As the global pandemic begins to fade, health programs are facing a new set of challenges.For many consumers, it can be said that the past 12 months have been very stressful, and for health plans, keeping their members informed, satisfied and (most importantly) healthy has never been so difficult
However, even if health plans solve the high “difficulties” in the current climate, membership satisfaction has never been so important to the financial performance of medical insurance and Medicaid programs. Since the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey indicators are four-weighted in the 2021 contract year, accounting for 32% of the overall star rating of the plan, the risk of providing a member experience that improves satisfaction is high. Those programs that have stable membership satisfaction must strive to maintain their status, while those that are lagging behind need to step up their efforts quickly.
What can the plan do to improve the overall membership experience so that you have a better chance of positively impacting their CAHPS scores (and stars)? Here are five things they should consider now:
- Make the healthcare experience convenient. In today’s world, Amazon has become the gold standard for providing consumers with a seamless experience, enabling them to easily and quickly find and purchase what they need. Vendors such as Devoted Health, Oscar, and Clover Health have adopted an experience-centric approach and have achieved varying degrees of success, but the plan should know that members expect to get the same level of experience they are used to in this increasingly on-demand world Convenience and service. This may include providing easy online access to forms during normal business hours, shorter call waiting times (or better yet, automatic call-back options), and online agents. In terms of access to healthcare, the plan is also addressing the digital divide. Efforts to address the barriers created by the digital divide will not only increase satisfaction and CAHPS scores, but also increase the value that members receive from the program.
- Personalized membership experience. Health plan members are not “one size fits all”, so the plan’s interaction strategy with members should not be the same. In the consumer world, restaurants understand and master this-for example, if you are a frequent customer of Starbucks, your experience on the company app is tailored to you based on your previous activities and preferences. In terms of healthcare, the plan should understand the channels and platforms used by its members and the types of messages they like to receive. Effective multi-channel combinations usually include email, text messages, phone calls, traditional mail, social media, interactive voice response (IVR), and face-to-face interaction (of course, if any). On a larger scale, the plan should also develop plans and services that meet the specific individual needs of members.
- Communicate clearly. Broadly speaking, health care is a complex topic, and it can quickly confuse some people, while for others it is downright intimidating. In this case, the plan needs to explain complex medical terminology in easy-to-understand language, while avoiding clichés, idioms, and slang used by medical professionals. Graphic design also plays an important role-simple and clear design helps improve readability. Understanding what drives the participation, behavior, and satisfaction of members through behavioral research shows that language and design that resonate with people’s beliefs and values can bring satisfaction because they feel connected to the information from their health plan. Most importantly, telling members what they should do is not enough; they also need to explain to them why this is important.
- Become an educational resource for members. When health plans become the first source of up-to-date and accurate healthcare information, they will become resources that their members increasingly rely on. This situation began to change at the peak of the pandemic last year, as insurance companies became the fourth most trusted coronavirus information after CDC, WHO, and healthcare providers, and ahead of TV and online news source. This makes it imperative to plan to provide information and access resources that members may not even be aware of, including resources provided through community partnerships. Another best practice is to anticipate potential dissatisfaction among members and communicate what they should do if they have a bad experience. Ultimately, members appreciate this degree of transparency.
- Proactively resolve known member issues. Many programs use simulated surveys to measure emotions and identify dissatisfied members, but the real value (and opportunity) comes from planning to solve the problems raised, preferably in real time. Taking action on common questions raised in simulated surveys–whether it’s making vaccine information easy to find or linking directly from the survey to nursing navigation or behavioral health resources–is an effective way to improve the overall member experience before the member receives the actual CAHPS. The survey is completed .
Finally, the plan needs to position itself as a valuable resource in the member’s healthcare journey, to get to know and talk to these individuals in a personalized way. This is no longer just for members to care. This is also to allow them to receive education and understand the benefits of the program itself and the resources available to make the member experience better.
Photo: Tero Vesalainen, Getty Images
