Feet and words right and wrong painted on an alphalt road

7 Member Engagement Mistakes Healthcare Organizations Make + How to Solve Them

Healthcare member engagement and loyalty are vital to strengthening plan performance, reducing costs and improving STAR ratings and HEDIS scores.

In fact, when Humana implemented their new consumer engagement model SmartSuite, they saw a significant reduction in claims which totaled $2.1 million in savings.

Plus, a study published in the journal Population Health Management found that Geisinger Health Plan’s telemonitoring program, which included Bluetooth scales with an Interactive Voice Response (IVR) solution, significantly reduced hospital readmissions and cost of care for members diagnosed with heart disease and saved approximately 11 percent per patient per month over a 4-year period.

The good news is that member satisfaction has increased in part due to plan administrators who have made information and communication a priority, according to the J.D. Power 2015 Member Health Plan Study.

Yet despite these gains, we have found that many healthcare plans are still falling short on member engagement.

Here, read on for 7 of the most common mistakes you might be making and strategies to fix them.

Mistake #1: Dropping the ball on onboarding
The most critical time in the buyer’s journey to establish a relationship with members and promote early engagement is immediately after they enroll in the plan. Also, since complaints usually happen early in the year it’s important that you establish expectations right away.

Yet for so many organizations who pour time and effort into converting leads alone, they miss this opportunity.

To remedy this shortfall, establish a strategy for new member onboarding that will keep members engaged from the beginning and reduce the likelihood of complaints.

One way is to call members to welcome them to the plan, explain their benefits, set expectations, and answer any questions they may have. These early connections are also a good time to re-confirm member data and tee-up health risk assessments.

Mistake #2: Making the experience generic
Members expect a personalized healthcare membership experience yet it’s no surprise that many healthcare plans lag behind when it comes to targeted marketing campaigns that keep members engaged.

You can create a personalized experience by using personal health and historical data, demographics, and opt-in preferences to determine the type of content and the appropriate channels to target members with customized content that will keep them engaged throughout their health journeys. Identifying and communicating through the member’s channel of choice will increase engagement and lower costs for the health plan.

Free Download: The Customer Rage Study: An independent study of customer complaint-handling experiences. 

Mistake #3: Missing vital touch points
Many healthcare plans fail to have a system in place to understand and reduce member churn rate, which are most common after the Annual Notice of Change mailings and right as AEP begins.

So after the initial onboarding process, it’s important to have a multi-touch program in place to address and resolve problems throughout the year, keep members engaged and lower attrition. One way to do that is to conduct your own survey before members receive the CAHPS survey.

Mistake #4: Viewing the call center as a cost
For most mid-sized healthcare plans, their strong suit is developing strong plan benefits, effectively collecting premiums and timely paying out claims. Yet as their plans grow, they can’t keep up with the demands of customer service especially if they want to keep everything in house.

The result? A call center that not only fails to serve its members properly, but more attrition,  lower STAR ratings and insufficient HEDIS data.

To overcome this obstacle, plans need to find partners who have the infrastructure to build a robust call center, train employees, build a strong reporting system and produce the desired outcomes.  It’s time to start viewing the call center as a profit center, not an internal cost.

Mistake #5: Failing to resolve complaints
Without the proper system in place many healthcare plans cannot follow up, or even properly address member questions and feedback. And without resolution, it’s more likely that members will complain and switch to another plan when AEP rolls around.

Finding a partner who specializes in data-driven marketing solutions and customer experience can help you design a customized process for member feedback, follow up to resolve issues and prevent complaints from happening in the first place. Plus, by using this strategy, you’ll also see a higher first call resolution, which will decrease your overall member servicing costs.

Mistake #6: Spending too much time on training
As they grow, healthcare plans need customer service representatives to handle the increased call volume and call complexity. Although they may have a strong training curriculum, many don’t have the best industry practices or the technology to execute it.

And without the proper infrastructure in place, it could take up to 6 months to get their member services call center agents to become proficient. Plus, if employees feel that they can’t do their jobs well, they’ll leave, which further drives up costs.

Working with a partner who can offer a best practices model, a strategic plan for agents to achieve goals at 30-, 60-, and 90-day increments, as well as the technology and resources you need, can allow you to have your staff quickly operating at a high level of proficiency.

Mistake #7: Hiring sub-par sales call center companies
How many times have you waited in a long, slow line to purchase holiday gifts only because the sales associates have only been on the job a few days?

It’s the same scenario for most healthcare plans who hire outside agencies during open enrollment to bring more representatives on board to handle the high volume. Yet this route is costly and not customized for the healthcare plan’s needs.

So instead of simply adding more people, it’s important to determine the buyers you want to target during the enrollment period and deliver on marketing campaigns.

Think about finding a partner who can offer a pay-per-performance model and will charge you cost per lead or acquisition. This model also reduces your internal risk and incentivizes your representatives to sell more.

The bottom line: member engagement can be challenging without support from a trusted partner. So consider teaming up with an organization who can offer a team that provides customized solutions for data analytics, member onboarding and engagement, campaign management and marketing to help attract and retain members, cut costs and improve your ratings and scores.

healthcare member engagement tips

Want more healthcare content?  Get it sent directly to you inbox by subscribing here 

Written by:

tim     Tim Collopy, VP Business Development

pete  Peter Schmitt, Chief Strategy Officer


More from Dialog Direct