3 Ways to Improve Member Experience and Engagement

Supporting person-centered care for Medicare Advantage health plan members requires listening to each member and tailoring communication to individual preferences and plan messaging goals.

When it comes to member engagement, “omnichannel” is the predominant strategy today. And while it’s true that Medicare Advantage health plans and their partners have many communication platforms at their disposal—email, SMS messaging, snail mail, phone calls, apps, social media—different messages and members require tailored approaches.  

To maximize engagement, plans should consider each member and their healthcare journey when determining the best way to communicate: Do you want them to learn something? Do you want them to do something? How old are they? How do they prefer to communicate? Effective communication can improve member engagement and experience, often leading to better health outcomes and higher Star ratings. These were all key topics of discussion at Strategic Solutions Network’s recent Medicare Market Innovations Forum in Orlando, Florida.

Heather Smith, Vice President of Retail Market Sales at Geisinger Health Plan, said some members are very comfortable with the latest technology: “They want all the bells and whistles and want to do the things they want to do their way,” with answers delivered by text or—even better—by chat, she said, speaking on a panel about responding to shifting member preferences. “That is vastly different from how the older senior population wants to interact with their health plan.”

A challenge, she said, is innovating and keeping up with technology while remaining compliant with state and federal regulations—and helping those “non-first adopters” learn and adapt to new tools. Effective strategies for communication and member engagement are key when evaluating potential partner vendors as well, she said: “We aspire to be a 5-star plan. Are you a 5-star operation yourselves? That's important.”  

Here are three ways that industry experts say health plans and their partners can better serve and connect with members:  

1. Solve Your Members’ Problems

There is likely no company on Earth that has 100% customer satisfaction all the time. Transportation is one area that can be very complex, especially when helping people who are frail or have medical conditions, said Brian Gebhardt, COO of SafeRide Health, so complaints and grievances occasionally happen. The important thing is to promptly address those situations and apply learnings to your key products and services. “We’ve really invested a lot of effort into better understanding where the patterns lie, which helps to identify and avoid those types of situations in the future,” Gebhardt said of SafeRide, which takes a technology-first approach to non-emergency medical transportation. “We’re also committed to keeping an open line of communication with our partner health plans,” he said, “making sure they’re up to date on a range of metrics that help us monitor member experience, from complaints and grievances to call center performance to member ratings and feedback on individual rides.”

Member challenges are not uncommon in the broader health insurance field: A 2023 KFF report found that 58% of insured adults had a problem with their insurance in the past year, ranging from claims payment and pre-authorization issues to provider network issues. Of those members, 28% said they paid more than expected because of the problems; 17% said they could not receive recommended care as a result; and 15% said they experienced a decline in their health. The good news is that most people have a positive view of their health insurance, with 91% of those on Medicare saying their insurance plan is “excellent” or “good”—so the foundation for member satisfaction is solid.

2. Stand Out with Excellence

Healthcare companies compete not just with each other but with every other brand for their customers’ attention, said Bill Phillips, Chief Strategy and Performance Officer at Linkwell Health: “How is Apple treating them? How is Amazon treating them? [Consider] the fact that I could type a text right now to rebook or change my seat on my flight tomorrow and United would thank me for bothering them.” On the other hand, some healthcare companies have ground to make up, at least when it comes to digital efforts: The U.S. Healthcare Digital Experience Study from J.D. Power found that nearly a third of commercial and Medicare Advantage health insurance websites and apps don’t meet foundational criteria for functional and intuitive digital solutions.  

Ensuring that a health plan’s website and apps perform well is just the start. Healthcare companies can actually make their members’ lives easier by ensuring information is clear and easy to find, and by helping members take steps to improve their health. Those efforts can make a real difference in how people view and value those companies. “One of our core beliefs is that people should love their healthcare,” Phillips said. That may be a “bold belief,” he said, “but you do see it happen when the health plans are there to serve their members before they’re selling to them.”

3. Build Trust with Your Members

Building trust with your members not only makes their experience more positive, it can translate to better health outcomes: The 2022 Edelman Trust Barometer Trust and Health Special Report found that 80% of people who said they had high trust in the healthcare system had routine checkups, compared to 58% of those who had lower trust in the healthcare ecosystem. The same report the following year found that 57% of those surveyed in the U.S. trust private and government providers of health insurance—a drop of two points from the year before.  

Health plans and partners can increase trust by truly listening to members, getting their information right, working to solve their problems, and prioritizing preferred communication methods. “We always try to meet the member on their own terms, understanding their communication preferences, what type of treatments they might need, what type of transportation requirements they have,” Gebhardt said. “The sum total of all that helps us make it a better member experience by providing what resonates the most—during that interaction but also afterward, making sure we meet their expectations for the service we’re responsible for providing to them.”  

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