How to Improve Health Plan Member Engagement

The focus on improving health plan member engagement has been steadily growing over the past several years. Much of this is being driven by the influence of consumerism on healthcare more broadly. In a recent press release, James Beem, Managing Director, Global Healthcare Intelligence at J.D. Power, stated, “Health plans are doing a good job managing the operational aspects of their businesses, but they are having a harder time addressing the expectations members have based on their experiences in other industries where their service needs are more effectively addressed with better technology”. This statement was based off of the findings of their annual Commercial Member Health Plan Study, which found that “coordination of care between different providers and care settings” was one of the top challenges health plans are facing today.

We couldn’t agree more. Most of our conversations with health plan prospects and customers revolve around what we can do with our digital technology to help improve health plan member engagement and close gaps in care. Since this is a hot topic for health plans and is a conversation we’ve had many times, we wanted to address it in this blog. Here are the key digital strategies that health plans can employ to better engage members and improve satisfaction.

Improve the call center experience when scheduling
Call centers remain a cornerstone of member engagement. From new member onboarding to closing gaps in care, the call center is often where the rubber meets the road between health plans and their members. Our work has focused on helping make it easier for call center agents to find and book appointments on behalf of members. Specifically, we eliminate the need for three-way calls with providers by enabling a digital scheduling platform for agents to use. It automates the providers scheduling rules, so their calendars are protected, and it gives the plan a way to make an appointment without calling the practice. A win-win. In fact, we’ve seen scheduling rates increase by 140% when our platform is in place, call times are cut in half, and even show rates go up (learn more in this case study). To make it all work, you have to build a digital network with your providers, which you can read more about here. You may be surprised to find that providers will actually like it!

Book the transportation, too
There is a lot of talk right now about social determinants of health (SDoH), and while it is all good, we want to focus on where we can make the biggest change right now. That is why we have worked with transportation vendors to include scheduling transportation in one workflow with scheduling an appointment. Many times, members know what care they need and even book an appointment, but due to unreliable or non-existent access to transportation, they can’t make the appointment. Then the care gap goes unaddressed, which is a knock on the plans quality metrics, and even worse, can result in a medical emergency that lands them in the ED. That is obviously a bad medical outcome, but it is also an expensive medical cost for the plan. By facilitating easy access to transportation as well as appointment scheduling, we are ensuring a better outcome for everyone.

Enable self-service online scheduling
This is a fairly straightforward concept. We’re talking about the type of functionality that consumers are accustomed to in nearly every other industry. Booking a hotel, or a flight, or even a dinner reservation can all be done online, and, more specifically, on a smartphone. Imagine being able to extend this type of convenience and consumer-friendly experience to your members. They come to your site or app to look up in-network providers for the care they need and can schedule an appointment right on the spot, no phone call required.

Automate outreach with scheduling
The self-service can be actionable, too. Instead of simply sending members test and phone call reminders of the care they need, plans can use our automated outreach solution to send those messages that includes the ability to schedule via self-service. Imagine the member receiving a text message, they confirm their identity, get their special health related message, and then are asked if they would like to schedule an appointment to get it taken care of. In a few clicks they are done, and you just closed a care gap without lifting a finger. Check out this short 2-minute video to learn more, or check out this case study to see a real-world example and results of deploying automated outreach.

Get the right phone numbers
The struggle to find and maintain accurate contact info for members is never-ending. Now that MyHealthDirect is a part of Experian, there is unprecedented access to consumer data. Experian has the largest consumer database, collected on more than 300 million consumers, to provide a deeper understanding of your current members or prospects in your markets. These data assets can enable the most effective marketing and communication strategies to improve enrollment rates as members are more successfully identified and reached. The data can also be leveraged to enhance internal analytics, like member risk score algorithms or other models, to improve member outcomes.

These key strategies have driven enormous value for our existing customers. To learn more about how a digital care coordination platform can help your organization through innovative solutions, download our guide: Digital Care Coordination for Health Plans.