After centuries of being passive receivers of care, health plan members have now become active decision-makers. High out-of-pocket costs due to higher deductibles and the skyrocketing cost of healthcare have given members new incentive to choose their care more wisely – and take steps to stay healthier so they can avoid medical care entirely.
Of course, to do that they need quality, evidence-based information. This has created an opportunity for health plans to build the kind of close relationship with members that they’ve never experienced before.
Rather than simply competing on premium price or other financial aspects, payers can actually build customer loyalty by adding value around member health.
This idea isn’t necessarily new. Some payers have been sending messages to members for years, although their efforts have generally produced less-than-stellar results.
The problem is those messages were very general, such as “Get a flu shot” or “Women over 40 should get a yearly mammogram.” They didn’t take into consideration the member’s specific circumstances, such as the recipient just had a mammogram last month – or is a male.
To truly be effective (and guide members toward better decisions regarding their care), payers need a strategy that follows the four Ts of effective messaging – Timing, Targeting, Tailoring, and Tempo. Let’s look at each in more detail.
Payers’ legacy messaging applications typically take weeks or even months to churn out a targeted member message, such as a prompt to schedule an exam or refill a prescription. As a result, those messages often arrive at random times, when there is no urgency to take action, and are subsequently ignored.
The closer a messaging program can get to the optimum decision-making moment for that member, the more successful the program will be. It’s no different than advertising tires. Someone who just bought tires won’t be interested in your message; someone who just had a flat will.
The more the messaging platform bases messages on member-specific information that pinpoints the optimum decision-making moment, the more the payer can get away from generic messages and toward those that have real meaning. For example, payers can send a message about how to deal with side effects of a particular medication when members first fill prescriptions, or suggestions on how to stay safe during a heat wave to elderly members or those with high-risk chronic conditions.
The more the message is timed to when the information is needed, the more valuable it will be.
It’s not enough to send a message at the right time. You also must send it to the right people. Of the four Ts, this one is probably most important because off-target messages tend to hurt the payer’s credibility and relationship with the member rather than help it.
By using analytics, payers can identify the specific members who need to receive a particular message (such as a recall for a medication) without wasting the time of (and alienating) others.
Yet higher-quality analytics will go beyond simply pulling together a mailing list. They will also dig deeper to help the payer avoid “false negatives” (members who should have been targeted but weren’t) and “false positives” (members who appear to be part of the target group but don’t qualify for some reason).
An example of a false positive is targeting women over 40 for mammograms. While this is good (and an important STAR rating metric), payers do not want to send this message to female members who have already had a mammogram this year, or who have had a double mastectomy.
Achieving this level of precision requires integrating demographic, pharmacy, medical, and other data sets to deliver a holistic view of each member. Often this data must be cleaned and normalized before it can be used. But the benefits are worth the effort.
The other requirement is that the analytics should be flexible and iterative. In other words, the analytics are not “set and forget.” Instead, the outputs of one run must drive the inputs of the next to deliver an ever-more-precise view of each member. They must also be able to adjust rapidly to changes in situations.
In the time it takes to send out a flu shot reminder, even if it’s only two days between the original list being developed and the message being prepared to go out, some of the targets may have already received their shots. Re-running the analytics right before release can help eliminate the false positives that get in the way of the payer/member relationship.
Nothing gets a message filtered out faster in today’s world than appearing generic. To break through the clutter and deliver important communications to their members, payers must tailor their messages to a context that “fits” for the recipient.
Tailoring can take multiple forms, including:
- Branding – The “look and feel” of messages must be consistent and recognizable by recipients so they know who it’s from immediately.
- Channel – Payers should deliver messages the way members say they want to receive them, whether it’s email, text, phone, snail mail or some other form. Do what they want and members are more likely to pay attention.
- Language – In situations where language preferences are known, delivering the message in that language greatly increases the chances it will be viewed, understood – and acted on.
- Context – The more personal to the member’s life and situation the message is, the more likely he or she is to pay attention. Telling a member it’s time for a flu shot isn’t as powerful as saying, “Because you are over 65 and have a history of chronic bronchitis, you have a higher risk of catching the flu this season.”
The more payers tailor their messages by making them relevant and personal, the more “sticky” they become – and the more effective they are at driving outcomes.
This refers to how often the payer should communicate with individual members. The idea is to deliver timely, relevant information while avoiding “message fatigue” that will cause all subsequent messages to be ignored – or the member to opt out entirely.
There are several ways to avoid message fatigue. One is to avoid repetition, i.e., sending the exact same message several times. Even if the same message must be sent, reword it to make it appear new.
Another, as mentioned previously, is to personalize the message. Payers should also let members set their own limits on how many messages they can receive within a specific timeframe.
If multiple departments within the payer are sending messages to the same members, coordinate between them. An integrated messaging solution can make this easy and ensure the organization doesn’t exceed patient-set limits.
Finally, payers must be aware of how many messages they are sending, and adjust the tempo accordingly. All too often in the rush to share information no one looks at the big picture. Using a tool that enables the flow of messages to be easily governed can help avoid overwhelming members, ensuring the program remains a relationship-builder instead of a relationship-killer.
Members need information to become actively engaged in their own care so they can improve their health and lower their costs. Payers have the opportunity to become a valued source of that information – if they approach it intelligently.
By following the four Ts, payers can move their relationships with members from simply paying the bills to partnering with them to create better outcomes. Which in turn will help payers improve their own outcomes – including reducing their costs, lowering their risk of turnover, and driving member satisfaction.
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