Health Insurance Member Engagement: 5 Tips to a Better Experience

With more insurers entering the ACA’s individual insurance markets coupled with the growth of Medicare Advantage plans, engaging members is the key to member retention and revenue growth. But many insurers struggle with legacy strategies like dated channels, siloed organizations, and an operational focus that ignores the needs of today’s members. Ultimately, that leaves members less engaged than they should be.

Here are five tips to improve health insurance member engagement:

It starts with your people.

Health insurance member engagement starts with your member services team. That team is likely the most visible aspect of your organization to your members. Yet consider:

  • Many member service members are young, female and the only wage earner in their household
  • They typically would need to earn upwards of $25 an hour to afford a one-bedroom apartment in their city.
  • It’s generally one of the more stressful customer service jobs available due to the health-related nature of calls received.
  • As a result, turnover is high.
  • That turnover leads to less knowledgeable member services representatives, which leads to worse member service.
  • Throw in that the COVID pandemic made many call center representatives reevaluate their jobs and it’s likely that call center churn may be higher when call centers are completely reopened.

Simply put, developing strategies to improve the lives of your member services representatives will likely deliver a return on that investment. That may mean better pay, more flexible working conditions, better incentive and reward programs, and more internal advancement opportunities. But it may also mean leveraging technology to make their jobs better. Replacing siloed, legacy systems with modern applications that are easier to use and make accessing member data faster can not only help the member services rep, but the member as well.

All too often when teams focus on improving member satisfaction, they look at some of the following items because they’re more glamorous. Delivering a great member experience starts with a knowledgeable, helpful team. All the cutting-edge technology in the world isn’t going to help if you have a poor-performing member services team.

First Impressions Matter

Almost all leaders of software-as-a-service companies track churn rates and lifetime customer value (LTV) to understand how well they retain customers and how much those customers are worth over the customer lifecycle. Better customer onboarding can improve those core metrics. The faster you get a customer to experiencing value from your software, the less likely they are to leave and the higher the LTV.

Take the Netflix onboarding experience as an example. After you give Netflix your name and payment details, it asks you to pick some movies and shows you like so it can personalize your home screen. It also prompts you to further personalize later by asking you about specific movie categories you watch and don’t watch. Then, it asks you to rate movies you’ve seen. Netflix leverages that data to personalize your home screen so you see more movies and TV shows you’ll like, improving your experience and likely leading to a longer subscription.

Develop a great new member experience

Health insurers need to think about their plan onboarding in the same way. What can you do to make your new member experience great from the start? For Oscar, they use an omnichannel (more on that later) approach that uses their app, website, print materials, and email to nudge members to take actions that will help engage them with their insurance. For example, Oscar has members complete a health survey that makes it easier to personalize the member experience. They encourage members to download the app. Then, Oscar sends a welcome kit with member IDs, helpful plan information, and a health care cheat sheet. They even encourage healthy activities — and the use of their app — by paying $1 toward an Amazon Gift card every day a member meets their step goals.

That onboarding approach likely plays a role in members being happier with Oscar than with other health plans. They touted an NPS score in the high 60s in 2017, in comparison to the average health insurance company’s score of 12. Those member satisfaction scores likely lead to a lower member churn rate and a higher LTV. Health insurance member engagement strategies need to start with the first impression.

Turn Transactional Communications into Strategic Ones.

According to McKinsey’s research, aside from coverage provided, the three biggest drivers of overall satisfaction with a Medicare Advantage plan are paying bills, making claims, and getting answers to questions or concerns. What do those first two items have in common? Insurers often take their billing and claim communication processes for granted. These are perceived to be transactional communications in nature, which means most health insurers don’t think strategically about the engagement opportunities they present.

Let’s take individual billing as an example. If your members are anything like me, they’ll spend more time with a bill than they will a marketing piece. When I get my mail, I open and review my bill. Anything else typically finds its way to the shredder fast. So if you aren’t leveraging your billing communications to engage your members, you’re missing a prime messaging opportunity.

That’s likely a monthly communication that can include any range of information that can help improve the member experience. For example, you can include a brief message about where to find your app, information about a new provider search tool, or encourage them to take steps to earn a healthy lifestyle reward. Putting together a plan to engage your members through transactional communications like billing notifications or claim communications can improve member engagement.

Think Omnichannel

A recent AHIP webinar included data that showed that 84% of baby boomers preferred a call to discuss their healthcare. In Generation Z, however, only 46% preferred a phone call. 41% of Generation Z preferred using an app or web portal. Member expectations are changing.

Those changing expectations mean you need to develop an omnichannel approach that makes it seamless for a member to interact with you, regardless of where they are. For example, assume a member completes a form on your website and then has a question related to that form. When they call your member services team, your employee should have immediate access to the form and be able to answer member questions without a delay. Or, if a member partially interacts with a chatbot, that data should flow to your member services rep when a call is made.

Channels to consider include:

  • Phone
  • Website
  • Mobile Apps
  • Social Media
  • Chat
  • Video Calls
  • Email
  • Direct Mail

By seamlessly integrating the data exchange across these channels, a member will be able to switch between channels and have their information flow between them. That not only delivers a better member experience but also ensures you’re meeting members — whether they’re a baby boomer or Generation Z — where they prefer to communicate.

Get Personal

Stitch Fix is a personal styling service that helps buyers find clothes matching their style. The process begins by asking buyers to complete a comprehensive style quiz. The retailer then ships five items of clothing, any of which the buyer can return for free. Stitch Fix learns over time what the buyer likes based on what they’ve kept and what they’ve returned, fine-tuning personalization with every interaction. That personalization has helped the company grow to nearly $2 billion in annual revenue.

Earlier we discussed how Netflix leveraged your history and ratings to recommend movies and shows. Stitch Fix also leverages your purchase history and their style quiz. The takeaway: To personalize an experience, you need to have great member data.

Insurers have a wealth of data they can leverage to provide a personalized experience. For example, say a member goes to the doctor for lower back pain. Insurers can leverage that information to provide information and remedies for lower back pain, delivering personalized information based on a member’s ailment.

Insurers have also had success using connected devices to personalize experiences. As we noted earlier, Oscar is incentivizing members to share step data. In the future, they can leverage that data to nudge members who fail to meet goals and commend those who meet their goals. It’s a simple way to deliver a more personalized experience to members.

Like any business, the more engaged your customers, the more likely you are to achieve your business goals. Improving health insurance member engagement can help decrease member churn rates and deliver a higher lifetime member value.

Certifi’s health insurance premium billing and payment solutions help healthcare payers improve member engagement while reducing administrative costs.

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