How to measure the success of Member Advocacy

How does your health plan define success? Claims denials, PMPM costs, and medical loss ratio are all important metrics to track. But how do health plans measure the success of Member Advocacy? By tracking the value it helps your organization deliver.

We outlined the key value drivers for our customers after implementing Member Advocacy.

Under a Member Advocacy model, health plans are empowered to deliver the highest possible value—for members and employer groups. We asked our customers what goals were most important for them to achieve, and how they could measure the success of Member Advocacy. These are the five value drivers that motivated our health plan partners to invest.

Improving member experience seems to be a ubiquitous goal. And there are several ways a member-first approach can benefit health plans. Removing barriers and creating a smooth member journey leads to higher acquisition, engagement, retention, & overall member satisfaction.

So how exactly can your health plan enhance the member experience?

Members are looking for the simplest way to solve their problems. If finding the help or information they need is not intuitive, it will be that much harder for your health plan to retain member trust. Deliver seamless communication by embracing omnichannel support. Your members may not always be willing or able to answer a phone call. But secure 1:1 messaging could be easier for members to use.

Better communication can help staff and care managers uncover pain points and other member experience trends. Alleviating these pain points can lead to more meaningful engagement and better retention. The ideal experience needs to be created with and for members, and tools and strategies should be mutually beneficial.

Metrics that matter:

Digital-first entrants and growing member demands pose a unique challenge to health plans. Adding specialized offerings and member-centric technology is essential to winning business and growing revenue. Across lines of business and stakeholders, innovation is key to continued success. But how can your plan be more competitive without outsourcing and losing competencies?

The member is your most important customer. That’s why many health plans’ core business offerings are built to connect with them. But members are not the only ones you should be thinking of. You can future-proof your health plan by appealing to employers, brokers, government entities, individual caregivers, and even your own employees.

Cost is the primary factor in employer decisions about health plans. Take advantage of this by offering solutions, tools, and products that drive down costs. Lowering costs leads to lower premiums, which keep you and your customers competitive. Don’t miss out on opportunities because you don’t offer flexible solutions like mobile apps and wellness programs.

Metrics that matter:

Staffing shortages are challenging the entire U.S. healthcare industry. From frontline care providers to administrators, there seems to be too few staff members to reach all your members. The right digital solution can empower your staff to work more efficiently and improve member reach.

A digital health management platform can help your plan support more members more effectively—without a significant cost increase. Instead, your staff can leverage digital tools to scale offerings and distribute work more evenly. Doing so allows care providers to practice at the top of their licenses, leading to better member experiences and care outcomes.

The right digital health partner enables your plan to differentiate your offerings without hurting your bottom line. Your team can also deliver more impactful services and build member trust. Plus, improving member impact leads to higher staff satisfaction and engagement.

Metrics that matter:

Helping members find the most appropriate care for themselves and their families—and putting information all in one place—will ultimately lead to better outcomes. Maximize your use of lower cost/higher value providers and services. This includes telemedicine and other technology-based communications.

Expanding use of such high-value care will lead to lower costs for plans and members. Reaching members digitally can help close care gaps, lead members to appropriate care programs, and improve quality scores. A recognizable brand is important. But your plan also has to have the power to steer members toward the low-cost, high-value providers.

Take a look at your network. Are you making the most of your relationships with ACOs and other industry players? They can help you reach more members. And once you reach them, it’s vital to deliver personalized information and services.

Metrics that matter:

This step goes hand-in-hand with enabling high-value benefits utilization. Offering a better insurance product at a lower cost is essential for differentiating on plan-product value. This means reducing unnecessary administrative and medical spending so you can offer a more competitive product.

Advancing plan-product value is about consolidating and uniting disparate offerings into a single plan-owned experience. Your services should address staff and member needs holistically, and make care and communication easier. Owning your solutions and services improves your plan’s self-reliance and maintain competencies. And that operational efficiency leads to lower internal costs and lower premiums for customers and members.

Metrics that matter:

To effectively measure the success of Member Advocacy, your plan has to align on key goals. Once you understand your goals and value drivers, you can work backward to identify the right metrics.