Engage Your Members. It’s Now or Never.

Member engagement is the new trend, taking the healthcare ecosystem by storm. Health Plans are now compelled to make themselves more approachable with enhanced member experience.

By definition, member engagement is the interaction health plans have with their members. Traditionally, this interaction was limited to collecting premiums and reimbursing claims. With the onset of mobile applications, however, interactions between consumers and service providers have increased exponentially. Consumers expect their service providers to be available for any query or concern and be proactive in their offerings.

Health plans are also expected to be proactive and engage with their members more frequently than before, to improve care quality and outcomes. This would also improve a health plan’s member satisfaction scores.

Let’s look at a few more reasons as to why a health plan must implement top-grade member engagement immediately.

Fast-paced Communication 

Both consumers and businesses alike are increasingly using their mobile phones, tablets, smartwatches, and other such gadgets to manage communication. Since the Covid-19 pandemic, consumers have been using their mobile phones to avail services ranging, from groceries to gardening. Owing to this, consumers have become accustomed to quick responses and personalized customer services.

  • Going forward, health plans must utilize these consumer touchpoints, through apps, to keep their members updated to ensure approachability and help members make informed care decisions.
  • Health plans must chalk out personalized communication strategies, urging members to engage, which, in turn, improves their member experience. With improved member experience comes higher member satisfaction scores, making health plans more desirable to potential members.

Capture Member Behavior

The sole reason why engagement with consumers has blown-up in the last decade is the ease of capturing consumer data. Through consumer touchpoints, businesses can collect data on consumer behavior, from their likes and dislikes to reactions and interactions.

  • Implementing member engagement strategies helps health plans gauge their members’ behavior and understand the member personas they are catering to.
  • Health plans can lay out personalized member engagement strategies based on the insights they receive from their previous strategies. Capturing member behavior can also help in predicting health issues members might face, helping health plans notify their members well in advance to ensure prevention.

Easy Follow Up  

With the Covid-19 pandemic and its vaccines doing rounds, contacting members and following up with them can be quite repetitive and time-consuming. Keeping that aside, there is a high possibility of missing out on contacting members, leading to inefficient vaccine administration which would simply end up in more chaos than it already is.

  • Health plans must utilize the multiple member touchpoints available to them and request members to adhere to precautions and use these touchpoints to follow up on them post-vaccine administration.
  • Health plans and healthcare providers can keep track of a member’s medication status via these touchpoints, allowing health plans to intervene in case of inconsistencies. In the post-Covid-19 world, appointments and follow-ups can be easily scheduled through these apps.

Regulatory Compliance  

Apart from the above-mentioned reasons to implement member engagement strategies, health plans are also bound by law to share information with their members, helping them make the right care decisions in terms of health and finance.

  • Compliances such as Interoperability and Patient Access final rule, Transparency in Coverage, and the oncoming Reducing Provider and Patient Burden rule all urge health plans to bring about modifications in their workflows to ensure improved member experience.
  • While improving member experience by sharing information with members, health plans must adhere to privacy policies to protect sensitive healthcare and administrative data.

These rules now apply to Medicaid and CHIP managed care plans, Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges, and state Medicaid and CHIP fee-for-service programs, and will move to blanket all bodies within the US healthcare revenue ecosystem.

We Can Help

Amidst processing tons of data and managing workflows, claims, and reimbursements throughout the year, health plans are seldom given the luxury to plan and execute member engagement strategies.

Health plans would have to recalibrate their traditional ways of member engagement and amplify their efforts at improving member experience. This involves switching up their IT infrastructure to ensure adherence to the technical requirements laid out in the rules. Health plans would need to redefine their policy offering based on the reactions they received on previous policies. They would need to proactively push notifications and reminders to help their members stay healthy.

Member engagement strategies must keep evolving in line with member expectations, only then will member experience be optimum throughout the member journey.

Would you like to have a compliant and dynamic member engagement strategy to keep your member engaged and updated? Look no further. Connect with our healthcare experts at info@nalashaa.com and let us help you chalk out the right strategy.

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Shireen Noushad

Shireen Noushad

Currently, trying to navigate through the ocean of Healthcare IT systems, processes, and workflows. Passionate about writing, and stringing together words in the simplest of ways for a better reading experience and easier comprehension.

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