Want to Engage Health Plan Members? First, Build Trust

Trust in health plans is critically low.

This is especially true for the sickest plan members who need care the most. According to a 2024 Kaiser Family Foundation report, only 68% of members in suboptimal health feel satisfied with their health plan. This dissatisfaction and trust deficit can prevent health plan members from seeking out health care services—care critical to improving their short- and long-term health and lowering their total cost of care.

We know socioeconomic factors, limited health literacy, negative experiences with the health care system, and more all contribute to skepticism. Still, proven strategies from behavioral science can help health plans build meaningful connections with their members, boost member trust in the health care system, and ultimately improve population health.

Lead With Empathy

When members feel understood and supported, they’re more likely to engage. That’s why health plans must foster a member-centric culture that emphasizes openness, empathy, and active listening. This starts with small details, such as using emotional cues in communication that show understanding, affirm patients, and reflect their world back to them. Consider a simple statement like: “We understand managing health can be overwhelming. Here’s how we can help.” This signals to members that health plans see them as individuals with unique concerns and challenges, rather than as just numbers in a system.

Preference-based, omnichannel communication is also important. Ask members how they want to hear from you, and honor their preferences—whether that means contacting them by phone, email, text message, or app notification. When you reach out, use a warm, human tone that builds rapport and delivers valuable messaging important to members’ lives—such as timely, seasonal health tips and other personalized information.

Proactively Remove Barriers to Care

It’s easy (but ineffective) to say patients should be responsible for their own care. If health plans are serious about improving trust, engagement, and health outcomes, they must proactively identify and remove any barriers preventing members from accessing the health care services they need.

Sometimes, these roadblocks are external. Members may have trouble getting transportation to their doctor’s office, for instance, or parking might be prohibitively expensive. These are sometimes the simplest problems to solve when health plans provide such services. By addressing these social determinants of health (SDOH), plans can demonstrate that they are trusted partners invested in their members’ well-being.

Other barriers are internal; these can be trickier. For example, some plan members with diabetes may have trouble adhering to their insulin regimen. For them, the issue may not be an inability to access their medication, but something deeper. Building rapport and trust, and discussing the importance of treatment can help uncover members’ resistance, supporting them in overcoming that hurdle and leading to better adherence over time.

Harness the Power of Data

At AdhereHealth, we have found that a variety of data-centric tactics work well to improve member engagement. For example, a diverse set of data sources—including claims data and publicly available SDOH data—provides a comprehensive view of the member population and can help plans prioritize who to target for outreach. Clinical notes for future outreach clinicians help to avoid member abrasion and increase relationship-building. Finally, continuous data ingestion for ongoing member tracking and support is necessary to sustain long-term medication adherence.

Looking ahead, the industry has already started to leverage the combination of artificial intelligence (AI) and behavioral science to personalize experiences. Together, these capabilities could help health plans better predict which interventions work best for which members—and for delivering those interventions initially and dynamically over time.

Take the Long View

Building trust isn’t a one-time transaction. Rather, health plans must continue to re-earn the trust of their members with each interaction, using each touchpoint as an opportunity to learn and improve. Over time, this trust will manifest in the form of better member engagement. It’s understandable to want to encourage members to make better health decisions right away, but building trust is needed to deepen member motivation for initial and sustained change.

By building a trusting relationship with members, health plans lay the foundation for a healthier population, better Centers for Medicare & Medicaid Services (CMS) Star Ratings, and lower overall costs. Plans also elevate their members' experiences and promote health equity.

The journey isn’t easy, and it’s not always straightforward. But health plans that make a concerted and continuous effort to build trust with their members will give themselves a long-term strategic advantage.

About the Author

As chief experience officer at AdhereHealth, Dr Chandra Osborn leverages over 25 years of experience as a behavioral scientist and business leader, specializing in patient engagement, medication adherence, digital personalization and behavior change strategies that drive health and business outcomes. In her role, she integrates behavioral insights into client interactions, and business and product development, to strengthen AdhereHealth solutions, brand credibility and market impact.

Prior to joining AdhereHealth, Dr Osborn provided fractional, strategic guidance to global wellness and domestic care management companies. She has over 180 scientific publications and currently serves as a business advisor for the portfolio companies of Redesign Health and New Enterprise Ventures. Dr Osborn holds a bachelor’s degree in both psychology and sociology from California State University, San Marcos, as well as a master’s degree and PhD in social/health psychology, plus a graduate certificate in quantitative methods from the University of Connecticut. In addition, she holds a master’s degree in public health from Northwestern University, where she was also a health services research postdoctoral fellow.