According to KFF, half of insured adults say they find at least one aspect of how their insurance works at least somewhat difficult to understand. At the same time, 58% of insured adults report they’ve experienced a problem with their health insurance in the past 12 months — with 17% of those adults reporting a significant delay in receiving needed care due to those problems.
As a result of this confusion, frustration, and overall dissatisfaction with the healthcare experience, many plan members simply choose to disengage entirely — as demonstrated by recent research revealing that only one-third of employees regularly use their health benefits.
These low levels of member engagement do more than just put employees at risk for improper care and illness. These challenges also affect employers, who invest significant money into benefits packages that remain underutilized, raising the risk for sick plan members who impact workplace productivity and incur higher healthcare costs over time.
Today, we’ll explore how member engagement strategies can help reverse these trends by taking a proactive approach to educating, guiding, and incentivizing employees during their care journeys — including how the Vālenz Health® suite of Member Experience solutions help employees make the most of their benefits coverage for higher-quality, lower-cost healthcare delivery.
Today’s employers are paying more than ever for employee healthcare coverage. The latest reports put the average yearly cost of employer-sponsored healthcare at more than $18,500 per employee per year — a significant sum in general, but especially alarming when few members use those benefits to their full potential.
But engaging members with their health benefits package isn’t just about justifying an employer’s yearly investment. It’s the key factor in overall health plan performance, whether you’re viewing it from a wellness, financial, or recruiting perspective.
First and foremost, member engagement with health plans directly influences healthcare outcomes.
Low healthcare literacy (the ability to understand and engage with the healthcare system) is frequently associated with more hospitalizations, greater use of emergency care, lower use of preventative care, and poorer overall health status.
On the other hand, members with higher health literacy are more likely to engage in preventative and necessary care, which can significantly reduce the risk of chronic diseases and improve long-term health outcomes.
Higher member engagement also often equates to lower healthcare costs for both members and health plan payers.
Better healthcare literacy is frequently linked to lower costs for inpatient care, emergency care, out-of-pocket expenses, outpatient care, treatment costs, and more. And, as mentioned above, members who frequently engage with their health plans are more likely to receive preventative care, which reduces the likelihood of high-cost complications and chronic disease — the latter of which accounts for 90% of all healthcare spending in the U.S.
Engaged plan members are healthier plan members — and that is often reflected in their work performance.
Research shows that benefits programs like Employee Assistance Programs (EAPs) have been shown to effectively reduce absenteeism, workplace injury rates, and health-related productivity impairments. Workers with health coverage miss, on average, 76% fewer workdays than uninsured workers, and improvements in employee well-being have long been associated with higher productivity.
In many cases, healthier employees are happier employees, which is why health insurance ranks as the most important benefit for job seekers in the U.S.
So, how can health plans overcome the confusion and frustration faced by many members to improve engagement with and proper utilization of benefits packages?
The answer can be found in member-focused strategies that put employees in charge of their own health journeys.
As a leading health plan member engagement platform, Valenz works with thousands of employers and plan payers across the U.S. In doing so, we’ve identified the strategies that are most successful in not only improving employee engagement but also in guiding higher-value, lower-cost healthcare choices that benefit all stakeholders in the process.
To improve member engagement, health plans must first resolve the confusion and frustration associated with the traditional healthcare system.
Digital tools like Valenz Bluebook help by directly connecting members to high-value providers and facilities for their care needs.
As our price and quality transparency tool, Valenz Bluebook uses a color-coded ranking system to help members find high-quality care at a Fair Price™. With estimates based on real claims data from thousands of shoppable procedures that are risk- and volume-adjusted for accuracy, Valenz Bluebook delivers an average of 50% savings per procedure each time a member uses the tool — creating significant savings for both plan sponsors and members.
Valenz Bluebook doesn’t just help members find care; it does so in an easy-to-use format that many other transparency tools lack. Education campaigns offer comprehensive education and training for members, showing them how to use the tool to select high-value, low-cost care. Personalized communication campaigns keep the tool top of mind, encouraging members to consistently use Valenz Bluebook throughout their care journey to maximize care value and cost savings.
As a result, Valenz delivers above-industry-average member engagement rates, such as the 30.4% average engagement rate experienced by one employer in the Southeast.
In addition to digital tools, employers can improve member health plan engagement by offering personalized, proactive support from experienced care navigators.
Healthcare navigation solutions help address issues related to provider distrust by empowering patients, offering clinical support that can improve outcomes for underserved populations. This includes creating a personalized treatment plan, identifying high-value provider options, answering questions about insurance coverage, and more.
For example, through the Valenz Clinical Engagement solution, members are assigned care navigators who serve as their advocates in finding and accessing high-quality, low-cost care. By identifying and engaging early with patients at high risk for chronic and other expensive conditions, our case managers proactively provide support to those who need it most — intervening before claim costs have the chance to escalate.
As a result, our Clinical Engagement solution significantly improves overall health plan member engagement, with some clients seeing engagement rates as high as 20% for millions of dollars in plan savings.
One of the best ways to engage members with their health plan benefits? Provide tangible financial rewards for doing so.
Financial incentives — such as wellness points and monetary rewards — have proven to increase member participation in preventative health visits and screenings and are consistently associated with higher member engagement rates.
These financial incentives are even more powerful when paired with the member tools discussed above. For example, health plans can enhance Valenz Bluebook with the Engagement Rewards feature to maximize use of the platform. Through personalized communication campaigns, Engagement Rewards encourages members to shop for high-value care using Valenz Bluebook — and rewards them for doing so in the form of debit cards, HSA/HRA contributions, and/or wellness points.
At Valenz, we believe improving member engagement starts with plan design. By incorporating the tools and resources members need to understand their benefits from the start, health plans can foster stronger engagement more effectively (and at a lower cost) than trying to retroactively add those capabilities to a plan that wasn’t designed to support them.
Our Member Experience solutions are designed to engage proactively with members early throughout their care journeys by:
With this comprehensive approach, our Member Experience solution suite doesn’t just create more engaged employee populations; it also saves them and their plan significantly on healthcare costs, often delivering a high return on investment within the first year of implementation.
As healthcare costs continue to rise, improving employee engagement with their benefits package is one of the most effective ways to control plan spend.
By proactively engaging with plan members to guide them to higher-quality, lower-cost care choices, health plans can make great strides in improving employee health, increasing productivity, and justifying their benefits investment.
Valenz offers a comprehensive suite of solutions to help make those goals a reality:
Learn more about these solutions — and how they can help improve your member engagement rates — by contacting one of our team members today.