Better member engagement helps payers cut healthcare costs, but knowing how to engage with members can be tricky.
The wrong terminology turns people off; few consumers can define accountable care organization or narrow network, for example. In other cases, good intentions fall flat; carefully curated quality metrics may mean less when choosing a primary care physician than, say, weekend office hours or a receptionist who speaks fluent Spanish.
At this week's World Health Care Congress in the District of Columbia, three payer executives described some of the steps they have taken to improve benefit and service design in order to attract new customers and better serve existing customers.
Follow the money. Harvard Pilgrim Health Care started a program that monitored what employees purchased at the grocery store, offering encouragement for good purchases and suggestions for alternatives to bad purchases. When coupons and recipes were the incentive, employee participation was about 20 percent higher, said Pranav Mehta, Harvard Pilgrim's senior vice president of product development and business planning. When the company offered participants $10 per month, enrollment doubled, he said--and purchasing patterns shifted "significantly."
Add value. UnitedHealth does a lot of Medicaid business and has found that going above and beyond what states' minimum Medicaid requirements are can make a big difference, according to Brett Edelson, a vice president with the payer. UnitedHealth's value-added services range from a variety of healthy eating, smoking cessation, immunization and neonatal care programs to social support services that provide free cell phones to members or help them pay utility bills.
Play games. Part of the success of Cigna Health Matters, a digital health coach, stems from its use of gamification, according to Eric Herbek, the plan's vice president of product solutions for consumer health engagement. Use of the health assessment tool among employer clients increased fourfold when Cigna switched from what Herbek described as the "bubble test" to a board game. The Cigna Compass tool, initially developed for JPMorgan Chase but recently rolled out to additional clients, likewise presents care recommendations in an easy-to-read format.
Boost support. Many consumers signed up for narrow networks solely because of the up-front savings and didn't fully understanding what they were getting into, Herbek said. Payers need to support consumers who are making the transition to a narrow network by explaining in clear, plain language who is and is not in the network and what services are and are not covered.
Engage providers. The average consumer would much rather talk to the doctor than the insurance company, the executives said. Edelson took the point one step further: Consumers would rather talk to nurses or office staff. Offer training and support to anyone in a physician office who interacts with members so they can address questions about consumers' insurance plans or at the very least point members in the right direction.
Better engagement means treating members as customers first, patients second
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