Four New Year’s Resolutions for Health Plan Executives Seeking Improved Member Quality of Care & Satisfaction

By Craig Johnson

The New Year offers new opportunities for health plans to fine tune their population management strategies and drive stronger and more sustainable member quality, satisfaction, and loyalty.

Here are four recommendations for 2015 to help health plan executives effectively change behavior and improve performance by identifying engagement inhibitors, tailoring member communications, and designing personalized, targeted, and efficient intervention efforts.

Resolution #1 – Eliminate member communication silos with cross-department coordination

Many departments throughout health plan organizations play a role in population management efforts – quality, case management, marketing, customer service, etc. – and they all have reasons to interact with members. Some of those interactions are in reaction to certain events, like new enrollments with the plan, or the onset of a new condition, while others are proactive, such as reminders for screenings/exams. However, when each department initiates its own outreach, members receive disjointed communications that can create member abrasion, discourage plan engagement, and seriously undermine the health plan brand.

To ensure a steady flow of helpful, targeted communications, plans can:

  • Develop a comprehensive, yet focused, population health management strategy with analytic underpinnings targeted to areas where the member requires the most help and is at greatest risk for adverse outcomes (including clinical, compliance, adherence, utilization, retention and satisfaction outcomes);
  • Craft consistent, brand-supporting messages to be deployed across all outreach;
  • Establish a single, centralized communication system (again, with analytic underpinnings) for all member communication;
  • Plan and coordinate outreach between departments throughout the year to ensure consistent, helpful communications that encourage plan engagement;
  • Include a response mechanism – i.e. a “call to action” – in every communication.

This type of coordination improves plan engagement as it presents a more unified face to members and helps avoid over- or under-communicating with subscribers.

By breaking down these walls, plans can create all-encompassing communications programs designed for effective population management. The sooner plans can achieve this level of engagement, the better their ability to create a base of members who can care for themselves and who will remain loyal to the plan.

Resolution #2 – Start now

All too often health plan executives wait until the 11th hour – for example, when a plan presents with a care gap, has an admission, or during open enrollment — to deploy or adjust targeted member communications.

Plans that understand how best to engage proactively with members year-round experience greater bottom-line results and better outcomes. Member health-seeking behavior and loyalty depend on member engagement that starts with the first interaction and is reinforced throughout the year as members continue to engage with the healthcare eco-system – plan, primary care physicians, and specialists.

The right time to manage quality of care and loyalty proactively is every day throughout the year. We have found that plans that deploy proactive strategies focused on quality of care, loyalty, and satisfaction throughout the year experience across-the-board outcomes.

Resolution #3 – Test and measure new communications channels

Get out of your comfort zone and move beyond traditional letter and phone communications. A wealth of new communications channels are at your fingertips: email, SMS, mobile applications, IVR calls, etc., but the key is to understand when to use them and to whom to target.

All channels work, but the key is determining what channels work for which members, and whether it makes financial sense to use those channels given the impact. You may find that the boomer generation is just as welcoming to digital communications as millennials. It is important to always analyze the outcomes of each outreach, compare the outcomes to a control group, and determine the segment-specific successes and failures.

The most successful health plans are those that work on targeting the right message through the optimal channel and constantly test new channels to determine the value for each of their population segments.

Resolution #4 – Abandon mass mailings for customized communications to members

The days of blanket messaging are gone. Big data analytics allow you to segment your membership based on their barriers to engagement – across all health plan domains such as compliance, loyalty, satisfaction, clinical risk, etc. Why alienate members with messages that don’t speak to their barriers when you can zero in on their areas of greatest need and craft tailored messages designed to drive engagement?

Every member is different. Understanding and acknowledging these differences in communications builds engagement and ongoing loyalty. Developing an engagement plan with analytical underpinnings can help you understand why a member is unengaged, and you can build a plan that addresses the members’ specific barriers to engagement, thereby increasing the chances that your message will resonate and engage the member. Big data analytics helps you do this efficiently by segmenting the population into homogeneous groups that have similar barriers, and communicating with each segment in a personalized manner.

Targeting the unique needs of each member and avoiding repetitive blanket correspondence that can result in greater engagement has shown to boost performance across the organization – from quality to utilization to loyalty.

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