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Medicare Advantage (MA) plans represent a significant segment of the overall insurance market. MA enrollment has nearly doubled over the past decade, bringing the member tally to more than 20 million patients. This growth trend is expected to continue as roughly 26 million baby boomers age into Medicare through 2030, according to Deloitte.

Motivating MA members to take the clinical actions needed to promote and support their care is a high priority for health plans. Insurers’ ability to drive healthy behaviors impacts member outcomes and health plan performance on key quality measures, both of which directly influence overall costs and earning potential for the health plan. With the weight of member experience scores slated to have an increased impact on Star Ratings, the manner in which health plans engage MA members is an equally important factor in success.

Effective communication plays a vital role in encouraging member action and ensuring member satisfaction. Even so, information and communication have consistently been among of the lowest-rated health plan attributes among MA members. In J.D. Power’s 2019 Medicare Advantage Study, fewer than 9 percent of MA plan members reported experiencing the study’s three key performance indicators related to effective communication. This feedback indicates that there is ample room for improvement in health plans’ MA member engagement strategies.

Tailoring member engagement and experience

To achieve better member outcomes, quality performance improvements and an improved member experience, health plans are increasingly leveraging data and analytics to better align care prompts with member preferences. By coupling data-driven engagement strategies with innovative avenues to care access, health plans can empower members to take the next steps in their care journey in a way that addresses their individual needs and challenges.

Here are seven ways health plans can offer MA members a more positive, personalized experience and cultivate improved outcomes throughout the care journey.

  • Conduct an onboarding campaign to set the tone and learn more about new MA members. This represents an ideal opportunity for initial health assessments, including evaluation of social determinants of health, which can help the health plan better understand and respond to patient risk and barriers to care.
  • Expand member data insights by aggregating internal and third-party patient data sets to build a more comprehensive picture of member health and preferences. Work to continually enhance this insight by incorporating new clinical and consumer data points.
  • Educate patients on their specific health issues. Personalize outreach and care recommendations based on known risk factors and chronic conditions to ensure that members feel that the health plan is invested in their personal growth.
  • Implement a high-touch engagement strategy for high-risk members with chronic conditions to stem the tides on downstream care complications and costs.
  • Target engagement efforts to close specific gaps in care, including missed wellness visits and preventive care measures as well as routine chronic care appointments.
  • Leverage segmentation to better appeal to specific member subsets. When drafting communications, customize messaging and recommendations to cater to generational differences, member psychographic profiles, compounding SDOH factors, etc.
  • Offer care access points and engagement channels that support member convenience. Incorporate digital health support tools and broader access points—including retail site and at-home health screening offerings—to make it easy for members to engage.

How to Get Started

Health plans can start by gauging member satisfaction throughout the year to look for opportunities to improve engagement programs. BioIQ helps health plans leverage their existing member data and analytics to offer a personalized experience and maximize the effectiveness of programs. By implementing a strategy that caters to member subsets and promotes activities that are easy and convenient for people to complete, health plans can ensure a positive experience and improved outcomes.

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