Ten Simple Ways Health Plans Can Retain More Members

“In era of healthcare consumerism, more health plan members are expecting a level of sophistication and customization that most ‘analog’ contact centers cannot meet. Technology and services that address unified customer engagement operations, and seamless digital self-service, complemented by trained customer engagement specialists can better align a contact center with the mission and vision of the entire organization. You will have to refocus your call center to reflect your brand promise and truly enable an effortless experience.”
- Anand Natampalli, senior vice president, global business development for HGS, a provider of end-to-end business process services

“Payers can do this by providing more clear pricing transparency through publishing accurate prices for cash-pay individuals and participating in emerging on-demand health platforms.  Consumers should have readily accessible platforms that translate complex pricing language into terms that customers can understand.”
-Bill Shea, vice president, professional services company Cognizant

“Make your plans easy to access, understand, and compare digitally. If your plans aren't clear, then consider partnering with an innovative insurtech expert to help you translate and differentiate your offerings. Until recently, nobody but HR, benefits managers, and brokers really understood health insurance. Today, plan members are more active than ever in deciding and paying for their plans, and they only want to use the easiest platforms available."
- Mike Levin, CEO, Vericred, a healthcare data services company

“When considering keeping patients happy and retention high, cost is a huge talking point. Patients get frustrated with multiple, conflicting, or higher-than-expected charges. Because getting a fair price and smooth service are key for consumers, health plan members are happier when costs are fair and charges are accurate, which can all be vastly improved by including a payment integrity service in your cost management program.”
– Chris Dorn, SVP of payment integrity services at healthcare payment firm MultiPlan

“We connect with members in a variety of ways to offer personal support with every aspect of their health. Leveraging advanced analytics, we recommended actions to proactively address health needs and help individuals reach their health goals. For example, an expecting mom may access a prenatal application, connect with a care coordinator, participate in a nutrition program, and join an online parenting community.”
- Susan Lee, senior director of care and wellness for insurer Florida Blue

“What is the best method for accurately measuring member satisfaction? Health plans are increasingly tapping new source data, including social media and call center data, to enrich existing data sources and learn more about the voice of their members. Applying analytics to such data, health plans can more effectively gauge and predict member satisfaction. Which among them are most likely to file a complaint? Which are apt to leave the plan? Which have a high customer lifetime value or net promoter scores? Armed with this detail, health plans can tailor programs and services to better serve their members, increasing both satisfaction and retention in the process.”
- Amanda Barefoot, principal healthcare consultant at software company SAS

"Retaining members is all about helping them meet their individual health goals-whether that’s managing their insulin levels, being well enough to walk their daughter down the aisle, or run a marathon. We help them achieve their goals through multidisciplinary integrated care teams and a network of community resources that brings the care tools they need to their doorstep. Health plans must act as advocates for the consumer along their personal health journeys. Acting to connect and coordinate members with local providers, resources, and services to improve their quality of life is key."
- Dan Finke, senior vice president of insurer Aetna’s products and services division

“Risk-based contracts move the needle on health and cost outcomes if providers are given the data and tools they need to earn their incentives. And providers are increasingly savvy about this. Let them know right away during contract negotiations what information and infrastructure they will be given to improve the health of all patient populations and to meet their quality measures.”
- Scott McFarland, president, HealthBI, a provider of population health management technology and services

“Payers have the opportunity to make a significant impact on the consumer experience. Payer organizations have invested heavily in member portals and apps; however, these tools often lack useful and robust healthcare payment information and options. Payers can retain members by helping them navigate healthcare payments, from understanding terminology such as deductible, copay, and coinsurance, to allowing members to pay all of their providers using a digital wallet. By doing this, payers also make it easier for providers to connect with their patients and streamline their payment processes as well.”
- Deirdre Ruttle, VP of strategy, healthcare payments network InstaMed

“Members need to be cared for and understood to be happy with the plan and stay with the plan.  This is easier said than done since each member’s definition of ‘cared for’ and ‘understood’  is different depending on their needs, culture, and clinical/psychosocial profile.  Our view is that to keep members happy, healthy, and in control of their health, we need to understand each member’s greatest health challenge and try to work with the member to solve this challenge.”
- Saeed Aminzadeh, CEO, management firm Decision Point Healthcare Solutions