The Hallmark of a 5-Star Plan is Exceptional Engagement. Why Is It So Hard to Achieve?

Every health plan talks about the importance of member engagement. So do all social media networks, fast-food restaurants, airlines, and every other consumer-facing business. Engagement is the way to drive long-term value and loyalty. But if it’s so important, why are so many health plans failing at it? 

When health plans talk about engagement, they often mean utilization management wrapped in friendlier language. Their actual engagement – the phone calls, emails, SMS messages, portal notifications, physical mailings, and the like – tends to be less of a comprehensive, orchestrated strategy designed around their members, and more of a free-for-all of uncoordinated vendor messaging and operationally-focused outreach. Add in the extended ecosystem of doctors’ offices, pharmacists, and the like, and it’s no wonder your members are loath to answer the phone. 

Plans win when they treat member engagement as a strategic competitive advantage. These plans orchestrate onboarding as a single, coherent experience rather than letting vendors operate independently. They deliver fewer, better touchpoints and align messaging across every partner. They segment members not just by health status but by financial acuity, communication preference, and life stage, because a healthy 68-year-old and a dual-eligible member rationing medications need fundamentally different types of engagement and are likely to respond to different communication channels. 

Health plans need to up their game when it comes to member engagement. It can be comforting to evaluate your performance within the confines of your industry, but that’s not the way people perceive the world. Your members are evaluating your plan’s engagement the same way they evaluate their social media network, fast-food restaurant, airline, or any other consumer-facing business. If these companies can tailor their messages to be personalized, relevant, and important, why can’t you?