Next-Gen Member Engagement for Healthcare Payers


Next-Gen Member Engagement for Healthcare PayersBetween inflation, the Great Resignation, and lurking threats of a COVID-19 rebound, healthcare payers now find themselves in a radically different environment than prior years. One of the most significant changes is in the member profiles. Next-generation members especially are cost-conscious, tech-savvy, and rely on technology for daily interactions. Health plans’ member engagement functions are not exempt from these expectations.

Next-gen members’ expectations of their health plan interactions, technology, and telehealth are here to stay. The same goes for the growing number of Medicare enrollees, who are likely to have different and unique needs and preferences when interacting with their health plan. 

Payers now have a prime opportunity to leverage automation and improve member engagement strategy. Adoption of fintech partnerships for open API access can serve as a vital connector to these member groups. Member engagement initiatives at payer organizations would benefit from considering the following to remain relevant and compelling.

  1. Enable easy automation at the self-service level.

Automated features and functionality like self-service, starting with appointment reminders and scheduling tools, are a strong first step toward end-to-end member engagement automation. This can add a layer of common-sense automation to laborious manual processes, thus improving accuracy and keeping customers engaged and responsible. Self-service features are a widely available low-hanging fruit ripe for the picking.

  1. Utilize APIs for provider directory management.

Realizing that a favorite provider is suddenly out of network or discovering a post-care lapse in covered procedures creates headaches for members, hurting their healthcare experience. According to a forthcoming report from the Aite-Novarica Group’s Healthcare Payments practice on member engagement and satisfaction, a third of surveyed member engagement professionals update their directories quarterly or less, while 14% are unsure of how frequently their directories are updated.

Building a consistent and accurate provider directory is a key area for payer differentiation. API enablement can help engagement executives rise to the challenge by facilitating real-time connections to a vast number of endpoints in the ecosystem, which keeps directories up to date and lowers member risk.

  1. Consider the chatbot.

The stereotypes of bad chatbots are well-known: frustrating to use, clunky and sluggish, hardly conversational and highly artificial. But the country’s largest banks, brokerages, and insurance companies have made the chatbot leap, and most are better for it.

When deployed correctly, chatbots automate large amounts of tasks, ensure data security, and provide members with a streamlined experience. While members may still opt for the human connection when discussing sensitive topics, chatbots provide utility by performing simpler administrative tasks, such as payment method verification, with speed, at scale.

The chief issue with chatbots centers around configuration; automated responses stem from a centralized dialogue tree and must be programmed for high levels of input complexity, along with considering patient privacy.

  1. Learn from outside industries.

Banks, financial institutions, and e-commerce giants like Amazon lead the pack in engagement, adopting highly configurable, omnichannel solutions to engage with customers and deliver highly relevant and impactful user experiences. The level of usable customer data here is high, and the stickiness of customer-company relationships tends to be strong.

It is true that healthcare is more personal, expensive, and sensitive than retail or online banking. However, the opportunity is there for payers to tap the automation well and create powerful and meaningful relationships with members through digital channels.

Want more on the latest in member engagement? Read our latest report, Member Engagement and Satisfaction: Payment Harmonization Benchmark, or contact me at [email protected] for more information.