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RED HOT Contributors


5 Ways For Better Health Plan Member Engagement



Despite the lack of certainty about what’s next for healthcare, we can be sure of one thing – consumer power continues to make waves and strengthen.

Healthcare Consumerism had a slow start in the early days of consumer-directed health plans over a decade ago. But now, high deductible plans represent more than a quarter of all employer sponsored plans, and nearly 40% of all private health insurance plans – meaning that patients are paying more out of pocket dollars for medical services.

A wide array of vendor companies now compete to serve health plans, self-insured employers and other payers with solutions for price transparency, telehealth, on-demand concierge, health and well-being improvement and several other areas intended to help members achieve better outcomes with their health and healthcare.

One problem is that most of these services are not broadly utilized. Participant engagement is low and potential vendor revenue is left on the table. Health plans and other payers are fully aware of their member engagement gaps, and most aren’t doing enough to overcome communications shortfalls and consumer apathy.

Part of the problem is that many payers aren’t strategic and disciplined enough about their own business objectives and outreach plan and aren’t conveying the member benefits with sufficient focus and emphasis.

Here are five ways to get more from your vendor partners and produce better overall results for your health plan and your members.

  1. Business Objectives: What do you want members to do?

A well-designed and clearly articulated member engagement strategy needs to address aspects of risk reduction, revenue generation, or cost avoidance – while also giving members a reason to take action. Whether it’s health system navigation, treatment selection, diagnostic lab choice, medication management or any of a variety of other services, members often do need guidance and don’t necessarily know where to go for help. Payers are well positioned to not only offer support, but also benefit financially from appropriate decisions.  

  1. Member Onboarding: How will you introduce them to the various services?

Health plans are notoriously bad at promoting their product to new buyers and need to do more to show members around to their various services and resources. Most members aren’t aware of many of the benefits available to them. The onboarding process should guide people to quickly and easily understand how to access information and how to take advantage of opportunities. Online tutorials and video clips can efficiently and effectively tell the story. Give members an incentive for completing learning modules and they’ll likely use their benefits smartly.   

  1. Digital Connectivity: How will you reach them most efficiently?

It is amazing that member adoption of health plan portals remains dismally low in today’s digital age. Portal and mobile app registration should be mandatory as should the sharing of email and cell phone data – with defined and agreed-upon usage parameters.  Most consumers easily give up this information to hotel chains, airlines, and pizza delivery services, yet health plans are still resistant to collecting and using these essential communications data which reduce cost and improve efficiency.   Members are health care consumers and should be treated as such, with text messaging, email reminders, portal-delivered updates, etc.  

  1. Targeted Outreach: What is your messaging strategy?

There’s an art and a science to crafting a piece of communications that tells enough of a story to pique interest and has enough appeal to initiate desire toward taking action. In advertising, it often takes repeated frequency for a message to resonate. Payers need to be doing more testing about what is appealing and motivating to their members and about how to segment their population to increase outreach relevance. 

  1. Call to Action: What will motivate them to respond?

Even if the messaging does resonate, there’s no guarantee of influencing action. The field of behavioral economics has taught us that people do behave irrationally, knowingly or not. Incentives and rewards can help. They became integral to wellness initiatives, to the dismay of many who believed that people should do what’s good for them without a financial nudge.  There are many areas of health behavior where incentives make good sense to use. In areas of price transparency, telehealth, health system navigation and medication management it may certainly pay out to reward people to behave as told. It tends to work in the auto insurance model with safe driver discounts and devices like the Progressive Snapshot. Sometimes people need cold cash to take action.

While engagement gets a lot of lip service these days, it has become an overused term that has little clarity. Members don’t necessarily want to “engage” or have a brand relationship with their health plan, but they do want support and will appreciate the value that is delivered if it helps them make good healthcare decisions or save them money.

Payers need to raise their game in connecting with members and offering true value – in the end, it will mean more risk reduction, revenue generation, or cost avoidance – essentially monetizing member engagement.

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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