Meandering Through Member Engagement: Save Yourselves a Setback

It has been reiterated time and again by the CMS that member engagement is crucial to both the health plans and members. To the health plans, engaging with members contributes to their shared savings, when their members choose a low-cost, high-value service post-consultation. To members, engagement with a payer results in proactive and well-informed healthcare decisions.

Keep An Eye Out For These Roadblocks   

The need for a member engagement strategy, as discussed before, is to connect with members and provide them with the necessary intervention and consultation. Now, to know the kind of intervention that would help, health plans must have access to more than just the member’s healthcare data.

In the previous blog, we discussed various stages in the member journey where health plans could collect data, to help them chart out future engagement strategies.

Contrary to popular belief, it’s not all smooth sailing for health plans once they have figured out the stages, and how to utilize them. Here are a few roadblocks plans might come across while implementing their strategies.

Communication Overload 

Most of the communication between health plans and payers takes place on digital devices. With an increasing number of personal devices, a member will have at least one device with multiple applications and more social media platforms.

 When health plans send out too many notifications hoping at least one would catch the member’s attention, there is a high possibility of notification blindness owing to communication overload.  The incessant notifications, emails, and reminders from other applications also contribute to said communication overload.

Health plans must identify the preferred type of content, context, frequency, personal details, and member behavior patterns such as response to notifications. These variables will enable health plans to wade through the clutter and be noticed by their members.

Deciphering Insights 

Member engagement solutions can only move forward with access to member data retrieved from all possible sources. Collecting data is no walk in the park, but what’s more daunting is milking the value of the data or finding insights.

Cleaning the collected data from all sources to retrieve insights for member engagement is crucial for implementing engagement strategies. A slight misalignment in the insights could tarnish the strategy purpose or goal, resulting in low member satisfaction scores.

The member data collected can be converted into personalized communication, giving members a sense of inclusion and preference. Health plans must keep in mind that this data is time-sensitive and must convert them into strategies or action items as soon as possible.

Asynchronized Details 

With member engagement strategies in place, member data is collected from multiple channels and platforms. The disparity in the data type and sources pose a threat to optimally utilizing the incoming data.

When payer systems receive asynchronous member data, it can lead to inaccuracies while gauging a member. Health claims, coverage details, history of prior authorization, RX claims, chronic condition, allergies, smoking status indicators, PHM details, SDOH and so on must be collected promptly to create a holistic picture of a member.

Absence of Feedback 

Keeping a track of member behavior as they go through the member journey is essential in drafting future solutions. Health plans monitor member behavior by capturing member response types and noting how quickly they responded to a notification or an e-mail. Feedback from members is essential to ensure the formulation and development of better and more efficient policies.

However, members don’t always indulge in sharing feedback. When they do, they do so with ‘yes’ or ‘no’ answers, leaving health plans with very little to work on. With little or no feedback, health plans are at crossroads when it comes to modifying their health plans. To add to it, they are also unable to gauge the effectiveness of their PHM programs.

Health plans must find innovative ways to capture feedback in ways that is interactive and beneficial to the member. Members must also be made aware of the impact they could have on future policies and policy benefits.

Get Help 

Member engagement is certainly no child’s play and there is a considerable amount of work that goes into it. However, a lack of focus on data collection, program efficacy, or personalization of communication or any other elemental aspects of member engagement can bring down the member satisfaction scores rendering the whole strategy ineffective.

Member engagement strategies must be charted out with extreme care, taking into account IT systems, workflows, data collection, data analytics mechanism, the communication language preferred by members, etc. Bringing these elements together and aligning them with the goals of a member engagement strategy is no easy task, and that’s why we’re here to help you out.

Nalashaa is equipped with experts that have been involved in healthcare for a good while and know the ecosystem, inside out. With reliable experience, we can help you navigate through the digital clutter with interactive and effective member engagement solutions. Connect with us at and let us help you out with a roadmap to happier and healthier members.

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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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