How to be member-centric

September 1, 2012

As the industry moves toward a retail environment, the importance of becoming member-centric can't be understated.

As the industry moves toward a retail environment, the importance of becoming member-centric can't be understated. Health plan members will be demanding more for their money and will be particularly sensitive to the levels of service a plan provides.

As of January 2011, 11.4 million Americans were enrolled in consumer-directed health plans (CDHPs)-a 14% increase over 2010, according to the Department of Health and Human Services. In fact, according to RAND, 17% of those with employer coverage chose a CDHP in 2011.

Being member-centric can improve members' plan loyalty, health engagement and treatment adherence. The more engaged members are with their care, the healthier they remain, which staves off costs downstream.

Exchanges under the Patient Protection Affordable Care Act (PPACA) will facilitate a retail shopping experience for individuals and families who will have their choice of plans. Of the 32 million individuals expected to gain insurance coverage, 24 million will come through the exchanges, according to a 2011 Congressional Budget Office projection. It will be fairly easy for an individual to move to another plan in the exchange if he or she is dissatisfied.

Today's projections vary on how much traffic will come through the exchanges but there's a clear need for new marketing strategies for health plans.

"We were already going down that path regardless of reform and exchanges," says Matt Manders, president of Regional and Operations for Cigna. "What reform and exchanges do is just put a further emphasis on the fact that going down this path is even more important tomorrow than we thought it was."

Plans must have a variety of tools prepared to serve members over the next decade.

1. Leverage social media

What members say about a plan drives the plan's credibility and trustworthiness. For example, uncensored member comments posted and resolved via Facebook and Twitter are becoming common for some plans.

Case in point: Aetna CEO Mark Bertolini recently helped a college student with cancer who was complaining on Twitter that he had reached the lifetime limit on his Aetna plan and was going to have to sell T-shirts to pay for his treatment. Bertolini saw the Tweet and prompted plan teams to contact the member by phone and resolve the issue, which touched off a media storm.

That same day, Aetna contacted the school and its legal team to discuss the student-plan offering. Eventually, Aetna and the plan sponsor negotiated a way to pay for the member's treatment.

Social media will become a significant touchpoint for all health plans in the next year leading up to the expected enrollment increases. Cigna, for example, reports an average of 170 inquiries per month coming in from social media.