Member Engagement Requires Advanced Analytics, Specialized Team

Member engagement strategies need to make better use of advanced analytics, be more attuned to members’ journeys of care, and culminate in a tight, dedicated team with a broad range of specialties to serve members’ needs expediently, according to research from McKinsey & Company.

“Health insurers are beginning to leverage the digital, advanced analytics, and personalization capabilities developed and refined in other industries to create new, more effective digital member support tools and to scale the member engagement solutions already available.,” the researchers found.

“Collectively, these capabilities and tools, when applied broadly, are starting to improve clinical outcomes, enhance member experience, and reduce near-term medical costs.”

McKinsey & Company recognized three major enablers that empower health plan member engagement:

• Advanced analytics
• Personalization
• Behavioral economics

Health plans can employ data science and advanced analytics to create accurate personas of different member populations. These personas can be critical for population health management. Real-time signal interpretations and episode analytics can illuminate patterns and value sources using both touch-point and third-party data.

Personalization is also critical to effective, 21st century member engagement, allowing members to receive relevant, useful information for their population. Just as in the rest of their life including retail shopping decisions, consumers want to see options and want companies to honor their preferences by, for example, prioritizing digital solutions over in-person or phone call troubleshooting.

With behavioral economics, payers can better develop member engagement strategies by understanding the behavioral drivers behind members’ economic decision-making.

McKinsey researchers outlined three steps to achieving improved member engagement with these three enablers in mind.

First, payers must properly define member populations and individuals to engage.

This calls for advanced analytics to make predictions about member behaviors and future medical needs. By projecting members’ needs, payers can better estimate healthcare spending.

Payers must outline patient journeys of care that unveil the decisions members must make in various medical conditions. These journeys of care may be specific to a disease or treatment, or they may outline more general care pathways, such as the decision to visit an emergency room.

These journeys help payers familiarize themselves with which decisions are most costly and the challenges members face on different journeys of care.

Members make hundreds of care decisions a day, so it is vital that payers isolate and focus on the most important ones.

A decision’s importance is rooted in its ability to affect the cost or outcome of the member’s health condition, including decisions that result in cost savings.

McKinsey & Company used episode analytics to narrow down the most important decisions and took into account the member’s agency in the decision-making. This can include, whether the member had enough data to make an informed choice and how much insurers can know about these moments in advance to support the member’s decision-making process.

Employing empathy maps can help build a machine learning software that is better attuned to members’ priorities.

Once the payers have identified the appropriate members, they must fashion the best messages and strategies for approaching that member and addressing their care needs.

Again, the best way to achieve optimal results would be to use advanced analytics to create these strategies.

Before payers engage with members, the members engage with their payers through certain “signals.” A doctor’s visit, payer app or website usage, or even a member getting married can direct the payer to the member’s healthcare priorities.

Payer responses to members’ signals should incorporate three elements, McKinsey researchers said:

• The solution or information for which the member signaled
• Messaging that incorporates the member’s other priorities
• A platform for the communication that works best for this particular member; often, communication with a single member will involve more than one platform

With certain member populations, it can be difficult to establish an effective method of communication, such as with Medicaid beneficiaries. However, payers that successfully incorporate these three elements into their rapid responses could see much stronger member engagement, McKinsey researchers suggested.

Lastly, payers should optimize engagement. This involves not just engaging with members but also with their care providers and creating a small team or teams committed to member engagement and business results.

Payers should dedicate a team of highly specialized individuals to member engagement. Team members should include a/an:

• Campaign manager
• Creative
• Digital media creator
• Analyst
• Operations leader
• Clinician
• IT expert

Actual strategies will vary based on the team’s focus, but the team will home in on fast, accurate problem-solving and predictions related to member engagement.

“Health insurers have yet to realize the full potential of digital member engagement,” the researchers asserted. “By empowering members to make higher-value care decisions, next-generation member engagement tools can improve clinical outcomes, enhance member experience, and reduce near-term medical costs.”