Executing consumer health engagement

Today’s healthcare industry transformation lingo often includes the phrase “member or patient engagement.” Most industry players see health consumerism or engagement as one of the strategic building blocks for the future of healthcare.

What does engagement mean?

Generally, engagement is getting a person to do something within a specific period of time. In healthcare, it means effecting things like a lifestyle change, following a care plan, coming into the doctor’s office to close a care gap or using generic drugs to save money. The outcomes of effective health engagement are positive for everyone. Better health outcomes and lower costs are good for value-based care (VBC) oriented providers, the insurance company and for the member/patient.

This transformation to health consumerism is quite the challenge for our industry and for consumers. For decades, employer-sponsored healthcare and HMO plans with nominal copays have shielded consumers from the costs of care. Insurance companies and providers negotiated contract terms and claims administration, trying to keep the consumer out of the middle. Furthermore, insurance and provider industries are certainly not known for their understanding or focus on meeting diverse consumer needs.

There are many learnings, or at least informed opinions, from executing consumer health strategies at scale in the Florida market over the last 15 plus years.

  1. Let the voice of the real customer guide you. Remember, health plan or hospital employees, particularly executives, don’t represent the typical health consumer.
  2. Don’t overvalue digital strategies and channels. Digital-based tactics are certainly efficient and often helpful and convenient for many consumers. Many consumers, particularly those with substantial health issues, prefer or need high-touch support. In Florida, over 300,000 members visit a Florida Blue center annually for help selecting the right health plan for their family, and for trusted advice on how to navigate the healthcare and insurance systems.
  3. Don’t underestimate the level of commitment and investment your company will need to make to become a consumer-focused organization. Executive alignment is absolutely required across the organization. The marketing or service organizations can’t get the job done by themselves. The transformation takes years of concentrated effort in IT and analytics departments and the delivery system areas. Healthcare organizations tend to focus on clinical issues and often don’t understand other issues their patients may struggle with that impact their ability to follow a treatment plan. Try to remember your company is likely far from being an effective consumer-focused company that can truly affect the business and support your customers.
  4. Assume most of your customers don’t fully understand the fundamentals. Furthermore, they don’t have much interest until they really need healthcare services. Concepts like coinsurance, efficient sites of service, in-network providers and the like are often elusive.
  5. Selecting the right people to support your customers is extremely important. Develop a profile of people who are specifically suited for this job (e.g. empathetic, good listeners). No training program or management system will overcome poor hiring decisions.
  6. It is critical to address the foundational infrastructure challenges of your business that negatively impact your organization’s ability to serve your customers. Archaic databases, non-sensical business rules, and bureaucratic and fragmented business processes filled with point-solution vendors can’t be overcome by a friendly service staff.
  7. Leverage all of your customer touch points. Many organizations are investing in outbound campaigns without ensuring that the inbound processes are prepared to support their customers. Of course, it’s much easier to talk to a member about an issue when they call or visit you than when you try to reach them during their busy day.
  8. Build a business case for the investment. Real execution of a consumer strategy can drive tremendous financial value for insurance companies and healthcare providers operating in a value-based care environment. Remember, most organizations are driven by financial considerations. Notions of customer experience or brand differentiation won’t carry the day, at least not for long.
  9. Remember the saying “different strokes for different folks?” Your offer must be relevant to the individual consumer. You must have actionable analytic-driven processes and coordinate your outreach efforts to be effective at influencing consumer behavior. Consumer engagement and a positive customer experience can coexist if you prioritize and coordinate your efforts.
  10. Finally, transformation to a consumer-focused company is a long journey. Make sure you make progress and create value along the way. Your company and your customers will appreciate it.

Companies that truly understand how effective consumer health engagement can support achieving their strategic goals are ready to start the journey to becoming a consumer-focused health company. A focused and persistent effort is required to actually execute the strategy. Execution of transformational initiatives is challenging for most companies, however, overcoming the challenge is required to walk the talk of health consumerism.