6 Reasons to Invest in Next-Generation Member Engagement

Health plan members expect to be known by their health plan and interacted with in the ways they prefer. They know it’s possible because that’s how their bank and online retailers interact with them. Likewise, health plans want to know and activate their members to improve health outcomes, costs, and member satisfaction.

Health plan members have some sense that personalized care is, in fact, possible. Just think about what Amazon and Alexa know about you:

• Your music playlist and preferences,
• What you’ve searched for on Amazon, Zappo’s and Diapers.com,
• When packages are expected to arrive at your house and, more importantly, what’s inside the boxes,
• What time you get up and go to bed.

And then think what Amazon can surmise about you with all this information. Certainly, your music listening behavior provides insight into how often and for how many minutes you exercise. The tone of your voice, coupled with other information such as your music choices, communicates your mood, and over time, likely some insight into your mental health. Perhaps your health status and conditions, too, especially if you order cold medicine, diabetic supplies, or blood pressure medications from Amazon or its subsidiary PillPack.

Health Plan Member Satisfaction

Overall, health plan member satisfaction lags other industries, even more so in the early months of the COVID-19 pandemic. In the J.D. Power 2020 US Commercial Member Health Plan Study published in May 2020, two-thirds of privately insured health plan members said they had not been contacted by their health plan with COVID-19 guidance or information and almost half (48 percent) said their health plan had not shown concern for their health since the pandemic began.

The 2020 study also found “proactive efforts by health plans to engage members—by providing advice on how to control costs or helping to coordinate care—drive significant improvement in overall customer satisfaction. For example, when a health plan helps members keep out-of-pocket costs low, the average overall satisfaction score is 819, which is 152 points higher than when no such effort is made.”

Based on the study, health plans have made some progress over the past year. Overall member satisfaction improved 10 points, driven in part by improvement in communication scores. Digital engagement and telehealth utilization increased with 32 percent of members saying they connected with their health plans via web, mobile app, or text message in the past year and 36 percent of members reporting they accessed telehealth services.

The level of member engagement differs between generations. The majority (62 percent) of Gen Z members (born 1995-2004) and 52 percent of Gen Y members (born 1977-1994) contacted their plan’s customer service at least once in the past year. Overall, 37 percent of members had no engagement with their health plan in the previous 12 months. Nearly half (44 percent) of Pre-Boomers (born before 1946) and Boomers (born 1946-1964) report no engagement, the highest percentage of any generational group.

Contemporaneously, there are increasing market pressures from vendors who offer member engagement solutions directly to employers who are eager to reduce costs and improve health outcomes. Third-party point solutions like Accolade “navigate people through the healthcare system with trust, empathy and ease” and report consumer satisfaction ratings at more than 90 percent and cost reductions of as much as $590 per employee per year.

In addition to increasing member satisfaction, the five other reasons health plans are investing in next-generation member engagement are to:

1. Provide a differentiated service offering for select employers;
2. Drive participation in existing programs and services;
3. Maintain or improve the plan’s Medicare Star ratings as the weighting of Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures of patient experience increased from 1.5 to 2 in 2021, and in 2023, will increase from 2 to 4;
4. Improve member engagement levels, measure and report on engagement activities, and demonstrate value for employers; and
5. Capitalize on member readiness to engage in their health as “77 percent said the COVID-19 pandemic has led them to pay more attention to their health in general, and 50 percent indicated previous stay-at-home orders helped them achieve their health goals.”

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Author: Lori Logan, Geneia Chief Product and Client Officer

To learn more, download the white paper, Next-Generation Health Plan Member Engagement: A Phased Approach