We talk with dozens of health plans each week, and they consistently speak of three macro trends driving the market today: the shift to value-based care, increased urgency to attract and retain members, and the rise of consumerism in healthcare.

Many plans have recognized that consumers play a central role in all three of those trends, and that their plan’s performance is often tied to how well they engage those consumers. While no plan is perfect, there are some key things that separate high-performing plans from the rest. Here are seven habits we know are critical to success.

#1: Align any consumer engagement strategy with business objectives

Executing an engagement strategy without first determining your business objectives is like setting out on a road trip with no destination in mind. How will you know where you’re going and when you’ve arrived? And what you’ll need along the way?

High-performing plans first identify the business objective (e.g. “close care gaps for our diabetic population” or “improve our Star rating”) and then develop an engagement strategy and key performance indicators (KPIs) to deliver against those objectives.

#2: Prioritize member activities that actually move the needle

Including general wellness activities like exercise in your engagement strategy isn’t a bad idea, but it’s difficult if not impossible to measure the impact they have on quality measures and population health. There are other activities that can make a bigger impact.

High-performing plans prioritize member activities that can help them achieve their business objectives. If you want to close diabetic care gaps, for example, focus on rewarding activities like an eye exam and kidney monitoring. You can still encourage members to engage in healthy behaviors, just make sure you’re putting your money behind the ones that count.

#3: Use segmentation to target engagement efforts

Painting your members with a one-size-fits-all brush might seem efficient from an execution perspective, but it’s ineffective from a performance perspective.

After identifying business objectives and high-value activities, high-performing plans segment the target population into two member groups: compliant and non-compliant. Then, they focus their resources on getting those members to act, while ensuring all members have access to the program.

#4: Leverage incentives, but optimize the reward value

Incentives can be effective in engaging consumers to take care of their health. However, finding the right reward or incentive value involves the Goldilocks principle. If it’s too low, members won’t be motivated. If it’s too high, you could be overspending.

High-performing plans know that some high-value activities have more barriers to completion than others and they align their rewards accordingly, making them “just right.” A colon cancer screening, for example, is more difficult to complete than a flu shot, and should be assigned a more valuable reward.

#5: Use an omni-channel communications approach

Many plans use just one or two channels, like outbound mail and a call center, for member communications. But different members prefer different channels, so there’s a risk those plans aren’t seeing the results they want.

High-performing plans know it’s important to use an omni-channel communications strategy to ensure members can engage using their preferred channels. It’s also important to optimize the channel mix to achieve a balance of cost and response rate. Digital channels like email, for example, are much less costly than a call center, and should be prioritized when they’ll be effective.

#6: Personalize member communications

When you send every member the same content, your message has to be general enough to apply to everyone—meaning it feels personal to no one. Consumers want the same thing from their health plan that they want from every brand or service they engage with: they want to be uniquely seen and understood.

High-performing plans know this and aim to deliver the right content, to the right member, at the right time, in the right channel. Consider setting up triggers around key activities, like when a member needs to complete a specific activity, and distributing that message automatically to create a more personal member experience.

#7: Foster cross-functional alignment around a member-focused strategy

When each department (such as quality, risk adjustment and marketing) has its own goals and objectives, and connects with members independently, it can create a disjointed member experience.

While it can be hard to break down organizational silos and march toward a set of common goals, high-performing plans know these practices are critical to success. One place to start is gaining cross-functional consensus around your plan’s cost drivers and how to best address them, and then pushing those strategies down into each department or team.

To learn more best practices used by high-performing health plans, check out this recorded webinar on “Driving Plan Performance with a Unified Consumer Experience.”


About NovuHealth
NovuHealth is the leading healthcare consumer engagement company, offering rewards and incentive programs that improve consumer health and plan performance. NovuHealth applies proven loyalty and data science strategies and leverages its deep industry and regulatory expertise to motivate high-value consumer activities. Headquartered in Minneapolis, NovuHealth has worked with nearly 40 health plans and served more than 15 million consumers across all 50 states. Learn more at novuhealth.com.