Industry Voices—3 member engagement pitfalls health plans should avoid

Doctor with patient
Many health plans still struggle with what and what not to do to connect with their members, especially traditionally hard-to-reach populations. (Getty/wutwhanfoto)

For evidence that member engagement is a hot topic in the healthcare industry, look no further than Google. If you type the phrase into the search engine, you’ll be given no fewer than 283 million results.

However, while the topic is certainly discussed often—including at every single industry conference I have attended in the past two years—getting engagement right remains a challenge for many health plans.

Health plans already know that engaging meaningfully with members is a win-win proposition. Increased member engagement provides a number of benefits, including happier members, better retention, higher quality scores, improved plan performance and, most importantly, better outcomes and healthier members.

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But few health plans excel at engaging members—they’ve never really had to until recently. So when it comes to designing and executing an effective engagement strategy, plans still struggle with what and what not to do to connect with their members, especially traditionally hard-to-reach populations.

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There are three common pitfalls that plans should avoid to optimize their engagement strategies:

  • Trying to reach too many (or the wrong) members. When engaging a population to motivate them toward better health, the first thought is often to reach as many people as possible. That approach isn’t the most effective or efficient, however.

When it comes to consumer loyalty programs in the retail industry, brands tend to target heavy users—daily visitors for Starbucks, or frequent business travelers for Delta, to name just two. This strategy gives consumer brands the best return on investment for their engagement efforts.

In healthcare, plans are best served by focusing first on the members who represent the most cost—those who have chronic conditions or open care gaps and are unengaged in their health as opposed to those who are already both compliant and engaged. In fact, the more that plans segment their audience, the bigger impact they can have. Analyzing different slices of the population informs plans on which segments would benefit most from increased engagement.

  • Using the wrong communication channels. A common rule of thumb in communications is to meet your desired audience where they are. That means knowing and using the communication channels they are most comfortable with. With this in mind, sending traditional mail repeatedly to users who prefer digital or mobile options simply doesn’t make sense.

In fact, some members may not even be able to receive traditional mail due to housing insecurities, so plans are increasingly adding text messaging to their channel mix as an efficient and cost-effective way to reach members. This makes sense considering that a full 95% of U.S. adults own a cell phone of some kind. And that number is nearly as high among lower-income adults too—92% of those with annual incomes below $30,000 own cell phones as well.

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  • Focusing on the wrong activities. There are two main questions plans need to consider when optimizing their communication and engagement strategies. The first question is, which segments of the population do we need to engage? The second question is, which healthcare activities are most likely to improve those members’ health?

Plans should personalize high-value activities for individual members based on the care gaps they need to close. So, rather than offering everyone in the plan an incentive for completing an annual wellness visit, activities for each member should be personalized to meet their specific healthcare needs, whether it’s a cancer screening, diabetic eye exam, colonoscopy, and so on.

Don’t assume that historically unengaged members won’t respond. A recent example taken from a sample of diabetic Medicaid members living in New York City showed that historically unengaged members who received communications encouraging them to take part in healthy activities were 92% more likely to complete them. Overall, 41% of the members who received the communications—all with open healthcare gaps previously—closed at least one or more of the gaps.

Meaningfully engaging members is a pivotal component to improving health outcomes, but it can be a challenge to effectively reach and target individuals' needs. But when implemented correctly, personalized engagement strategies can make a real impact on plan performance, quality scores and health outcomes.

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With a continual cycle of engagement, everybody can be a winner. Individuals become healthier because they’re more likely to be actively engaged with their own care.

Plans improve performance because they’re consistently delivering improved outcomes among the segments of their populations that need it most. And since delivering care when and where it’s needed is a goal of the broader healthcare industry, the system as a whole stands to benefit as well.

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