We Are Members Too: Time for Health Plans to Rethink Member Outreach

September 6, 2023

At 86Borders, we believe that we are members too. Just like a health plan’s most vulnerable members, we have families, healthcare needs, responsibilities of daily living, and the desire for a seamless and positive healthcare experience.

That’s why we’ve built our entire approach around treating health plan members the way we want to be treated by our health plans. Here are four foundational principles that guide our 86Borders member-first philosophy.

Consider how you want to be treated

Think of your own personal relationship with your health plan. What kind of experience do you want? We’ve asked ourselves this question countless times, and the answer is clear. We want a plan that:

  • Offers great benefits
  • Explains how to access those benefits
  • Improves our health and reduces our costs
  • Connects us with benefits and makes it easy to engage

Benefits are important, no doubt about that. But their true value lies in how effectively they are communicated. Proper timing of member outreach is essential. And once a connection with the member is made, health plans should seek to build trusted member relationships. Only then can complicated benefit descriptions be discussed.

Meet members where they are

Health plan members need to be engaged in a manner that works best for them. This is not always what works best for the health plan to reach their engagement numbers, nor should it be.

First identify a member’s immediate needs and provide instant connections to solutions. This could be enrollment in a community-based food bank to address food insecurities. If they are struggling with housing issues, narrow down the problem to connect them with the proper solution. And ensure regular follow-up with members to make sure their needs were fulfilled, and gaps were closed.

Know which member outreach modality is best

How would you like to be contacted by your health plan? Do you prefer a personalized email, a friendly phone call or perhaps a tailored text message? We understand that communication preferences vary from person to person and preferences vary from person to person and preferences must be accommodated. Consider the following questions and fine-tune member outreach accordingly.

  • Is the member employed and unreachable during specific work hours? What are those hours?
  • Can local telephone numbers be used instead of a toll-free number to improve the probability that the member will answer a call?
  • Does the member speak a different language?

There are so many factors at hand when it comes to each individual member. We believe that personalized, member-centered outreach is the most effective and considerate way to engage with members. Once this trusted member relationship is built and the member’s immediate needs are met, then we can focus on the specific health plan’s metric.

Build trusted member relationships first

Navigating the opportunities of a health plan can be complex and often begins with a basis of mistrust with the member. By putting health plan member needs before outreach metrics, health plans build trusted member relationships, improve member satisfaction and Star ratings, and successfully create an uplifted healthcare experience.