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Effective Strategies to Engage Health Plan Members

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Member engagement is a hot topic throughout the health insurance industry. Numerous studies have been done to understand what some of the most effective engagement solutions are and when it is best to deploy them. Member engagement is important across the entire continuum of care, but there are some opportunities where health plans have a better chance of improving outcomes and experiences.

Initial Enrollment

    • When a member is new to a health plan, or health insurance in general, they are inundated with information from new member welcome kits, member handbooks, ID cards and consent forms. While there are some mandated forms of providing information, it is important to ensure this information remains accessible for the duration that they are enrolled and that you offer a mechanism to quickly address questions about the health plan and benefits.

New member welcome calls provide members with the opportunity to address questions and ensure the health plan has the most accurate contact information to reach the member going forward. Welcome calls and texts not only help patients feel valued, but can provide information on benefits, accessing information, and more.

Planned Admissions

    • For planned admissions such as surgery or continued outpatient treatment, the health plan can engage the member with educational content or provide the option to speak to a care manager. Some members may prefer text messages, phone calls, emails, or smartphone applications. Others may not want any engagement at all prior to their treatment.

For those patients who are willing to engage in their care, pre-arrival education and surveys can offer a myriad of benefits to both the plan and member. Ensuring members understand what to expect, or asking about their care status can help reduce stress, improve communication, and give information to the care manager to help anticipate member needs once they are discharged.

Post Discharge

    • After a member experiences a significant health event, offering multiple modalities for engagement that meet member preferences such as call, text, or email outreach, can help your team understand what members’ needs are and ensure they follow care instructions. With post-discharge engagements such as follow-up calls or care management programs,


    you plan can prevent unplanned readmissions, preventable infections, and other adverse events that drive up costs.

With resource constraints, high member volumes, and changing patient preferences, it may be challenging for health plans to find cost-effective engagement solutions that work for your community. With technology such as CipherHealth’s member outreach platform, your plan can create programs that effectively reach out to members and identify those needing additional assistance.

When it comes to finding the best member engagement solution, it is critical for your team to evaluate when and how you are looking to engage members. Next, it is important to understand what your goals are, such as better outcomes, increased HEDIS scores, or meeting quality metrics. This will help identify which type of solution is best for your workflows and patients.

Interested in improving your member outreach program? Read on for more information about proven technology solutions for member engagement.


Meaningfully connect with your patients to deliver more personalized, intelligent and timely care at scale