Healthcare consumer engagement is ailing

June 28, 2018
Tate McDaniel
Senior VP,
Engagement Solutions,
Change Healthcare

A study commissioned by Change Healthcare1 found that 72% of consumers say their engagement experience with both providers and health plans hasn’t improved—or has worsened—over the last two years. Yet at the same time, investment in consumer engagement is a top priority for 80% of payers, who invest up to one-third of their health IT dollars to improve the consumer experience.

Clearly something is amiss. But it doesn’t need to stay that way. There are a number of things payers can do to close that gap and improve consumer engagement.

If you look at other industries that have been successful at engaging the consumer, many are not doing anything overly complicated. They are simply making things easy for their customers. For example, the credit card industry sends one statement outlining all charges for a specific period, making it easy for consumers to understand. In healthcare, members can have a difficult time getting a simple explanation about the status of their bill, what they owe, and to whom they owe it. As consumer financial responsibilities continue to increase in healthcare and provider bad debt rises, simplifying the experience for members can help drive better engagement, satisfaction, and a propensity to pay.

Another suggested improvement would be “gamification,” which is successfully used to engage consumers in many industries. Payers could use gamification as part of their consumer strategies in a host of ways: Wellness challenges, rewards for making cost-effective decisions, portal registration challenges, etc. Leveraging gamification can help break down consumer barriers with payers and drive increased consumer behavior.

While payers are investing to better engage their members, today’s benefit plans are as complex as they’ve ever been. Indeed, the Journal of Health Economics2 found that in 2013, less than 14% of people understood their benefits, or the most basic benefit terms like “deductible,” “co-insurance,” and “co-pay.” Yet today’s plans can include narrow networks and different benefit coverage for up to five tiers within the same network. To drive better consumer engagement, payers need to simplify their offerings and make it easier for their members to know how much they will pay.

Trust vs. frustration

Consumers tend to have a low level of trust with payers, primarily due to general benefit information, inaccurate cost estimates, or digital tools, but there are ways payers can overcome this. Payers can build trust by finding ways to offer assurances in certain circumstances (e.g., prices shown in digital tools are the prices they pay), to build confidence that the information being provided is accurate, and the plan will stand behind it.

Another concern is that payers make it too difficult to register for their web portals; some registration processes are so archaic that many people abandon them altogether. A simple solution is to auto-register members, and allow the consumer to opt out at any time. This eliminates the need to register, which often requires users to input personal information the payer already has. We’ve conducted user testing that found people are reluctant to enter their personal information via the web to register for a health portal, but are comfortable seeing it presented back to them for verification. So, payers should pre-populate the necessary information, and eliminate a large barrier to better consumer engagement.

Opportunity knocks

There are plenty of opportunities for payers and their network providers to collaborate and deliver a better consumer experience. One of those is bundled payment: Payers and providers establish a clear price for episodes of care, helping members understand the costs better, and structuring payments with high-value providers to improve outcomes. Clarifying the consumer’s cost of care and billing can result in broader engagement and satisfaction.

Consumer businesses know how to reach their members on a personal level, and payers can learn to do the same. Doing so simply means taking what they already know about a member and using it to delight them. It’s as easy as saying “Thank You,” “Happy Birthday,” or “Congratulations.” There are certainly opportunities to do more with the amount of data payers have. However, sometimes it is the simplest of gestures that can delight and build trust in the payer/member relationship, just as in a more retail-oriented consumer business.

Consumer engagement is a journey, and there is no single roadmap to the destination. By following these guidelines, and adopting a consumer-oriented mindset, health plans can make serious headway in the quest to engage members.


  2. 2017/