With the health care system continually evolving, today’s consumers are playing an increasing role in choosing, utilizing and evaluating their health insurance plans. Plans must move beyond focusing on member acquisition and toward building a seamless, comprehensive and personalized experience that spans the organization and meets the current and changing needs of their members.
This integrated consumer model is a paradigm shift that reflects the role of consumers as the ultimate purchasers of health care products, and recognizes that in an environment where risk adjustment and chronic disease interventions help manage costs, interacting with consumers makes sense.
Since the best information about a member resides with him or her, plans need to invest in consumer engagement strategies focused on consumer interaction, consumer tools, business process automation, and data and analytics.
Plans can begin building that engagement at the first step of the process — enrollment. This is particularly important in the group commercial area where consumers are entering the market through an open enrollment period. Open enrollment is a vital touch point because it influences and drives behavior. By helping consumers pick the right coverage for them and their families, plans improve group penetration and the likelihood consumers will choose the right plan for their specific needs.
Information collected during open enrollment creates initial consumer engagement. Contact and email information can be used to establish long-term engagement, profiles, preferences and appropriate communication channels. This data also helps to establish a “persistent identifier” with the member that will exist throughout the plan life cycle.
This sharing of personal information and setting common expectations can increase satisfaction and strengthen the relationship between plan and member. The plan is now on a journey with the member, identifying any risk he or she may present, engaging him or her in plan benefits and determining the best approach to care. If managed correctly, this journey can lead to ongoing, positive consumer engagement.
To read more about identifying population risk, download our article “Consumer engagement program paves the way for stronger member satisfaction, lower costs.”
About the authors
Clay Heinz, Vice President, Client Practice, Optum
Clay Heinz is responsible for developing new business concepts at Optum. As Vice President of Client Practice, he lends his expertise and innovation to payers, providers, employers and government entities in the health care marketplace. Prior to joining Optum, he worked for Extend Health as an innovator in the early years of exchange-based sales. Prior to Extend Health, Clay worked at BlueCross and BlueShield of Florida, where he developed D2C strategies to engage the health care marketplace.
Raj Madhure, Vice President, Payer Consulting, Optum
Raj Madhure is responsible for providing strategic and IT consulting, and for implementing Optum’s front-office solutions. As Vice President of Payer Solutions, he works with health plans, broker and employers. Prior to joining Optum, Raj worked for Kaiser Permanente, with overall accountability for commercial sales and marketing systems. Prior to Kaiser Permanente, Raj was part of Deloitte’s e-marketing practice.
Jayant Parthasarathy, PhD, Sr. Director, Innovation and R&D, Optum Technology
Jayant Parthasarathy (J.P.) is the Senior Director, Innovation, Research and Development at Optum Technology, a division of UnitedHealth Group (NYSE: UNH). At UnitedHealth Group, he has led various innovation initiatives in price transparency, chronic disease management, mobile health and device connectivity. J.P. also created myEasyBook, an award-winning consumer marketplace for health care services aimed at significantly improving access to high quality and affordable care. J.P. currently serves on the Board of Directors of the Personal Connected Health Alliance and on past Advisory Boards of the MidAmerica Healthcare Venture Forum. J.P. received a PhD from the University of Minnesota for his work on neural implantable devices.
Lori Stevens, SVP, Payer Solutions, Optum
Lori Stevens is Vice President and General Manager for Optum Payer Acquisition and Retention solutions. In this role, Lori is responsible for the strategy and business development of payer sales solutions supporting modernization, efficiency and growth goals. She has over 20 years of experience with health plans in actuarial, management and strategy roles. Lori joined Optum in 2000 and has held several management positions in the sales, product development and account management areas. She has her bachelor’s degree in mathematics and statistics and is a Fellow of the Society of Actuaries.