What Is Health Action, and How Does It Relate to Member Experience and Health Outcomes?

In this commentary, the Icario team emphasizes the importance of health action and how plans can engage more with members to improve outcomes and reduce costs.

Health plans are tasked with figuring out the best ways to reach and engage members in a positive, productive way. Some elements of progress can be determined by measuring interaction—think clicks on an email or text link, or phone calls answered. However, the ultimate marker of success is getting members to complete specific activities, or health actions, that improve their health in a variety of ways. So how does this happen? Let’s start at the beginning.

What Is Health Action?

In years past, health plans focused solely on member health engagement. But while high engagement rates are great, this isn’t the same as inspiring health action. Health action happens when a member does something specific that will help them live longer or better.

It could be filling out a health risk assessment (HRA) or going to an annual wellness visit (AWV) with their primary care provider. It could also be getting a lab test or preventive screening like a colonoscopy or mammogram, or enrolling in health coaching services. 

The Health Action Challenge

Although health actions are generally positive in nature, many members aren’t interested in doing them. The reasons for this run the gamut: They’re scared. They don’t have time. They don’t think they really need to because they’re healthy. They’d rather do a million other things instead. The list goes on.

Plans need to encourage members to take these actions through outreach. But content or messages that are compelling to one person may not resonate with another. Understanding what to say and to whom is what makes this challenge so difficult to address. Plans must determine what sparks action without creating member abrasion.

It’s time to close the gap between health engagement and health action. Not only is this important for members, but it’s also critical for health plans that need to assess member risk to help them take the necessary steps toward better health and ultimately lower costs.

How Member Experience Sets the Stage for Health Action

A large part of the member experience comes down to communication. For communication to be effective, it has to be personalized. This means plans need to learn about their members. Across the country, plans are now looking at their members more holistically, not just as a collection of symptoms or conditions.

We hear repeatedly that members want to feel like their health plan is listening to them, that they want to feel their needs are heard. Now’s your chance to give them a megaphone in the form of how they respond to your outreach initiatives. 

Leveraging Data and Machine Learning to Drive a Very Human Approach

Data analysis that leverages machine learning helps you establish a productive, trusting relationship which becomes the foundation for an improved member experience. Capturing—and making sense of—data about preferences, habits, health risks, and social determinants of health enables you to walk the fine line between motivating people to complete health actions and member abrasion. 

From how best to send the initial message to establishing regular communications, data analytics can augment incomplete contact data, track interests and languages spoken, and assess channel, message, and day/time preferences. Over time, having these insights leads to greater personalization and a far richer member experience, paving the way for health action.

A Closer Look at Using Personalization to Enhance the Member Experience

We live in a world where ads, messages, and services are hyper-personalized. It’s simply not acceptable to use broad communication strokes when trying to reach your audience with important communication about their health. When people feel they’re being addressed honestly and in a way that indicates their plan understands them as an individual, they’re more likely to engage and consider the ask. Figuring out which messages are resonating and generating responses is one of the ways machine learning can be incredibly effective and powerful. 

Multi-Channel Communication

Personalized messages are critical, but they’re only the first step in the process. Now you need to determine which communication channel works best for each member. It may be phone calls, interactive voice response, emails, and/or text messages—or even direct mail or a knock on the door. A test and learn approach is great if your organization is committed to truly learning from each campaign and making adjustments based on the results achieved. 

Never make assumptions regarding communication preferences (or any other aspect of your members, for that matter!). Assuming that seniors don’t text or younger members won’t answer the phone could lead you to miss the opportunity to make powerful connections. In fact, a recent AARP survey found the pandemic has accelerated technology reliance in those over age 50. 

Using Rewards and Incentives to Encourage Health Action

Many Medicare and Medicaid health plans offer rewards and incentives that get members motivated about taking important health actions that they may not really want to do. From completing an HRA to scheduling an AWV, positive reinforcement in the form of a useful, tangible reward is a great way to help people improve their health.

UnitedHealthcare Community Plan of Tennessee works with providers and local resources to give free diapers to Medicaid families for completing critical health actions such as well-child visits and immunizations. The results are positive for all involved: Babies are healthier, moms and kids receive the care and daily staples they need, the plan lowers costly claims related to diaper rash, and providers see more patients.

Health Action Is a Critical Step Toward Improved Health Outcomes

The reason health action is lighting up the health care scene is because it really works. Here are four examples of health plan outreach initiatives that resulted in measurable improvements and better health. 

• Blue Cross Blue Shield of Rhode Island found members who completed an AWV during the program were 9x more likely to close other health care gaps, such as cancer screenings.
• A forward-thinking health plan got results with a previously unengaged diabetic population by getting 89.6% of respondents to make an appointment with their doctor. 
• A multi-state Blues plan was struggling to motivate their Medicare population to schedule a primary care physician visit for a breast cancer screening. Through data analysis, the team discovered it took 2.2 outreach attempts to spark action from the members engaged.
• One of the largest health plans in the world used supplemental contact information to get a 16% year-over-year increase in flu shot completions. 

How Health Action Benefits Plans

Plans are wise to understand the benefits of health action and how member experience plays a role. From enhanced loyalty and retention to higher quality ratings, lower costs, and ultimately better health outcomes, this approach can help plans achieve notable results and healthier members.