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RED HOT Contributors


How Digital Strategy Drives Health Plan Member Engagement


Health plans can become the ultimate healthcare navigator for their members by offering guidance toward best solutions, lower cost options, new service offerings and a range of other resources that can benefit both the member and the plan. Digital offers efficiency, personalization, ease of access, and many other attractive benefits.

But it takes a lot of work on in the areas of strategy, tactics and technology infrastructure to succeed.

Thinking back, it wasn’t too many years ago that health plans had little regard for consumers. Their business was built on managing risk through effective provider networks, and efficient claims processing – and they sold through benefits consultants to large groups. An insurance company exec once told me they viewed members as “cost,” and that dealing with them meant added customer service time on the phone.

And now with their focus on member engagement, they recognize that healthcare consumers have the same wants and needs as consumers in other categories. They actually do care about cost and quality and value and timeliness and accuracy. They just didn’t have the ability to make many choices or have the information needed to make them wisely until healthcare consumerism finally blossomed.

Today, the balance of power is shifting. Members want to interact with their health plan more often than less, and want to do so online and on their own schedule.

Health plan members are the same consumers who regularly use self-service portals from retailers, banks, airlines, hotels and other businesses in their daily lives. Those sites have set high expectations for user experience with intuitive design, ease of use, ease of conducting transactions, ease of finding information, and other features.

Health plans will be held to the same high standards and must do more to deliver a digital experience that is seamless and aligned with member expectations – and without the typical difficult-to-access data and hard-to-use forms.

Health plans also have major upside opportunities to reduce risk by delivering meaningful digital engagement that produces real results. But this is not easy – it takes transformative commitment to bridge the divide between yesterday’s legacy systems and mindsets and tomorrow’s best-in-class solutions.

  1. Start with clear business objectives

The starting point for digital engagement strategy is your business objectives. What do you want members to do on your digital platform? Think of the platform more like an action-producing engine than static information repository. That engine can be geared to achieve any of an array of outcomes that can lead to risk reduction, such as saving administrative cost, promoting wellness and health improvement, and guiding heath system navigation. Each of these have a broad set of potential tactical applications. For best results, these details need to be fully fleshed out and delineated in an action plan designed to define and assess the impact of digital interactions, and lead to refinements when needed.

  1. Use systems thinking

Identify the main points of interest for your members, based on past experience and business objectives. Outline the various navigation paths members may take based on their interests. Map out the possible scenarios and enable the information and resources that support their search to appear. Anticipate knowledge gaps and seek to fill them with appropriate content displayed for easy access. Guide them to solutions related to price transparency or telehealth or medication adherence or health system navigation to help active their consumer tendencies – and help reduce risk. Give them a reason to want to return – good experiences on the first few encounters are likely to make the platform a go-to resource for your members. And, consistently great experiences will help drive up satisfaction levels – a key business objective.

  1. Be seamless

Plan content and links with consumer experience in mind. Most health plans will have incorporated services and resources from a number of vendor companies, but the portal doesn’t have to look and feel like patchwork quilt with unrelated views. Design the integrations so the content appears to be from the same source. Use single-sign-on and data integration to make the engagement experience complete – new tabs from outside sources should appear be just another page on your website, with consistent look and feel. A rich and robust digital platform will be helpful in guidance and motivating toward desired actions.

  1. Personalize and tailor 

Digital consumers expect to be remembered when they return to a site based on prior visits, but health plans can do so much more by customize the brand experience for their members. A member’s health profile, including demographics, claims history, selected providers and other data can combine to create unique experiences. AI can add dimensions as well, based on recent actions, program enrollments, discounts earned, and other elements of interactivity. You can enhance profiles with short quizzes that can offer insight into health literacy, personality traits, social interests, and more. Personalizing the experience delivers better engagement and better outcomes.

  1. Lead with mobile 

Mobile has never been more important in our culture and our economy. Smart phone penetration is nearly 80% in the US. There is no excuse for not having a mobile app integrated with your digital platform and there is no reason not to collect email addresses and mobile numbers from your members. For years, vendors and other services providers to health plans have bemoaned that health plans don’t have contact data of their members. Those data need to be collected at enrollment or renewal along with member communications preferences and full assurance of privacy.

Today’s digital member engagement opportunity is vast and largely untapped. With data access and integration, health plans are uniquely positioned to be the ultimate hub for healthcare consumers – with the ability to effectively guide individuals to better care at a lower cost – and with reduced risk for the plan.

About Frank Hone

Frank Hone, CCXP is a healthcare customer experience and engagement strategy leader with a unique platform. Since 2008, when he published “Why Healthcare Matters,” a business book on healthcare consumerism, he's used advertising and marketing principles to drive deeper and better customer experience and consumer engagement with healthcare solutions. Across the many phases of his career, I’ve focused on customer experience, from advertising and new product work to healthcare engagement and consumer marketing. With broad expertise across many healthcare sectors, his current emphasis is on designing strategic frameworks that incorporate behavioral economics, process excellence, journey mapping, digital engagement and relationship marketing principles that can create meaningful customer experience. Through his recent leadership positions at Healthways, Healthcentric Partners, and Healthx, he's served dozens of customers, helping them achieve their business objectives related to health system steerage, population health, administrative cost savings, and other areas by developing relevant solutions that promote positive customer experience.

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