Effective member engagement allows a health plan to accurately assess the health status of its members. Engaged members are more likely to participate in their healthcare, seek information about providers, and adhere to treatment plans—all of which lead to better health outcomes and lower costs. Members who take an active role in their health and wellness are also more likely to adopt healthy behaviors and respond to messaging and incentives. Leveraging analytics and meeting members where they are can identify areas with high levels of engagement and areas where members are disengaged and may likely be going without care.
With the rise of healthcare consumerism, it’s critical to build trust with both providers and members. Building trust requires ongoing initiatives to demonstrate that a health plan is committed to the well-being and satisfaction of its members. As you prepare for 2024, we’re sharing three ways to improve member engagement and enhance your risk adjustment and quality programs.
Cultivate Strong Provider Relationships
Providers play a vital role in delivering care to your members. Building and strengthening relationships with these providers is crucial. Members often have established relationships with their healthcare providers, making it more likely that they will actively engage in their care. By establishing robust relationships with your providers, you can encourage them to reach out to members and foster better engagement. Plans that prioritize relationships with their providers are more likely to have satisfied and engaged members who receive high-quality care.
Collaboration between plans and providers also facilitates better care coordination and informed decision-making among members. When providers and plans work together, they can ensure that members receive the right care at the right time, while reducing unnecessary or duplicative services. Health plans can improve care coordination and member engagement by implementing remote access to a provider’s electronic medical records when possible. This allows plans to check appointment schedules and schedule members who have not yet been seen. Additionally, changing provider payment arrangements to be risk-sharing, incentivized, or value-based can help align providers’ actions with the health plan’s priorities.
A provider’s performance also affects how members feel about their health plan, possibly impacting CAHPS survey results. We continue to see healthcare consumerism as a trend and members are more interested than ever in seeking information about healthcare providers, treatments, and costs to make informed decisions. Ensuring that members see their plan as a trusted partner in their care goes a long way toward helping them feel in control of their health.
Host In-Person Events and Focus Groups
Health and benefits fairs offer an excellent opportunity for members to connect face-to-face with providers, health plans, and peers. It also provides a forum for members to learn more about their benefits, receive health screenings, and schedule follow-up care with their providers. Additionally, having guest speakers discuss specific health concerns relevant to the member population can boost engagement among specific groups. Hosting events in urban areas can be an effective way to attract both city and suburban residents, especially when there’s an activity or event that can draw a crowd. Following up with a webinar after an in-person event allows for additional engagement opportunities. During webinars, members can interact with each other through chat, ask questions, and get more information about upcoming events that may interest them. This provides continuity and helps keep members engaged even after the event is over.
Members are increasingly open to collaborating closely with their health plans and care teams. It may seem obvious, but a highly effective approach is to directly seek members’ opinions, enabling honest and actionable feedback. There are several vendors and solutions available to facilitate focus groups, allowing members to share their experiences and give health plans valuable information about preferences. This also creates a sense of community as members engage with peers who may share similar concerns.
Leverage Analytics to Meet Members Where They Are
As part of your member databases, you’re likely collecting demographic data. Use these data points already available to you to better understand your member population. We’ve found that geotargeting based on zip code information can be a valuable tool for identifying high-risk members within your population. We know that members in rural and low-income areas may face challenges with care access and are more likely to face barriers due to social determinants of health. By creating heat maps with your data, you can develop targeted programming aimed at proactively supporting these members. Analyzing your geotargeted data can also help identify areas where in-home assessments are necessary, which can uncover additional health concerns that may go unnoticed in a traditional clinical setting.
Additionally, analytics can help determine a member’s likelihood to engage with AI/ML models. Knowing which members are more likely to respond and which methods are most effective can help a plan make better use of its resources and investment in member engagement campaigns. Results from member engagement initiatives can also be utilized to expand training data sets and further understand member populations likely to respond, leading to increased success in outreach to prospective members and scheduling PCP visits.
Investing in effective member engagement strategies leads to better health outcomes, lower costs for plans and members, and more personalized care—further positioning plans for success when it comes to risk adjustment and quality initiatives. Explore other ways to improve your risk adjustment programs here.