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The 6 Keys to Increased Health Plan Member Engagement

Choosing a health insurance provider and a health plan are two of the most important and personal decisions a person can make. After all, when you choose a provider and a plan, you’re handing over your sensitive medical data and trusting your insurer to help finance the medical care you need and, in some cases, can’t live without.

It’s no wonder, then, that health plan members have started to demand a higher level of service and a better overall member experience — or that health insurers have started to look for ways to improve member engagement and long-term member loyalty.

For health insurers looking to enhance their services and increase member satisfaction, consider this the six keys to increased member engagement.

1. Make an Immediate Impact on New Members

There’s nothing quite like a good first impression to set the tone for overall experience, and for health insurance providers, that first impression typically happens during new member onboarding. Whether they’re an individual seeking a health insurance plan or a company seeking a group policy for its employees, new members expect their onboarding process to be simple, expedient, and transparent.

The first two pieces are pretty straightforward: No one likes a long or needlessly complicated onboarding process, whether they’re on the member or the provider side. An easy way to make onboarding faster and more efficient is to use a customer relationship management (CRM) system to automatically create, assign, and track all tasks and information associated with plan onboarding. By using automation to guide new members through onboarding, health insurance providers make it easier for employees to collect critical member data — while simultaneously freeing them up to focus on other, more pressing tasks — and save members the effort of filling out page and page of onboarding paperwork.

In terms of transparency, a CRM solution also makes it easy for carriers to maintain open lines of communication with new members throughout onboarding so that member questions and complaints are addressed early and often. A quality CRM will outline the steps of the onboarding process and flag opportunities for member engagement, such as notifying a member of their progress each time they complete a step or sending a follow-up email when the organization is waiting on information from a member or group administrator.

2. Deliver an Exceptional Member Experience

Taken as a whole, the insurance industry has been one of the last to get in on the concept of customer-centricity but, now that it has, it’s doing so in a big way. In the health insurance industry, specifically, self-service and personalization should be at the top of every insurer’s list when it comes to providing an exceptional member experience and increasing health plan member engagement.

The health plan member of today is independent, on the go, and expects their insurer to accommodate their busy lifestyle — that means being able to access their policy and plan whenever, from anywhere in the world and handling issues without ever having to pick up the phone to contact a representative. Health plan providers can use CRM technology to build member self-service portals, which a member can log into to view their benefits, outstanding bills, claims history, and so on.

A CRM can also store all member data within a centralized repository and use it to create individual member profiles. That way, should a member decide that they require assistance from a live service representative, the rep can easily pull up that member’s profile and provide personalized service based on their needs. Compared to when member data was spread out across disparate systems, a CRM saves time for reps and members alike.

The consolidation of member data in a CRM system is also invaluable in that it enables sales team to engage in more effective upselling and cross-selling by providing personalized offers to members. Since CRMs offer a “member 360” view, sales reps can see which products members currently have, which ones they don’t, and which ones they’d be well suited for.

For example, a CRM can analyze member and product data and show a sales rep that one member — let’s call her Tara — is aging out of her current plan. A sales rep can reach out and discuss Tara’s new plan options and retain her business for her next phase of life. It’s a win-win situation: Tara walks away from the experience feeling like her health insurer really understands her needs, and the company profits from her business.

3. Stay in Touch at Every Stage of the Member Lifecycle

Remember those open lines of communication we talked about during onboarding? They need to remain open long after onboarding is over. In fact, one key way for health plan providers to increase member engagement is to maintain consistent contact throughout the member lifecycle; this can be as simple as sending a congratulatory email to a member after they’ve had a baby or notifying them of drug recalls or formulary updates based on their prescription history.

Health insurers should be mindful to meet each member at their level — that is, to contact them through their preferred channels. Although there are many touchpoints to choose from — phone, text/SMS message, email, social media, live chat, and so on — most members have a mode of communication with which they’re most comfortable. Insurers can use their CRM to track member communications, such as how many times they’ve logged into the member portal for self-service or how many times they’ve called into the member service hotline, to get a read on how they prefer to be contacted.

4. Show Members That You Value Their Time

There’s nothing more frustrating to members than feeling like their service requests or complaints have been left to languish, but the reality is that health insurers’ call centers are often inundated with a higher volume of requests than they’re able to keep up with.

To prevent these requests from falling to the wayside and to show members that their time is valued, health insurance providers need to establish internal processes and procedures to improve customer service and call center efficiency and then implement them through their CRM. For example, a health insurer could create service level agreements that set expectations for response times based on the mode of communication — say, 4 hours for a phone call, 24 hours for an email, and so on.

Maintaining consistent communication is another way to reduce call center volume and to make members feel valued. Rather than wait for something to go wrong to talk to members, insurers should provide regular updates and periodically check in to improve member engagement and resolve issues before they occur. Member self-service is another great way to reduce call volume; the more information an insurer can provide members to help them find answers to their own questions rather than call in and speak to a live person, the better. For those calls that do inevitably come through, service reps should use member profiles pulled from their employer’s CRM to better understand each member’s individual needs — that way, they can get to the heart of the issue and on track to a resolution that much quicker. A CRM can also provide valuable analytics around call center data, such as which plans get the most benefit questions, for member education and member engagement.

5. Pair Service Representative Training With Technology

Many health plan member service teams find that they struggle with the seasonal volume and complexity of service requests; this isn’t a reflection on the quality of individual representatives or the team as a whole, but rather on the training they received prior to fielding requests and seasonality of the business. Most service rep training focuses on the basics of quality customer service — strong communication, problem-solving, resourcefulness, patience, and so on — but fails to factor in technology.

A representative can provide impeccable member service but, without being taught how to use how to use their employer’s CRM system, will find themselves limited in what they’re able to accomplish. Therefore, health insurers need to invest in comprehensive training that accounts for their existing IT infrastructure, organizational change management, and basic industry best practices in order to be truly effective. For an added boost of support — and for superior member engagement — insurers should consider investing in cognitive services that can listen to service calls, run analytics, and offer feedback and resolutions based on what a member is saying, all in real time. These helper features go a long way toward making the system easier to use for reps and can reduce the time it takes a rep to get to the information they need.

6. Identify Opportunities for Preventative Care

The chances of a patient being readmitted after a recent emergency hospitalization are high, which poses a significant problem for health care and health plan providers alike. As a result, more health plans are looking into ways to develop loyalty programs that use wearable devices to track members’ health, encourage better behavior patterns, and implement preventative care. Health insurers can incentivize this behavior by offering members rewards, such as gift cards or savings, for making health-conscious choices. In the end, everyone wins: Members save money and benefit from their healthy choices, and insurers increase health plan member engagement, ensure member loyalty, and reduce the amount of money they pay out on claims.

 

Member Engagement Success Stories in the Making

At Hitachi Solutions, we have decades of experience helping health plan providers find new and innovative ways to leverage CRM technology. Whether it’s identifying the coverage that best meets the needs of each individual member or using members’ browsing history to deliver key analytics-based insights, our Engage for Health Plans CRM solution harnesses the power of Microsoft Dynamics 365 so that health insurers can provide the best service possible to new and existing members.

Start your journey to superior health plan member engagement by talking to one of our representatives today.