Member support that actually works and benefits your health plan

October 28, 2021
Josie Livengood

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Your health plan’s member support capabilities are perhaps the most important service you offer, right after actual health coverage benefits. You can have the best network and rates out there, but if your members can’t navigate the healthcare system or have to wait twenty minutes to speak with your member support team, your retention is going to plummet and growth will stall. Not to mention that your reputation can become tarnished since people tend to only leave reviews when they’ve either had a very good or very bad experience.

You know your member support could use some help, but how do you get that help without overstretching your team or going over budget? We have a few ideas.

Engage with your members before there’s a problem.

Member engagement is a big pain point for many health plans. The main two reasons that members don’t engage with their health plan are:

  • They aren’t educated on their benefits and how to use them.
  • Plans aren’t proactive in their member support programs, only reactive.

Granted, #2 can also apply to members; rarely do you interact with your health plan until you have a problem. But that ties back to member education. It’s going to take a mindset shift for both parties to create a better member engagement experience. An easy way to proactively engage with members and educate them on their benefits is through consistent communication. The key is to not overload members with information in one long email or letter. Meet them where they are when they need you. Use multiple mediums like email, text messages, phone calls, and even good old snail mail. Even better, if you have an app with your services, send them contextual notifications.

This can look like sending an email once a week that breaks down each of their benefits and scenarios in which the member would use them. Most people don’t understand complex medical terms or complicated health insurance language. So make sure you’re speaking to members with everyday language that they would use if they were explaining their benefits to a family member or friend. This may be followed up by a monthly text letting them know they can save money on their medications if they use a certain Rx search tool or go to a more affordable pharmacy near them. Finally, send a quarterly letter reminding them what services they have and how they can use them.

Educating members on how their benefits work and getting them to be proactive will reduce the number of calls from stressed members in even more stressful situations. And if you do this well, you’ll also build a deeper relationship as members feel like you truly care. We recently saw an example of a health plan sending members cute onesies and a small gift when they had a new child. This kind of member engagement goes a long way in improving retention.

Give power to members.

What’s that old saying? “Give a man a fish and you feed him for a day. Teach him to fish and feed him for life?” Incredibly cliché, we know, but it’s a great analogy for this next point. When you think of “member support” it might sound counterintuitive to have members help themselves, but actually, it’s one of the best ways to create happier members and reduce your team’s workload. For example, you can give members power over their own health by offering healthcare navigation tools. By offering a healthcare navigation feature, such as a search-and-compare app for healthcare services, you can empower members to take control of their health. They’ll feel less stressed going into a healthcare experience when they know the provider they selected is in-network. Or if they choose to go out of network, they'll be relieved to know what price they'll pay. They can even find the most affordable option for their prescription medications and manage their health information all in the app too. All this will help reduce your member support requests and will fulfill the desire most members have for digital self-service capabilities from their health plans.

Final thoughts.

To wrap it up, there are two big things you need to create member support that actually works for members but also benefits your health plan. They are:

  • Better member engagement that begins with you being proactive and communicating with members on their benefits.
  • Putting power back into the hands of members through healthcare navigation and digital self-service tools.

Download How to Leverage Ambulatory Surgical Centers for Lower Costs and Higher Satisfaction

Discover how TPAs, health cost sharing groups, and limited benefit medical plans can benefit from the use of ASCs.

Is Your Health Plan a Tech Whiz or a Dinosaur?

Take the quiz to find out!
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Download the Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Lowering Member Costs

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download Healthcare Consumerism 101: A Playbook for Health Plans

Learn the best strategies and tips for retaining your members while keeping costs low.

Download Your Guide to the Transparency in Coverage Rule

Discover how the the new rule will affect TPAs and health plans and how you can start your journey to compliance.

Download Your Guide to Unique Benefit Offerings that Don't Break the Bank

Discover how to add value to your health offerings that delight clients and members but don’t cost a fortune.

Download the Complete Sedera Case Study

Discover what health plan members had to say about the value of patient advocacy in our survey.

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