by Jon Rogers, Sr. Consultant, Risk Adjustment
As we move through the second half of 2024, managed care organizations must prioritize member engagement, especially for individuals with chronic conditions. This period presents an opportunity to embrace strategies that encourage essential healthcare visits, such as annual wellness and primary care appointments.
Read on for member engagement tactics that focus on precise member identification, compelling messaging, effective communication methods, flexible visit options, and rigorous measurement.
- Precise Member Identification
Precise member identification should focus on members without a PCP visit in 2024, those with known chronic conditions (as identified through claims data review), and members with suspected chronic conditions (derived from lab, prescription, and durable medical equipment data). Collaborating with quality, HEDIS, Stars, and population health teams can enhance this process by comparing at-risk and denominator members; efforts that are conducted in concert foster a more seamless experience for the beneficiary. Leveraging data analytics to cross-reference various sources of health information will enable plans to identify the most vulnerable members accurately and prioritize them for outreach.
- Effective Messaging to Members
Crafting the right messaging is crucial to encourage members to engage with their PCPs and should emphasize the importance of proactively managing chronic conditions. Messaging should highlight the benefits of early detection and management of chronic conditions, which can prevent complications and improve quality of life. Additionally, encouraging members to write down questions for their provider can lead to more productive visits by ensuring that all concerns are addressed. Offering scheduling assistance with the PCP office can further ease the process for members, making them more likely to follow through with appointments.
- Match Communication Methods to Member Preference
Choosing the appropriate communication methods is vital to effectively reach members. Each method has its pros and cons:
- Mailing. Traditional and trusted, especially among an older demographic that may prefer physical mail. It allows for detailed, tangible information that can be revisited easily. However, it can be costly and time-consuming for health plans.
- Email. Cost-effective and quick, making it easy to send personalized messages to a large number of members. However, it may be ignored or filtered into spam folders.
- Text. High open rates and immediacy make texts an effective way to reach members quickly. However, texts can be seen as intrusive if not managed properly, and they may have character limits that restrict detailed messaging.
- App/Patient Portal Notifications. Direct and engaging, these notifications can provide immediate updates and reminders. They rely on member usage and familiarity with the technology, which may vary among different demographic groups.
- Outbound Call Campaigns. Personal and persuasive, calls allow for direct interaction and the ability to address questions in real-time. However, they are labor-intensive and can be perceived as intrusive if members receive frequent calls.
- Coordination with Provider Groups: Leveraging provider groups’ scheduling staff to make outreach attempts can be highly effective. This method adds a layer of trusted communication and convenience, as members may be more likely to respond to calls from a provider’s office than from the health plan.
- Help Members Understand Visit Options
Offering flexible visit types and helping members understand which options are available can significantly enhance member engagement.
- In-person visits allow for comprehensive physical examinations and personal interaction, which some members may prefer, especially if they have complex medical issues that require a thorough evaluation.
- Telehealth visits provide convenience, especially for those with mobility issues, transportation challenges or busy schedules. Telehealth can also reduce the risk of exposure to contagious diseases, which remains a concern for many members.
- Measure Results and Hone Approach
To evaluate the success of an engagement program, it’s essential to measure specific metrics. These metrics include the number of members reached, the number of members with PCP claims data, and the number of members who have had their conditions addressed, as verified through medical record reviews. Additional metrics might include member satisfaction rates, engagement rates by communication method, and the overall impact on healthcare outcomes such as hospital readmission rates and emergency room visits. Regular analysis of these metrics will help identify areas for improvement and ensure that the program is achieving its goals. Advanced analytics and reporting tools can provide deeper insights into the effectiveness of different strategies and help refine the approach.
ATTAC Consulting Group’s risk adjustment experts are here to help your plan implement best practices, address challenges, and ensure your program delivers the best possible outcomes for members. Contact ATTAC today to learn more about how we can support your efforts to create a compliant, high-performing member engagement program.
