Member Engagement — Are you listening to your members?

Member Engagement — Are you listening to your members? Do you understand what prospective members need and want from a health plan? Are you acting on the feedback you receive from your members? If you answered “no” to all or just one of these questions, your health plan may be missing opportunities to engage members and understand their needs.

Some of the most successful organizations are leaders when it comes to member engagement.  “When we look at companies with continuous long-term growth such as Nordstrom and Amazon, it is not attributed to just selling to new customers. It strongly based on keeping their current customers happy so they continue to purchase products from them. The Medicare Advantage industry should look at these companies as models for how their members should be treated,” says Diane Hollie, Senior Director, Marketing and Sales Strategy at Gorman Health Group (GHG). This success is not by accident — these organizations spend a great deal of time developing ways to proactively gain and retain members. In the healthcare industry, we are now evaluated on how well we communicate, provide services, and overcome challenges. It’s not enough to have a good benefit design — health plans must do much more to survive in this competitive marketplace.

In our quest to improve health plan performance, GHG has established tools to calculate the revenue impact of a single member. As you consider the value of investing in activities directed at the engagement and retention of members, it is helpful to understand the financial impact of member engagement. How much does a new member cost versus a retained, currently enrolled member?

Member communication, building trust, and consistent dialog throughout the member’s journey plays a critical part in the success of member engagement. Each engagement method should be tested for effectiveness. Key member communication should include several components for the overall member experience:

  • Welcome Communication To build a positive first impression and begin the building blocks for member satisfaction and loyalty, new member outreach should include:
    • Welcome Call — Welcome new enrollees and create a positive first impression
      • Confirm they have received their ID card, plan materials, and understand benefits
      • Assist with any “immediate need” — coordination of care
      • Assistance with network considerations and primary care physician (PCP) changes
      • Invite new enrollee to an upcoming member meeting
        • Navigation through healthcare process
  • Education Communication — Member education helps ensure they understand benefits, features, and requirements for accessing their care. Confusion and frustration occurs when adequate information is not provided to the member and results in increased dissatisfaction. Providing members with accessible programs to help them navigate their benefits, available programs, and cost savings tips will help build loyalty. These programs should include:
    • Post Annual Notice of Changes meeting
    • Preventive care
    • Medication
    • Emergency
    • Low Income Subsidy
    • Identify socio-economic needs, financial support, transportation
    • Communication strategy for any service area reduction
    • Communication strategy for network changes affecting current patients
    • Care management
  • Engaging Communication — The cost of getting new members to enroll can be considerably greater than the cost of retaining current members, so placing emphasis on retention and loyalty throughout the year can make a meaningful difference and directly affect whether a member will stay with your plan. This program should include:
    • Loyalty programs, over-the-counter products, gift cards for yearly annual examination
    • Surveys: new members and those who have disenrolled
    • Monthly member events
      • Healthy cooking class, gardening tips, physician education, inspirational  speakers, health screenings
    • Reminders
      • PCP reminder call, flu shot reminder call
    • Thank you calls
    • Anniversary call/card
    • Birthday call/card

Careful design of proactive and reactive engagement initiatives and a commitment to communication will deliver a significant and positive impact on enrollment, member satisfaction, and revenue generation.

Now is the time to plan how to incorporate a member engagement strategy into your upcoming enrollment efforts, and GHG is here to help! Be the Amazon and Nordstrom in your marketplace!



Designed to meet a health plan’s concerns for retention and service to the member while remaining compliant, Gorman Health Group’s member experience assessment responds to the industry’s demands by breaking down barriers that hinder the member experience. Visit our website to learn more about our Member Experience Services >>

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