-sharing responsibility and decision-making power, it’s never been more important for health plans to establishing a strong, enduring connection with members, and continuing to cultivate the relationship throughout the year.

To learn more, download Carenet Healthcare Services’ new ebook, 7 Key Steps for Successful Member Onboarding and Relationship Cultivation. Implementing these steps will lead to greater member engagement, satisfaction and retention — and ultimately better clinical and financial outcomes.

Click here to download the complimentary ebook, 7 Key Steps for Successful Member Onboarding and Relationship Cultivation, now.

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