Closing care gaps and improving quality metrics remain a big challenge for health plans. Often this challenge exists because members are not engaged or actively participating in their health. There are three key ways that health plans can address WHY members are not engaging and turn those metrics around.
In early 2021, a survey showed that only 34% of respondents gave the public health system a positive rating, down 9% from 2009.
Trust in the health care system has faced increase strain in the past few years due to the COVID-19 pandemic and increased awareness to disparities in care based on gender, race, sexual orientation, and socioeconomic status.
Another survey showed health insurance companies ranking last in trust among the health care system, with only 33% of respondents stating they completely or somewhat trust them.
Trust can be hard to build, but there are key actions health plans can take to start building trust with their hard-to-reach members.
Shifting from a one size fits all approach to a one size fits one, empowers members in their healthcare journeys. A tailored experience builds trust by showing individualized care and attention.
Personalization can include using preferred names, pronouns, and inclusive messaging. Algorithms are helping brands across the internet offer catered experiences to their customers, and with the right partnerships, health plans can provide this same level of personalization to their members through digital health experiences and reward systems.
Gamification is a powerful tool in increasing member engagement by providing personalization in the use of rewards, storytelling, and building confidence through autonomy and competence.
Combining the specialization tools of digital health with a team of live support that is empathetic and available for questions, concerns, and check-ins reinforces the human touch that creates relationships and trust.
A key concern for many health plans in the coming years is surveying for SDOH information including age, race, gender, sexual orientation, and socioeconomic status (and ensuring they are getting comprehensive and accurate information). The question in the mind of their members is around why this information is being collected.
Transparency in these answers is crucial to building trust with members and assuring that ultimately this data is used to close health care gaps and improve health outcomes for the members.
Staffing shortages throughout the US adds another barrier to adequately addressing member questions. Partnering with digital solutions can make communicating information about data collection easy and personable to make sure members understand how their information is used to improve their care.
While the pandemic led to decreased trust in the healthcare system, it simultaneously reconfigured the way we think about healthcare access. The use of telemedicine increased dramatically, with the ASPE reporting medicare telehealth visits jumping from 840,000 in 2019 to 52.7 million in 2020.
89% of the US population now has steady access to the internet. In looking at just the 65+ age group, access has improved with 75% having internet access and 60% owning a smartphone.
Strategically partnering with digital health solutions helps close care management gaps with wider access and real time member interventions. For example, Wellth’s live support team is able to intervene after missed check-ins and the member receives personalized outreach to get more information if further assistance is needed. Not only does this create accountability on the part of the member but also is able to address any problems with the member’s care management plan.
Members are more engaged when they know their health plan wants them to succeed and cares about them.
“The program reminds me to take my medicine and check my blood pressure. Before, I used to forget and would end up not taking my medication or checking my blood pressure. Having to take the picture on the app helps me stay on track. I want to tell my insurance team and Wellth thank you so much for thinking about me and allowing me to participate in the program. I love it!” - Wellth member
When vetting programs to partner with, it is crucial to make sure that they prioritize health equity in their model. Quality measures are beginning to reflect the push to close health equity gaps, so it is important to select partnerships focused on improving key metrics and measures that uplift the hardest to engage members.
Wellth’s model is created with the least engaged members in mind. This is why an extensive and diverse outreach and support team is available for Wellth members working in tandem with rewards structured to specifically offset social drivers of health.
Investing in your members uplifts them in two ways: influencing a desired behavior and investing in their communities.
Wellth uses principles of behavioral economics to set members up for success by creating long term habit change rather than a one time desired behavior. Loss aversion in behavioral economics says that people are more likely to want to keep something they already have rather than gain something new. Members are endowed with a certain amount of rewards and must follow their daily care plan in order to keep those rewards.
The cue-routine-reward cycle modeled in a user-friendly and engaging platform creates long term habit formation to the point where the results from prolonged adherence are equally if not more valuable than the rewards themselves.
“The rewards give you a sense of confidence that you can manage your medication routine every day. I am developing a good habit and that habit has developed into a characteristic.”-Wellth member feedback
Wellth members have also illustrated significant decreases in ED utilization and inpatient days, which results in big savings for members and health plans alike. One large Arizona Health Plan lowered high-cost utilization by 42% in Medicaid populations from using the Wellth app.
Increasing cash flow has also proven to uplift underserved communities. By rewarding members, health plans are investing in the communities they serve. Even with online shopping on the rise, over 90% of everyday purchases are made within 20 minutes from home.
Having specifications of how rewards can be spent assures that rewards given through health incentives directly benefit communities and counter the effects of social drivers of health.
Employing trust, accessibility, and incentives to promote member engagement not only improves health outcomes, but also improves the quality of care the member is able to receive. While the work of making systematic changes can seem impossible when they compound, strategic partnerships with digital health solutions can ease these changes and make health equity changes tangible in the short term and the long term.
