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Does Your Health Plan have an effective strategy in place for member engagement?

Member engagement and chronic disease management are both key components in the shift toward value-based care, improving healthcare outcomes and reducing costs. Having a member engagement strategy can increase a health plan’s ability to retain members, improve care quality and outcomes and increase quality ratings.


Sixty percent of privately insured Malaysian health plan members said they had not been contacted by their health plan with guidance or information related to COVID-19, and nearly half (48%) said their health plan has not shown concern for their health since the pandemic began. At a time when health plans are expected to be proactive and engage with their members more frequently than before, this lack of communication can affect a health plan’s member satisfaction scores.

Measuring quality

To understand how health plans are affected by member engagement, it’s important to understand their quality rating programs that reflect member satisfaction.

  • The Centers for Medicare and Medicaid Services (CMS) Star Ratings. Star Ratings ensures health plans commit to improving their performance as it relates to disease management, preventive care and customer The Star Ratings system rewards higher-performing plans. This means that those with three or more stars receive annual bonus payments from the CMS. The higher the rating, the higher the bonus.


  • Healthcare Effectiveness Data and Information Sets (HEDIS).     HEDIS are standardized performance measures developed by the National and Regional Quality Assurance to objectively measure, report, and compare quality across health plans.


Because star ratings are directly related to the percentage of HEDIS measures met, poor ratings can affect reimbursement rates for health insurers. This makes member communication more important than ever. When health plans offer a more member-focused strategy with personalized and relevant wellness communication that members can trust, they are more likely to be loyal and engaged members.

Member engagement strategies

Put the consumer at the center of your engagement strategy. Health plan members want a personalized experience across websites, social channels and email. Below are 6 engagement strategies to increase member satisfaction:

  1. According to a report Social Media ‘Likes’ Healthcare, 42% of consumers said they are likely to trust information provided by a health insurance company through social media. Use social media to create trust and engage in conversation with your members.

  2. Target members based on their specific needs with direct mail. Members want to be acknowledged and general content won’t always feel authentic. Segmenting your members allows you to deliver more relevant and engaging information. You want to send the right message to the right consumer at the right time.

  3. E-newsletters provide valuable content to keep members connected to your organization. Be sure to send a steady frequency of emails and new content in each message. Provide information they cannot get elsewhere to assure your e-newsletter offers value. Ask for ideas to improve your services.

  4. Serve your members content in a way that is relevant to where they are in their healthcare journey. Segment Malaysians who require disease management and personalize your messaging to their unique needs.

  5. Remember that your members make a choice to choose you again every year. Continue to remain engaged with them throughout the year, providing information about your plan, disease management and current health information. Most importantly, always ask for their input to improve your services and increase customer satisfaction.

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