Less than 2% of people respond when mailed information about enrolling in Medicaid, highlighting a major hurdle for health plans trying to connect with members, especially those with complex needs.
The Engagement Gap: Why Talking *To* Patients Matters More Than Ever
Table of Contents
Health insurers are struggling to meaningfully connect with members, especially those in Medicare Advantage and Medicaid, and simply sending messages isn’t cutting it.
- mass communications like texts and automated calls frequently enough fail to drive real engagement.
- Personalized outreach that addresses both health *and* social needs is far more effective.
- Technology can help, but it’s no substitute for human connection and empathy.
- Investing in care coordination yields better health outcomes and a stronger return on investment.
For health plans, engaging members is always a priority, but it’s particularly challenging with those in Medicare Advantage, Medicaid, and dual eligible special needs plans (D-SNPs). These individuals are often hard to reach, more likely to seek care in expensive settings like emergency departments, and frequently behind on preventive screenings. A health survey offering iPads as raffle prizes only achieved a 7% response rate, with fewer than 4% fully completing it.
The Power of a Personal Touch
What truly moves the needle isn’t simply *sending* a message, or email shouldn’t be considered engagement.True engagement means members actively participate in their health, keeping up with appointments and screenings while accessing care in the most cost-effective settings.
Tech Isn’t Always the Answer
Technology can enhance the member experience, but many vendors overestimate its power. A 2023 study revealed that Medicaid and Exchange plan members in california receive as many as 20 automated messages *per week* from various vendors, leading to information overload. Similarly, a 2022 study of over 428,000 adults found that patients receiving 10 or more text messages or two or more automated phone calls were considerably more likely to opt out of future outreach-a clear sign of message fatigue.
Programs prioritizing human-to-human contact may have higher per-member costs than automated reminders, but the benefits-improved quality metrics like CMS Star ratings and HEDIS scores, increased member loyalty, and better retention-can deliver a far superior return on investment.
Hallmarks of a Accomplished Person-to-person Program
- Accessible Communication: Members respond best to outreach that feels approachable and convenient,not impersonal or automated.
- Genuine Connection: Conversations should be authentic and tailored to individual needs, building trust and fostering future interactions.
- Address Priorities: Effective programs recognize and respond to immediate needs, such as SDOH challenges. For example, nearly 50% of families reported a diaper need in 2023, a 42% increase since 2010-a notable barrier to childcare for struggling families.
- Family Focus: Health needs frequently enough extend beyond the individual,and programs that consider the broader family context can have a greater impact.
- Local Expertise: Programs reflecting local culture and resources build stronger relationships and improve follow-through.
Ultimately,meaningful engagement requires authentic,person-to-person connections. members respond when care coordinators listen, solve urgent issues, and guide them toward recommended screenings and appropriate care settings. While technology can support these efforts, it can’t replace trust, empathy, and human problem-solving.
Combining personal outreach with smart technology can close care gaps, improve quality measures, build loyalty, and improve retention. Investing in the human touch delivers stronger health outcomes and better returns than tech-only approaches, ensuring members feel supported, valued, and empowered to manage their care.
