How to operationalize your member advocacy strategy

It’s never been more important to focus on the member experience. Outsourced consumer engagement services are capitalizing on your members’ dissatisfaction. Overall, employers gave their plans a C+ grade point average on their ability to direct employees to high-quality healthcare. Plus, 75% of members said their health plan did not meet their expectations for care coordination.

These factors, coupled with the acceleration of digital transformation brought about by the pandemic, require health plans to reimagine their member relationships. Many health plan leaders acknowledge that this shift requires a Member Advocacy model, sometimes referred to as a navigation or concierge offering. But few plans know where to start in giving members and employers the experiences they want.

Here are the proven steps that successful health plans take to implement Member Advocacy.

Define success to set an organizational direction

  • You need team buy-in on what defines success for your health plan. Your first step is establishing an evaluation framework.
  • Consider the long-term business outcomes you aim to achieve. This could be market growth and retention, improved utilization, better quality performance, increased member satisfaction, or IT transformation.
  • After specifying the end goals, establish key performance indicators (KPIs) at set milestones—and use your evaluation framework to track progress toward that goal. These KPIs should enable evaluation at the patient, care team, and program levels.
  • Make a plan to verify and share results internally for accountability, as well as externally so you can better represent your services in a competitive market.

Develop an iterative go-to-market plan

  • Focus on quickly launching to one or two groups first. You can learn from that initial launch and invest accordingly based on engagement and additional needs.
  • Make sure you are able to track the following critical metrics to drive improvement as you expand your offerings:
    • Onboarding rates of targeted members onto your digital platform
    • Weekly and daily member engagement rates within the platform
    • The key characteristics—such as age, gender, and program type—of enrolled patients on your platform
    • The number of members each staff member manages within your digital platform
    • How active your staff is within the platform and the number of touch points they’re creating with members
    • The amount of time your staff is spending on each of those member touch points

Apply proven marketing practices to drive member recruitment

  • Actively recruit members into the program to ensure adoption and keep members engaged in a way that’s valuable to them.
  • Partner with your marketing team to achieve your member volume goal, as it’s challenging for health plan staff to recruit members to your platform using telephonic channels alone.
  • Leverage your marketing team’s insights on reaching and engaging more members in different ways, through channels such as email and social media.
  • To make sure your outreach is relevant to the member, target your marketing campaigns to key events along the member’s healthcare journey, such as open enrollment.
  • At each touchpoint, ensure your messaging will resonate with the segments and personas you’re targeting by speaking to the member’s needs and challenges while avoiding jargon.

Organize staffing models around whole-person support

  • Take a multidisciplinary approach to care delivery, with collaboration across the health plan organization to deliver an exceptional and holistic member experience.
  • Hand-select a team to serve as the single point of contact for members, often referred to as a “health advocate,” in order to identify and quickly adapt to changing member needs.
  • Include staff from medical management, utilization management, or customer service.
  • Be sure to offer additional staff support to the health advocate as needs arise, including a clinical navigator, care manager, engagement specialist, or community manager, depending on the populations served.

Deliver an exceptional digital experience

  • Use the right technology at the right time to amplify the person-to-person connections that create a differentiated member experience.
  • Deploy a member mobile application to meet members on their own terms.
  • Position this app as a single trusted resource for members throughout their health journey. It should include digestible, interactive guidance on navigating the healthcare system, as well as support for unique health needs or conditions.
  • Consider integration opportunities with your existing mobile app, as well as customer support to ensure a unified and personalized experience.
  • Ensure member actions within the mobile app inform staff workflows, whether it’s surfacing a gap in care or a social barrier to health. As a result, your members will get timely and relevant support, driving improved satisfaction with your health plan.
  • Make sure this app can support meaningful relationships between members and staff through secure messaging.

Find out how Wellframe’s proven approach can make your digital ambitions achievable, all while positioning you to own the member experience.

Request a Demo