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Five ways health plans can ‘personalize’ the member experience


Here are five ways to use big data and predictive analytics to get insights about members and create a personalized member experience.

According to a report by Prophet and GE Healthcare Camden Group, a whopping 81% of consumers are unsatisfied with their healthcare experience

And the happiest ones? They use the system the least.

ColopyIn order for healthcare plans to improve member satisfaction, re-enroll members year after year, improve their scores, and make the member experience outstanding, they must use big data and predictive analytics to create a member journey that’s relevant and highly personalized.

Since only 10% of healthcare executives are doing so, according to a recent KPMG survey, there’s an opportunity for healthcare plans to get ahead of the curve.

Here are five ways to use big data and predictive analytics to get insights about members and create a personalized member experience.

1. Create customized content

According to a survey by Xerox Corporation, 36% of members want personalized communications from their healthcare insurance providers.

Instead of sending a direct-mail campaign to all of your members with generic healthy living tips for example, use data to understand individual members and send them customized content.

With personal health data, health risk assessments, results from provider visits, hospital claims and prescription fulfillments, you can create targeted campaigns that are personalized for individual members and their specific health conditions.

For one member who is pre-diabetic for example, a targeted campaign might include a direct-mail invitation to a local seminar, a video that explains the welcome packet and an outbound call about ways the member can lower blood sugar.  

Another member who recently had a baby might benefit from a campaign that includes an email to congratulate the member, tips on caring for a newborn and a coupon for diapers.

Next: Talk to members where they are



2. Talk to members where they are

SchmittA multi-channel approach to member onboarding and engagement is a great way to ensure a highly relevant and personalized member experience.

In fact, nearly 40% of people say that they prefer a multi-channel solution that includes mail, Internet or both to receive communications from their health plans, a survey by Pitney Bowes found.

By using demographics and opt-in preferences, you’ll know which channels will be most effective to reach and engage members.

For example, SMS text messaging is well suited for 30-something young professional members, while direct mail or outbound calls are better for elderly members enrolled in a Medicare Advantage plan.

3. Use personalized video

Experts agree: Interactive, personalized video is one of the hottest and most effective marketing trends right now. And as a health plan, there are so many ways to use video to personalize the member experience.

Ask members to fill out a form and use the data to deliver personalized, interactive, real-time video. Or use data to send an email campaign with a link to a video which explains a topic that’s relevant to that member. It could be a video that talks about the difference between brand name and generic prescriptions or a guide so they can understand their explanation of benefits.

Next: Take advantage of inbound and outbound calls



4. Take advantage of inbound and outbound calls

Both inbound and outbound calls are a great opportunity to capture HEDIS and STAR data, foster engagement and personalize the member journey.

Your call center can use data to remind members about getting their flu shots or follow up on wellness visits.

5. Survey members

Data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and access and availability of care surveys is important for HEDIS scores and STAR ratings, but it will also help you understand whether members are truly satisfied with your plan.

If you’re proactive about getting feedback and resolving issues before members make complaints, you’ll ensure they’ll have personalized journeys.

At relevant, strategic times throughout the year, use various channels to ask for member feedback, resolve issues and analyze data on members’ motivations, challenges and pain points.  

Peter Schmitt is the chief strategy officer at Dialog Direct, where he provides strategy formulation and execution across multiple business units.

Tim Collopy is the vice president of healthcare development at Dialog Direct, where he is responsible for helping provide custom member acquisition and ongoing engagement solutions for healthcare clients.



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