In the middle of open enrollment for health care, we asked Dogu Celebi, MD, MPH, Chief Medical Officer of Decision Point Healthcare, to explain the role that patient engagement plays in creating member loyalty. He also discusses the use of data analytics in identifying engagement and disengagement (or dissatisfaction), and how digital communications can affect loyalty.
- When should health plans start planning for open enrollment season? What does it entail?
Planning should occur year round. Plans that engage with members from the first interaction and continue to provide individuals with what they need to better engage with the plan, their doctor, and the entire medical eco-system will likely see higher levels of loyalty, and improved satisfaction and retention. Improving engagement is about providing members what they need, when they need it.
Loyalty comes from maintaining high levels of positive engagement throughout the member life cycle. This cycle begins when an individual initially signs up with the plan, and continues with providing support to the member through their life and health events. Plans that focus on relevant, meaningful communications targeted to the right people at the right time, and framed in an engaging way that is also understandable and actionable are the ones that will garner greater loyalty.
- In what ways is patient engagement the next frontier for managed care plans?
As health plans move to a more consumer model, as is the case with Exchange, Medicare, and Medicaid plans, getting members to engage quickly and continually is important. Engagement can manifest itself in increased confidence in self-care, improved health literacy, self-advocacy, and improved satisfaction with the plan and their doctor. The sooner plans can achieve this level of engagement, the better they can create a base of members who can care for themselves and who are loyal to the plan.
- How does year-round enrollment planning and patient engagement factor into enrollment satisfaction?
With year-round engagement, we are trying to achieve loyalty and improved outcomes. When people get what they want, when they need it – in a language and framework they understand, higher levels of engagement follow. We believe it is important to introduce concepts like benefits, health reminders, etc. in a way that resonate with the individual, acknowledge the individual’s unique challenges, and enable them to understand, engage, and act. With that, better engagement outcomes are achieved.
- What is the role of data analytics in identifying unhappy or disengaged members?
Data analytics can play a very large role in identifying unhappy members who are at risk to disengage.
By sifting through millions of data points, data analytics can zero in on disenrollment risk and provide insight into why an individual might not engage, disengage or report dissatisfaction with the plan. Engagement and behavioral analytics are key to this understanding. The goal of analytics is not only to understand the likelihood of dissatisfaction, disenrollment, and disengagement for each member, but also to understand why. By zeroing in on members who are likely to disenroll, and addressing their potential barriers to engagement in a framework and language they understand is key to changing behavior and promoting engagement.
- Can you give an example of specific insights provided by data analysis?
Certainly. We know that a member’s disenrollment behavior is at least partially related to their experience and engagement with the entire healthcare system – not just the health plan.
Citing analysis of over 500,000 Medicare subscribers, we found members who had at least one visit with their doctor are far less likely to disenroll from the health plan than members with visits.
This means that members who are not engaged with the healthcare system are more likely to disenroll voluntarily than engaged members. Comparing healthier patients to sicker patients (measured in terms of their number of diseases), we know that:
- Sicker patients with no doctor’s visits are two times more likely to disenroll than sicker patients who have a doctor’s visit
- Healthier patients with no doctor’s visits are almost 1.5 times more likely to disenroll than healthier patients who have a doctor’s visit
- What investments, resources, strategies, and tools are plans applying to hold patients’ attention and ensure enrollment satisfaction?
Plans deploy many tools to achieve these goals. They invest heavily in understanding patient engagement, communication channels, and how best to reach patients. However, with all this attention paid and investments made, a gap remains between what the health plans think is important and how the patient interprets a plan’s value, and the in-the-moment perceived value. Data analytics looks at engagement from the patient perspective and seeks to assist the deployment of those resources in a smarter way that results in greater engagement success.
For example, a plan may have built a call center that communicates frequently with members to remind them of screenings and routine tests, assists with onboarding, etc. However, data analytics zeros in on those members who need the most assistance at a time when the communication is most relevant to the member.
- What role does digital communication play in planning and strategically implementing a patient retention plan?
Often health plans ask what channels work the best. Our answer is they all work in some ways for some people – email, SMS, mobile applications, live or robo calls, etc. The real focus needs to be on what is the best communication for whom and when.
Plans differ in their use of and depth of digital communications. Some plans are reluctant to use digital communications for seniors despite changes to that population where younger seniors use digital media in so many forms more frequently than do their older peers.
We are not advocating for coming up with more digital communications approaches. We believe that communications provides education, which makes members more healthcare literate and, in return, drives engagement. Our approach focuses on targeting the right message through the proper channel.