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How Payers Can Uncover Key Member Engagement Opportunities


Open enrollment for healthcare coverage is in full swing. As millions of consumers shop for health insurance, health insurance companies are under pressure to attract and retain members. It’s therefore important for payers to understand consumer needs and interests. And while loyalty is difficult to achieve in health insurance, it’s not insurmountable. Here are tips to help insurers identify their high- versus low-value members and reduce member churn.
 
healthcare payer customer engagement opportunitiesSmarter Insights

Over the past couple years, health insurers have had to work harder to gain customer loyalty, as moments of truth are realized through positive member experiences. For many insurers, unique customer experiences aren’t easy to deliver due to an inability to capture and analyze granular levels of data.  Beyond basic segmentation, insurers are challenged in capturing and leveraging data to more effectively understand a prospective member’s needs.
 
Advanced analytics and data capturing tools can help form a clearer picture of customers and enable healthcare insurers to engage in meaningful ways with customers. By analyzing a customer’s initial conversation or online browsing history, an associate can better position the conversation to help identify the most appropriate plan for the caller.
 
The associate could say, “We’re offering several plans and if you’re willing to share some additional information, I can help you find the best match for your needs.” Perhaps the caller mentions his or her spouse is a smoker but exercises regularly. The analytics platform can take those responses into consideration and show the associate information for a high-risk plan.
 
Additionally, by gathering data from prescriptions, treatments, claims, and more, an analytic solution can help insurers further subdivide their members into segmented groups and recommend health plans to each group with the highest optimal care outcome.
 
Proactive Care

Understanding the drivers for member loyalty can also help mitigate member churn. Identifying the characteristics of insurers’ most loyal members and those who are likely to churn can help craft and strengthen member retention strategies.
 
For example, records may show that a member who has been relatively healthy for 10 years is reaching his mid-50s and has college-age children. It’s likely that the member will want to make changes to his health plan under these circumstances. Instead of waiting for that member to contact the company, an associate could reach out and let him know he is a valued member by offering him a competitive rate in return for renewing his plan.
 
Companies could also share exercise and wellness tips, and even discounted gym memberships with members as they reach certain ages. After all, there are clear incentives for members to stay healthy so why not personalize their journeys and offer helpful advice and tools to stay on track?
 
The bottom line is that regardless of the industry, healthcare is moving into an environment of transparency. Consumers are looking for absolute clarity about their options, the costs they will incur, and how they’re going to be treated. But compared to other industries, health insurers are often viewed with distrust, making it crucial for payers to go above and beyond for customers to earn their trust and ultimately win their loyalty. Data analytics and proactive care won’t provide all the solutions, but they can help companies build stronger customer relationships.


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Related Content:

Blog Post: Open Enrollment Essentials: How to Build Lasting Relationships with Members

Video: Three Ways to Enable a Great Customer Experience