Health plans are spending more, using multiple channels to improve the member experience, according to the seventh annual survey.
Health plans are beginning to spend less on challenges stemming from COVID-19 and more on efforts to meet rising member experience expectations, including a greater emphasis on member engagement and its supporting infrastructure, according to the seventh annual RISE/Engagys survey on health care consumer engagement practices. In addition, plans are leveraging a multi-channel communications strategy to “reach consumers where they are.”
The annual survey, which tracks the consumer health engagement tactics, budgets, challenges, and priorities of the nation’s leading health plans, was conducted in mid-September 2022 and includes responses from more than 150 organizations. More than half of the health plan executives who participated (55 percent) in the survey reported an increase in their 2022 member engagement budgets and three in four (75.3 percent) also said there is an increase in the attention placed on these departments.
“This is good news for health care consumers,” says Kathleen Ellmore, cofounder and managing director of Engagys, who will present the full survey findings next week at the Medicare Marketing & Sales Summit in Las Vegas. “Even in the face of a national effort to improve member experience, we had seen some signs that health plans were pulling back on member engagement spending in the last couple of years. This year, survey results suggest that many health plans have been back on track with the resources to deliver a world class member experience.”
Jack Newsom, principal, Engagys, first unveiled the survey results at the 13th Annual RISE Star Ratings Master Class in December 2022, which took place at the same time that the Centers for Medicare & Medicaid Services (CMS) released its 2024 Medicare Advantage proposed rule and its intention to reduce the weight of patient experiences/complaints and access measures by half. Despite CMS’ proposal, Newsom urged health plans not to “take the foot off the gas in their efforts to improve the voice of the customer and the patient experience.”
In prior years, this survey has shed light on how COVID-19 forced changes in health plan spending priorities. In 2019, for example, as health plans took the lead in communicating with consumers in the first year of the pandemic, the survey showed that member engagement budgets swelled. Then, in 2020, the survey showed that increases had continued, though for a smaller proportion of plans. By 2021, the percentage of plans reporting budget increases was level as compared to 2020.
Among the key findings from the most recent survey:
Health plans used a multi-channel communications strategy in 2022, with outreach spread more evenly across channels than in prior years. For 2022, they reported increased use of nurses or care coaches and email for member outreach and less use of call center agents, printed letters, and automated phone calls. Use of SMS text messaging remained static. This is in stark contrast to the early years of this study, when health plans relied heavily on call center agents and printed letters, and use of SMS text messaging was uncommon.
No clear frontrunner emerged among communication channels in 2022, suggesting it’s getting harder to connect with members. This finding also suggests support for plans’ multi-channel communication strategies. Only four of 10 communication channels tracked in the survey cracked the 30 percent effectiveness mark in 2022. These were nurse or care coaches (35.5 percent), portal website (35.5 percent), call center agents (35 percent) and coordination with physicians (30 percent). In 2021, six channels reached at least the 30 percent effectiveness level.
Data and infrastructure priorities topped health plan priorities in 2022. Nearly half (45 percent) of participants reported an effort to standardize data fields across the enterprise, a five-fold increase over 2021. Rounding out the top three priorities, 50 percent of respondents said they had continued to develop multi-channel communication capabilities, and nearly as many (48 percent) indicated investments in the member portal had been a priority in 2022. Surprisingly, health plan interest in capturing and acting on social determinants of health (SDoH) declined in this survey, with only 26 percent of respondents citing it as a priority in 2022 in contrast to 45 percent in 2021. This is perhaps a reflection of the epidemiology of COVID-19. Of significance, respondents were asked to identify the top three priorities of 2022 for this question.
Plans embraced quality and clinical outcomes metrics over cost and ROI for consumer engagement programs, perhaps signaling a shift to pre-COVID-19 priorities in 2022. Asked to select all that apply, response rate led as a metric, with 76 percent of plan executives selecting it in 2022, as compared to only 57 percent in 2021. In a tie for second, 56 percent of executives selected quality and ROI. In 2021, quality earned 29 percent and ROI 62 percent. Clinical outcomes was third, with 49 percent in 2022 and 29 percent in 2021. Net promoter score or consumer satisfaction was fourth, with 44 percent in 2022, down from 48 percent in 2021. Cost was fifth, with 34 percent in 2022 and 33 percent in 2021. Finally, consumer behavior change was sixth with 32 percent in 2022 and 29 percent in 2021.
Some SDoH measures are easier to influence. Asked to cite the SDoH challenges their plan has successfully addressed, more than three in four (77 percent) participants pointed to transportation, and 64 percent identified food insecurity. Others named include social isolation (50 percent), behavioral health (45 percent), adequate housing (36 percent), literacy (32 percent), personal safety (27 percent), and utilities (18 percent).
Trends for 2023
As health plans look to the future, they face some key challenges and opportunities, says Ellmore. “The emphasis is shifting to investments in technologies that will help engage members,” she said.
This includes investments in infrastructure, like longitudinal records and common data elements. “We have an obligation to help members get back into care. Also, it’s on us to find a way that works to communicate with you, the member. Not the other way around.”
Other trends to consider:
- Inflation is driving up costs and making seniors feel less confident
- As the pandemic fades, preventive care is starting to rebound
- Telehealth is here to stay; 75 percent of plans said in the survey they plan to expand telehealth or keep it at post-COVID-19 levels and less than six percent expect to reduce their telehealth offerings