Using Member Engagement to Balance Personalization, Participation

Health plans are on a mission to provide their members with the best services, resulting in more holistic health at an affordable price. Incentive programs and other initiatives help plans achieve these goals by driving positive changes in member behaviors and connecting members to appropriate resources.

Plans and members can significantly benefit from these programs. A new case study shows over $2.6 million in annual savings for a payer after implementing a food-is-medicine program for its Medicaid and Marketplace members. The success of these programs, though, depends on the right balance of robust participation and personalized communications, whether plans are helping members access healthy foods or directing them to lower-cost care sites.

"For example, widespread participation when utilizing incentives and engagement strategies ties nicely when plans are looking at impacting the cost of care," explains Kristin Gasteazoro, senior vice president of SmartShopper sales and client performance at Zelis. In this example, Gasteazoro points to plans that use a digital platform to educate and direct members to lower-cost care sites.

"We want to encourage as many people as possible to use that platform. The more they do, the more savings plans can generate by redirecting to a different and lower-cost site of service," she continues.

Meanwhile, plans looking to improve scores for the Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey or pay-for-performance models should lean more on personalized communications. Similarly, a more targeted approach to payer programs can benefit employer clients with, for instance, a high concentration of employees with diabetes. Targeted engagement is more of a priority to ensure members with diabetes benefit from the program.

"It's something to consider when we tie back to program design and incentive strategy. Those considerations come into play to determine personalization and the overarching participation strategy," Gastaezoro says.

Striking the right balance between robust participation and targeted communications is challenging for health plans. After all, all types of programs need at least some of each to drive engagement and improve outcomes. Plans must be strategic about engagement, leveraging technology and personalized communications for programs across their lines of business to generate ROI and support members.

"Giving our members the choice of how they interact with us is important," states Reagan Greene, vice president of brand, marketing and communications at Blue Cross Idaho. "We want to use all the tools available to us to help create a more personalized experience that gives us the better chance to increase member engagement in a way the member wants and helps us achieve our goals as a business."

However, health plans sometimes must depend on paper to communicate with members, especially on employer plans where members typically enroll with their employer without providing a personal email address to the health plan. That's a challenge for engagement. While some members may prefer paper for communications, and plans at times need to send mail to comply with rules and regulations, it is better for many members and the health plans to drive toward a more digital experience.

Members, even older populations like those in Medicare, have increasingly adopted digital tools. That's why plans should integrate digital engagement strategies through an omnichannel communications approach. In addition to paper, the omnichannel toolbox includes texts, outbound calls, an interactive voice response system, emails and web-based access to communications.

When health plans use such a diversified communications approach, members can engage with their health plans using their preferred method, while plans can encourage a more convenient, digital experience. 

"Taking advantage of all the channels you have, and letting members choose how to interact, is key to building better engagement," Greene explains. "We've found it's important to use digital channels like text or email in conjunction with online self-service tools and educational information, while also allowing one-on-one connections as well for clinical programs to help members navigate the complexity of the health care system and improve their health. Giving members options puts them in the driver's seat, which helps build trust and encourages engagement," she emphasizes.

Trust in health plans is generally low. Members tend to trust their providers more than their health plans, creating challenges for payers looking to implement a holistic-health approach to care. Plans should consider how to foster improved trust and transparency with programs to engage members in a way the member prefers and meets them where they're at in wanting to engage on their health. Providing meaningful communications to members can help to foster trust and participation in payer programs.

"Payers message their members a lot already, and they partner with vendors who message their members a lot," Gastaezoro states. "In many instances, they're working on creating a cohesive member experience and trying to reduce the touches to membership to those that are most meaningful."

How plans communicate program goals and design is important to participation and ongoing engagement. Personalized communications help members understand their specific goals and what needs to be done to achieve them. Members should also be able to monitor the status of their rewards or improved outcomes. For plans to provide this level of personalization, they need a digital front door.

A digital front door facilitates interactions between members and plans at every major touchpoint of their health and well-being journey. This often takes the form of a digital platform accessed through the web for a seamless member experience, even if plans are running programs concurrently. These platforms can support widespread participation and personalization by delivering the messaging members need to interact with and actively participate in programs.

The technology powering a plan's digital front door should deliver personalized messaging in a user-friendly format that provides support across communication channels. Members should be able to use the technology to engage in payer programs, understand their benefits and access support for a more holistic approach to care.

By employing these strategies, plans can effectively balance personalization and robust participation in incentive programs, ultimately driving better health outcomes for their members.

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Part of Zelis Healthcare's comprehensive suite, SmartShopper Propel is a member activation and engagement solution that makes highlighting open opportunities for care easy and convenient. Propel meets the consumer where they are to build engagement and trust, all while helping payers meet plan goals. Learn more here.