How Payers Can Improve Member Engagement by Partnering with Members

Payers have continued to see low consumer satisfaction with member engagement throughout the coronavirus pandemic, as plans scored an overall satisfaction score of 719 out of 1,000, a recent JD Power survey found.

The survey looked at six core areas to determine member engagement, according to James Beem, managing director of global healthcare intelligence at JD Power. These areas have emerged over the 25 years that JD Power has conducted this survey. The survey asked 35,000 to 45,000 consumers about their experiences in one of around 150 health plans represented.

“Over time, based on our research and based on our level of statistical modeling, we understand which experiences are most important to consumers,” Beem explained to HealthPayerIntelligence. “Those six factors really, at a very high level, define all of the attributes that drive member satisfaction.”

This year, as in the past, the numbers were clear: payers did not come across to members as delivering patient-centered care and communication.

Six in ten members who were part of a private payer health plan said that they were not contacted by their health plan with coronavirus-related information. Nearly five in ten (48 percent), said that their health plan did not show concern for them during the pandemic. And merely a quarter of the survey participants responded that their health plan was a trustworthy partner in pursuing their personal wellness.

Telehealth was a new source of confusion for member engagement during the pandemic.

Many payers have taken action to expand access to care via telehealth in recent months. Member satisfaction was closely linked to telehealth expansion, resulting in a 39-point bump for payers that expanded telehealth access.

Nonetheless, one of the areas of payer-member miscommunication that surfaced during the coronavirus pandemic was around telehealth benefits. Over half of the survey participants (54 percent) were uncertain about 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.

One perennial member engagement problem that reemerged in this year’s JD Power survey was the lack of trust regarding costs. As healthcare costs and cost-sharing with members continue to grow, consumers are lacking trust that payers are protecting them from high healthcare out-of-pocket healthcare spending. This perspective has been especially prevalent the past three or four years.

“Consumers tend to fail to meet those high deductibles year in and year out and that produces a level of pent up frustration. They largely assign the blame to the health insurance carrier rather than the employer or the local health systems,” Beem explained.

Integration can counteract that negativity, though. The survey showed that health systems with an integrated health plan have higher member satisfaction rates than the typical health insurance carrier.

The circumstances could make the health payer industry ripe for disruption, Beem indicated.

“The logical end point to that is: does that put the private health insurance market at risk for disruption?” Beem speculated.

Beem pointed to two major gaps in member satisfaction left by larger healthcare payers that disruptors could easily step into. Either the disrupter could lower costs for the consumer, or the plan could develop a way to allow the member manage their own costs through better price transparency.

“If traditional health insurance plans want to resist the threat from disruptors, they need to demonstrate partnership with members—and on behalf of employers—to improve member health, reduce costs and help members navigate the healthcare system,” Beem said in the press release.

The JD Power survey noted payers that partnered well with their members and had high satisfaction. Ten of the 21 health plans highlighted in the JD Survey report scored above 735. Two of those were Blue Cross and Blue Shield of Michigan (736) and Humana in Florida (783).

How Blue Cross Blue Shield of Michigan partnered with members

Blue Cross and Blue Shield of Michigan (BCBSM) was among the first health plans to offer testing at no cost, waive COVID-19 treatment costs, and offer medical and mental telehealth services to members free of charge.

BCBSM also added non-benefit-related approaches to its member engagement strategy, Bob Crawford, vice president of corporate marketing and customer experience at BCBSM, noted in a statement provided to HealthPayerIntelligence by email. Among other efforts, Crawford mentioned that the payer’s strategy included

• Conducting nurse outreach to vulnerable member populations
• Starting education campaigns with the goal of making members aware of their free telehealth options
• Developing around 1,000 unique communications for stakeholders in order to generate a positive member experience

For BCBSM, a major challenge was how to connect directly with members. Since most of its members were in the group health insurance market as part of an employer-sponsored health plan, the payer did not always have a direct channel of communication with the member.

Crawford said the payer has made strides to overcome this challenge by collaborating more closely with the employers. BCBSM also offers a highly-rated app that provides information access and allows members to view their claims and charges breakdown. The app also has an artificial intelligence-enabled bot to help answer member questions.

BCBSM has also focused on creating omni-channel engagement tools to engage with members in the right way at the right time, strengthening the consumer feedback process, launching an app-supported, care management program for high-risk members, and expanding telehealth options.

How Humana in Florida partnered with members

In Florida, Humana was also at the forefront of waiving testing and treatment costs during the pandemic.

The health plan engaged with its members during the coronavirus pandemic by waiving telehealth costs, creating a support plan for members to combat the mental health impacts of social isolation, hosting webinars for members on health and wellness and regarding other common questions. Humana also offered yoga classes to incarcerated individuals, veterans, and those suffering from substance abuse.

One challenge that Humana faced is how to address social determinants of health.

The payer’s strategy was both individual and communal. Humana designed programs to help address the needs of its individual members, such as lack of transportation. However, the health plan also donated significantly to local health, non-profit, and religious organizations that can influence the health and wellbeing of local residents and Humana members.

The payer indicated that part of partnering with members is to collaborate with employers.

For example, when some employers expressed a need for personal protective equipment for their employees, Humana helped arrange for access. Other employers wondered about safely returning employees to the workplace and providing the necessary health screenings. Humana collaborated with the employers to find a vendor that would conduct the wellness checks.

Some of the lessons learned from the past couple months may prove useful to payers as they seek to improve their member engagement and improve low member satisfaction.