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Through Member collaboration, MCRA helps drive performance improvements, deliver exceptional service, transform care, and champion the health and wellbeing of the communities we collectively serve.

3 Digital Health Strategies to Improve Health Plan Member Experience

Originally posted by Fierce Healthcare | April 17, 2023


Health plans have innumerable reasons to focus on improving member experience right now. The Centers for Medicare and Medicaid Services (CMS) are heavily weighting member experience in STARS ratings and HEDIS scores. And healthcare consumers want more accessible care and support.


Digital member engagement tools give health plans the opportunity to deliver a better member experience by making healthcare more convenient—which, in turn, drives satisfaction and retention. Members are also looking to get the best value for the high prices they’re paying for health insurance coverage.


But adopting a new digital health solution can be challenging, especially when it comes to aligning goals with staff and member expectations. Building a digital engagement strategy requires buy-in from individuals across an organization. Here, we’re highlighting three strategies health plans can use to improve digital adoption and enhance the member experience.


1. Build staff and member trust in a digital tool


Digital engagement can earn members' trust by giving them a place to share and store health and wellness information outside of telephonic touchpoints. It can also give members text-based messages and other information to look back on, rather than trying to remember details of verbal conversations. For staff, communicate that embracing digital engagement tools is about more than building member connections—it also impacts their bottom line. Health plans and care teams have to do more with less. Digital member engagement tools make it easier for clinicians and customer service staff to reach more members through automated alerts, reminders, and text-based messaging. At the same time, the right tools can make it easy for members to access relevant and timely health and benefits.


2. Keep the “why” crystal clear


When it comes to the reasoning behind choosing a particular digital tool, your plan may have buy-in from your executive and clinical leaders. But many health plans experience breakdowns in communication and messaging between upper-level and middle managers, leading to confusion or frustration during implementation.


Enable your managers and supervisors to hold their staff accountable, feel confident in the tool, and feel like they’re an integral part of the process. Staff training is a start, but team members need to have the will to take full advantage of digital tools—in addition to the skills. Understanding how your staff would benefit most from a digital engagement tool makes it easier to streamline internal workflows and better serve your members.


It might take time to streamline and perfect your digital member engagement workflows. But if your staff is on board with the motivation and the end goal, they’ll be ready to adapt to meet implementation challenges.


3. Identify the metrics that align with your strategy

Almost all health plan’s value drivers include “improve clinical outcomes.” But the strategy is going to look different depending on your staff, your member populations, and your company goals. How can you align your strategy with measurable KPIs? It’s okay not to know the best and most impactful metrics to track on day 1. Digital engagement and implementation are a cycle, and it can take time for your teams to get their footing. When building your digital strategy, set check-ins at 3, 6, and 9 months to review your progress and identify areas of improvement. Don’t forget to include individual KPIs and assessments, and to check in with your staff regularly to make sure goals aren’t being hit by only a few individuals. Once you have a sense of where your teams are starting from, you’ll be better informed to increase benchmarks and set ambitious (but achievable) goals. Don’t forget to think about the next steps when you’re measuring performance. For example, once care teams meet onboarding goals, they could focus on:

  • Closing care gaps

  • Readmission reduction

  • Improving resource navigation

  • Addressing social determinants of health

Now more than ever, health plans have a key opportunity to improve member experience using digital engagement tools. Communicating across the organization, measuring progress and performance, and pivoting based on experience can all help drive digital implementation. Health plans are facing pressure to leverage digital tools across their organizations. Remain competitive by using digital engagement to give your members the most convenient and relevant healthcare experience.


This article originally posted by Fierce Healthcare and was created in collaboration with the sponsoring company and our sales and marketing team. The editorial team does not contribute.

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