Now that consumers have more choice when it comes to purchasing a health plan, it’s more important than ever for payers to attract and retain members, and help them forget “100 years of bad press about insurance companies.”
“Since the rise of the ACA and the individual exchange market, there is a lot more soliciting going on. The employer-sponsored market has been reduced, and the exchange marketplaces have become a very large part of the marketing strategy for payers,” Rivkin says.
“But, if there have been 100 years of bad press about insurance companies around things like pre-existing conditions, the denying of claims, and people going bankrupt because of fights with their insurers, then there is an historic background that is still out there with a lot of people.”
In a recent conversation, Rivkin outlined three key ways payers can improve their customer engagement in this new era of health plan purchasing:
1. Roll Out a Retail Strategy
Payers can overcome consumer fear and hesitation by developing and executing a retail approach to service that consists of more proactive outreach, Rivkin says.
“I think traditionally, payers didn’t use the retail model of customer engagement as their benchmark. Their customer service tended to be reactive and claims-based… The number one thing [for payers to know] is that people are expecting a legitimate customer experience that is equivalent to a retail or finance industry experience from their health plan,” he says.
“The customer is not just thinking about insurance once a year at open enrollment anymore and is, hopefully, thinking of the health plan as a partner in their care. Customers are expecting a customer service and mobile technology experience that would be equivalent to a bank or retailer.”
Payers have warmed up to this idea and are now marketing to their members on a more consistent basis, Rivkin says, to try to build a year-round relationship.
“In the beginning, the average marketing budget for payers was only at open enrollment, and it would be tied to mass marketing, such as TV commercials. Then you wouldn’t see those commercials the rest of the year. Now, instead of just having an open-enrollment, renewal mindset, it is more of a continuous presence mindset that combines marketing with care coordination and member satisfaction.”
Insurance companies that don’t successfully satisfy consumer demand for a better service experience will pay the price when it comes to member enrollment, Rivkin says.
“With employer-sponsored plans, people had very little choice. Now with the availability of the exchange products, people can switch, and they will vote with their feet.”
2. Have Providers Deliver the Message
Insurers want their members to be engaged in their own health so that they will prevent, or at least manage, chronic and other conditions that can result in costly procedures, ER visits, and hospitalizations if left unchecked.
However, due to the lack of trust that exists between many consumers and their health plans, one solid strategy for payers, Rivkin says, is to use providers to deliver messages around wellness and prevention.
“When outreach is occurring and payers are trying to do genuinely good things like wellness programs, adoption and patient perception are much higher when the communication comes from the provider rather than the payer,” he says.
While patients may not realize it, Rivkin adds, payers and providers are becoming much more aligned in their efforts to engage patients in programs and treatment plans designed to improve outcomes and control costs.
“People don’t quite get that payers and providers are a lot closer than they used to be with provider-owned health plans, mergers across the board, and blended CO-OPS,” he says.
“Payers are trying to collaborate with providers to bend the cost curve, especially with high-risk populations, to try to get people to comply with their care plans… A more aware patient or member is usually a healthier patient or member. Everyone wins, especially in capitated models, if patients are healthy.”
3. Use Analytics Tools to Segment Members
As healthcare data analytics tools become more sophisticated and robust, payers should harness the information to target potentially at-risk and high-cost members with wellness and engagement messages, Rivkin says.
“Clinical data is being combined with claims data and that provides a nice pool of data to mine. It allows for segmentation on a continuous basis for patients and members being affected by chronic conditions,” he says.
This level of data sharing, however, brings with it some challenges around security, Rivkin says, noting that payers are “deathly afraid of a breach, as they should be.”
Additionally, he says, insurance companies need to be mindful of not being perceived by members as overstepping their bounds.
“A lot of clinical data is being combined with claims data so providers can provide better clinical care coordination, but payers have to be careful not to offend their members. When trying to have that continuous presence, as compared to only at open enrollment, insurers have to be careful not to cross that line,” he says.
“There is a very fine line between being an effective healthcare partner as your insurance company and being annoying, threatening, or offensive. You don’t ever want a member asking the question, ‘How did you know that about me?’”
Rene Letourneau is a contributing writer at HealthLeaders Media.