Payer Expands Member Engagement Program, Digital Outreach to ACA Members

After a successful Medicare Advantage (MA) rewards program, Blue Cross and Blue Shield of Kansas City (Blue KC) has expanded their partnership with a member engagement company to cover ACA members.

The vendor, HealthMine, will build an incentives and rewards program for Blue KC’s Individual Family Plan ACA patients to increase member engagement.

"Blue KC is excited to offer our ACA members the opportunity to participate in the HealthMine rewards program as part of our overall commitment to giving them tools as they work to improve their health and wellness," said Lori Rund, vice president of government programs for Blue KC.

Blue KC's MA rewards program saw gap closure compliance increase tenfold for registered members compared to non-registered members. According to Rund, the program has driven a member-centric experience and helped Blue KC members engage with healthcare decisions.

The ACA member rewards program will utilize digital outreach, including email and text messaging, to reward members for completing assigned exercises such as a digital Health Risk Assessment (HRA). The individualized health insight data from digital HRAs will allow Blue KC to direct members to health programs and assure they have access to care.

The platform uses personalized outreach to encourage member engagement. The program offers a mobile application experience as well as an individualized archive of NCQA-certified health education information. Additionally, members can select specific gift card rewards for certain actions.

Blue KC will roll out the program to all ACA Individual Family Plan members at the beginning of 2021.

Payers across the industry have seen low member engagement and consumer satisfaction throughout COVID-19 according to a recent JD Power survey that asked 35,000 to 45,000 consumers about their health plan experiences. Around 150 health plans were represented in the survey.

As in the past, the numbers were clear for 2020: payers did not come across to members as delivering patient-centered care and communication. On average, plans scored a satisfaction score of 719 out of 1,000. This is among the lowest scores of all industries evaluated by J.D. Power.

According to the study, health plans lack customer centricity and member engagement. Customer satisfaction is contingent on efforts by health plans to engage with members. For instance, when a payer communicates with members on ways to control costs, customer satisfaction increases. Additionally, payer communication on coordinating care levels up customer satisfaction.

As healthcare costs continue to rise, consumers are lacking trust that payers are protecting them from high healthcare out-of-pocket healthcare spending, a perspective that has been especially prevalent over the past three or four years.

Overall, when a health plan assists members in keeping their out-of-pocket costs low, the average satisfaction score is 819. This is 152 points higher than when payers do not readily communicate with members regarding lowering out-of-pocket healthcare costs.

COVID-19 sparked payer-member miscommunication around telehealth benefits. Over half of the survey participants (54 percent) did not know whether telehealth was available to them as part of their offerings.

“Plans need to get more aggressive around working with their health plan members around understanding their telehealth options,” Beem said.