It's no secret that member confusion around how to use medical benefits continues to be a major driver in inappropriate health care spend. For the Medicare population specifically, a recent Healthmine study showed that only 22 percent of Medicare Advantage members have knowledge of what star ratings mean when it comes to choosing their care. This confusion and lack of knowledge often gets highlighted through the statistics shared around inappropriate benefit utilization (such as inappropriate emergency room visits) and the expenses incurred as a result of chronic conditions.
The communications addressing this issue today are good at capturing preventive activities like sending notifications to members for appointment reminders, seasonal vaccines, and other routine screenings. But what about the critical pieces of information around important topics, such as navigating their chronic conditions or understanding how to choose a quality provider?
To that extent, outbound conversations shouldn’t be limited to just preventive benefits. Providing proactive population health management and coordinated care requires that a health plan look at all aspects of a member’s health—physical, mental, genetics, socio-economic status, etc. - and must be accessible to the patient as appropriate. It’s also important to keep in mind that while highly-personalized communication tools, such as text, IVR, and online content, are good resources, many consumers simply do not know what to do with that information or what questions to ask. This is especially true with older adults, individuals in a poor socio-economic status, those newly diagnosed with a chronic condition, or new members understanding new plan benefits. Members in these scenarios benefit from an interactive telephonic outreach that helps them navigate their health and drive to the right resources. And its no surprise that 73% of members still find telephonic engagement a more effective option to answer their healthcare questions, and remove any barriers (financial, physical, or otherwise) as preferred way to getting the care they need.
To manage a member who needs a higher touch, an effective communication strategy will include the ability to provide critical and relevant information at a time when its most impactful and with an outreach that fosters conversation. Members want timely information on how to manage their chronic conditions from their plan and care providers
For more on how Citra partners with its clients to create successful outbound telephonic engagement strategies, download our case studies here.