In today’s healthcare environment, consumers are demanding more from their Health Plans than ever before. Over the past several years, health plans have felt a shift in consumer expectations as the industry’s move towards increased digitization continues to mature. Consumer engagement is no longer optional—it is a critical component for health plans striving to deliver financial outcomes, improve population health and enhance member satisfaction. Building meaningful, personalized engagement strategies that are both effective and sustainable is key to fostering member trust, improving health outcomes and driving long-term success.
Defining consumer engagement in healthcare
Let’s begin with a broad yet practical definition of the health plan consumer. A consumer includes anyone who is currently a member, has been a member in the past, or could become one in the future. This inclusive view drives strategy, helping health plans deliver more personalized, meaningful interactions at every stage.
Consumer engagement is pivotal across multiple functions including sales, marketing, value-based care, risk management, care management and quality improvement. However, engagement strategies that operate independently or with limited integration can lead to oversaturation, misaligned messaging and diminished trust. A unified, consumer-centric strategy is key to standing out in a competitive landscape that increasingly ties reimbursement to strong member satisfaction scores.
1. Acquiring and managing consumer data
A comprehensive view of consumer data forms the foundation for engagement strategies. Many health plans face gaps in their data infrastructure, such as the absence of a robust identity management system or limited interaction histories. Health plans can address these challenges through developing a plan for:
- Data integration: Consolidating information from clinical, operational and consumer sources.
- Data mastering: Resolving complex identity issues across multiple systems like membership and claims databases, member engagement platforms, care management platforms and EHR systems.
- Centralized data structures: Building the frameworks necessary to support advanced analytics.
- Solution evaluation: Conducting a build verses buy analysis to determine whether an in-house or vendor-provided solution best meets your organization’s data management needs. By assembling and managing robust data repositories, health plans can lay the foundations necessary to unlock the insights required to personalize and optimize consumer engagement.
2. Transforming data into actionable insights
Data alone isn’t enough; meaningful engagement requires actionable insights. Health plans often excel claims data but lack behavioral and engagement intelligence. Leveraging advanced capabilities such as predictive analytics allow organizations to anticipate consumer needs, driving impactful interactions across the care continuum. Best practices include:
- Consumer segmentation: Developing multidimensional models to group consumers effectively.
- Attitudinal analytics: Identifying traits like loyalty and health management tendencies.
- Social determinants modeling: Using data to uncover barriers to care and behavioral drivers.
- Marketing analytics: Evaluating engagement effectiveness across channels and campaigns.
- Collaboration with providers: Health plans should leverage insights to work with provider partners to improve overall care coordination to enable members to connect with the right providers at the right time.
These insights empower health plans to build deeper connections with members, enhancing both individual experiences and organizational outcomes.
3. Aligning processes and systems
For consumer engagement strategies to succeed, health plans must integrate their operations into a seamless ecosystem. While many organizations have adopted individual tactics, they often lack the coordination needed for a unified consumer experience. Health plans should bridge these gaps by:
- Systems integration: Connecting engagement platforms to analytics systems for real-time functionality.
- Next best action systems: Enabling systems to recommend personalized, immediate actions based on historical data.
- Holistic design: Aligning engagement strategies with overarching consumer goals.
This alignment ensures consistent, relevant messaging across all touchpoints, fostering trust and loyalty among consumers.
4. Delivering personalized content
Content personalization is essential for consumer engagement in order to meet the expectations of today’s consumers. Instead of rigid campaigns or ad-hoc materials, health plans should create tailored content to meet specific consumer needs in real-time. Solutions to consider include:
- Content management systems: Implementing or designing systems for dynamic content creation.
- Digital asset integration: Ensuring seamless access to personalized content across engagement systems.
- Strategic planning: Designing content frameworks that align with consumer engagement goals.
- Insights from consumer behavior: knowing who your most and least engaged members are, and what is important to them is crucial to developing personalized content.
By delivering the right message at the right time, health plans can build stronger relationships and improve outcomes.
The consumer engagement framework
An effective framework integrates consumer-centric strategy with advanced technology. It is designed to accelerate performance while delivering a seamless, personalized experience. Regardless of the technology platform or vendor relationships, health plans can achieve results through five critical focus areas:
A comprehensive strategy for modern health plans
Effective consumer engagement isn’t just about meeting today’s needs—it’s about anticipating tomorrow’s challenges. Baker Tilly can help health plans build a sustainable, scalable consumer engagement framework that fosters trust, improves health outcomes and drives long-term success.
Baker Tilly’s healthcare consulting practice addresses the unique needs of health plans by combining strategic expertise with technical know-how. From journey mapping to change management, we offer end-to-end support for developing and implementing consumer engagement programs that deliver measurable results.
Learn more about our approach and how we can support your organization’s consumer engagement goals at Baker Tilly.
