Health insurance remains one of the lowest-rated industries in terms of consumer satisfaction. That’s nothing new. What is different is that these payers are seemingly beginning to understand the importance of increasing and improving their digital presence for members. It won’t be easy, though. 

In a 2022 study conducted by Forrester Consulting, healthcare payers described their digital experiences as basic and transactional in comparison to other industries. The study noted that members were dissatisfied with their payers’ online offerings, which made them more likely to utilize offline channels. The problem with that is that more than half of members who communicated via phone were dissatisfied with those interactions. 

Health plan members’ preferences and expectations have been changing over the past few years, largely due to the rise in healthcare consumerism. Defined by the Patient-Centered Outcomes Research Institute (PCORI) as people proactively using trustworthy, relevant information and appropriate technology to make better-informed decisions about their healthcare options, both within and outside the clinical setting, healthcare consumerism means payers’ members expect to be treated with the same level of service they receive in other industries.  The healthcare industry is simply the latest to the consumerism trend.

The Cost of Member Dissatisfaction in Healthcare Services

Most payers already are challenged to reduce operating costs while improving member experience. They’re also tasked with handling increasingly complex claims. Communicating with members more efficiently through those consumers’ preferred channels is simply another obstacle to overcome. 

What occurs when healthcare payers fail to meet evolving member expectations? Often, these payers lose members. Research from McKinsey & Company found that members with high-cost unplanned follow-up care were 2.2 times more likely to switch their payer. The primary reason? The members cited their payer not meeting their expectations for their specific condition. 

Another report, this one from Accenture, detailed that about half of members surveyed left their payer because of a bad experience. Factors included in those bad experiences typically consisted of inaccurate or inconsistent information, unanswered questions, poor experiences using digital tools and discomfort with how payers used their personal data. 

Member dissatisfaction has the potential to affect more than a payers’ total enrollment. It can markedly impact the Consumer Assessment of Healthcare Providers & Systems (CAHPS) scores and Star ratings of Medicaid and Medicare Advantage payers. 

Preferred Channels for Care Coordination 

How, then, can healthcare payers improve their communication with their members? What channels are best for meeting these individuals where they are in their healthcare journey? 

McKinsey & Company identified eight best-in-class channels for member-payer communication as mobile, email, website, phone calls, chat, contact center, social media and video calls. Gone are the days when payers only utilized telephone calls and mailed materials to provide members with information about their health plan. 

In a J.D. Power survey, roughly one-third of commercial health plan members reported connecting with their payer over the past year through text message, mobile app or web — the highest percentage ever recorded. The use of digital health tools is the preferred method of communication for almost half of all health plan members, and almost 70 percent of members use digital tools at some point throughout their healthcare journey.

Digital health resources aren’t only used by members to access information about their plan. Nearly 80 percent of consumers prefer using digital channels to pay their healthcare bills.

The Value of Digital Health Tools for the Healthcare Industry

There’s a reason many members prefer using digital tools to communicate with their healthcare payer. In addition to convenience, these resources meet the increased demand for data and price transparency and enable members to engage in real-time conversations with their health plan. They negate the need for long wait times for information by providing members with immediate support and offering them rapid resolution of issues. Members are more easily able to find out which healthcare providers are in their plan network, thereby reducing out-of-pocket costs. 

By making digital health tools like HIPAA-compliant text messaging available to their members, payers are more easily able to share actionable information, streamline access to care and promote patient engagement. Engaged members, in turn, help increase enrollment and retention, lower the cost of claims and improve health outcomes and quality ratings. 

Similarly, regular communication between payers and members through these digital channels help to advance care integration and optimize health monitoring. The result is a reduced risk of medical errors, increased use of preventive health services and improved overall care delivery. That increased utilization of preventative care has the potential to reduce members’ likelihood of developing costly chronic conditions. 

Conducting outreach via digital health tools is especially important for payers targeting high-risk member populations. This regular communication from the perspective of value to the member can be used to assist in improving their health and ease of navigation along the healthcare spectrum, all of which leads to increased member satisfaction and higher long-term savings for health plans. 

The Role of Digital Health Tools in Payer Communication Strategies and Provider Claims

Digital health tools enable health plans to improve their communication with members, but they’re not intended to fully replace other customer service channels. Members should have access to a variety of digital resources that provide them with a convenient — and personalized — experience. 

These tools should be part of a member-centric communications strategy and one of the payers’ strategic priorities. They should be integrated with other payer resources to mitigate the need for members to provide the same information more than once. 

Not only is the communications channel important for healthcare payers to consider, but so is the content. Messaging to members should be timely and consistent and take into account, if possible, their level of health and digital literacy

Examples of information payers can send to their members using digital tools include:

  • Details about their health plan coverage
  • Reminders about preventive care
  • Information about wellness programs and services
  • Promotion of member self-care
  • Cost savings achieved through a visit to an urgent care facility instead of the emergency department
  • The reduced cost in visiting an in-network physician or healthcare facility 
  • Updates on claims
  • Resources available for support
  • Information about additional care services, including virtual care

At Providertech, we know that communication is critical to engaging member populations in their care plans. That’s why we give you the tools to remove barriers that prevent your members from receiving the care they need. Talk with our solutions team to understand how our secure two-way text messaging solution will enhance your member communication and engagement.