The imperative to orchestrate a better member experience has never been greater. Given industry consolidation, shifting consumer expectations, and the rise of nontraditional competitors, leaders must consider new strategies to deliver the seamless, on-demand service required to remain competitive. Many health plan leaders acknowledge that this shift requires a new kind of advocacy service, sometimes referred to as a navigation or concierge offering. But few know where to start to give members and customers the experience they want.
Learn the five proven steps successful health plans take to operationalize member advocacy.
1. Define success to set an organizational direction
The first step to implementing a high-performing advocacy strategy is to establish an evaluation framework to reach internal alignment on the organization’s definition of success. Consider the long-term business outcomes you aim to achieve, such as market growth and retention, improved or appropriate utilization, better quality performance, improved member satisfaction, and service line and IT transformation.
After specifying the end goals of your program, you should establish key performance indicators (KPIs) at set milestones, and use your evaluation framework to track progress toward that goal. It’s also crucial to have a plan in place to corroborate and communicate results both internally for accountability, as well as externally, so you can better represent your services in a competitive market.
2. Develop an iterative go-to-market plan
When launching an advocacy program, successful health plans focus on quickly launching to one to two groups or populations, learning from that initial launch, and investing accordingly to engage larger populations. But of course, you can’t manage what you don’t measure. Make sure you are able to track critical metrics such as these to drive continuous improvement as you expand your offering:
- Onboarding rates of targeted members onto your digital platform
- Weekly and daily member engagement rates within the platform
- The key characteristics, such as age, gender, and program type, of enrolled patients on your platform
- The number of members each member of your staff manages within your digital platform
- How active your staff is within the platform
- The amount of time your staff is spending on each member touch point
3. Apply proven marketing practices to drive member recruitment
As many health plans will agree, it’s not enough to simply offer a digital health platform. Organizations must actively recruit members into the program to ensure adoption and keep members engaged in a way that’s valuable to them. It’s also challenging for health plan staff to recruit members to your platform using telephonic channels alone. But by partnering with your marketing team, it’s possible to achieve your member volume goal.
Leverage your marketing team’s insights on reaching and engaging more people in different ways, through digital channels such as email. To make sure your outreach is relevant to the member, target your marketing campaigns to key events along the member’s healthcare journey, such as open enrollment. At each touchpoint, it’s crucial to ensure your messaging will resonate with the segments and personas you’re targeting by first speaking to the member’s needs and challenges while avoiding jargon.
4. Organize staffing models around whole-person support
Throughout their health journey, your members’ needs may be ever-changing, and can often include periods of low risk, when they’re not in need of regular outreach from staff. But a triggering health event can require intensive and timely support. That’s why an exceptional, holistic member experience requires a multidisciplinary approach, with collaboration across the health plan organization.
Hand-select a team to serve as the single point of contact for the member in order to identify and quickly adapt to changing member needs. Often referred to as “Health Advocates” this team can include staff from medical management, utilization management, or customer service. Be sure to make additional staff available to support the Health Advocate as needs arise, including a clinical navigator, care manager, engagement specialist, or community manager, depending on the populations served.
5. Execute an exceptional digital experience
In delivering a digital component to your advocacy strategy, most leading health plans deploy a member mobile application to meet members on their own terms. Make sure this app can support meaningful relationships between members and staff through secure messaging. It should also serve as a single trusted resource for members throughout their health journey, with digestible, interactive guidance on navigating the healthcare system, as well as support for their unique health needs or conditions. This often requires integration with your existing mobile app, as well as customer support to ensure a unified and personalized experience.
Members’ interactions within the mobile app should inform staff workflows, whether it’s surfacing a gap in care or a social barrier to health. As a result, your members will get timely and relevant support, driving improved satisfaction with your health plan.