Transforming Member Experiences into Retention Continuums

At the 2016 Direct-to-Consumer Healthcare Marketing Summit, Amy Swanson, Vice President of Marketing, Advocacy and Member Experience at UnitedHealthcare, gave a presentation on how United is transforming the traditional Medicaid member experience into one that builds loyalty at every touch, from the point of on-boarding to benefits navigation and daily member service support.
They have achieved such transformation by making a concerted effort to listen to consumers, beginning by conducting focus groups that ask members to map out their member journey by answering the following five questions:

1. What happened before you enrolled in Medicaid and what situation caused you to seek coverage?
2. What happened after Medicaid enrollment was completed?
3. What happened after you were selected or assigned to UnitedHealthcare?
4. What has happened since?
5. What are your plans for the future?

By asking members to answer those five questions, they were not only able to put a face to their members, but were able to more holistically understand individual’s unique motivations along each critical journey point and how their emotions and level of satisfaction changed from one point to the next. More importantly, they were able to understand how the experience of receiving healthcare through United has impacted their overall lives and the goals they have for themselves and their families.

Upon assessing the member journey from a more up-close and personal perspective, it was then they defined five ways in which they could enhance the member experience:

• Seamless on-boarding
• Personalized and targeted communications
• Two-way dialogue
• Optimized service levels
• Integrated and effective high-risk population health engagement programs

Seamless On-Boarding:
Swanson illustrated how United improved the member journey, beginning with a more seamless on-boarding experience, through the story of one of their members, “Richard.”

As part of United’s member journey mapping initiative, United began their on-boarding process by first learning about Richard’s healthcare experience prior to United. In doing so, they discovered that he was uninsured, hadn’t seen a doctor since 2004 and had tried the ACA Marketplace, but did not qualify. With this information at-hand, they knew they had to make his on-boarding experience as stress-free as possible, and that he was going to need a lot of support getting his health back on track and learning how to understand, navigate and utilize his benefits. With such in mind, United immediately connected Richard to their Members Matter service upon sending him his ID card, handbook and provider directory request. Through the Members Matter service, Richard was appointed a member advocate who integrated with his providers, clinicians and community organizations to ensure that he was tapping into all the resources available to him and best making use of his benefits to get healthy and stay healthy.

Next, United sent Richard a personalized invitation to a Member Community Day, which is a community event held in member’s local neighborhoods that welcomes them to the plan and teaches them about their benefits and health education, while offering family activities, giveaways and prizes to help them feel connected both to their plan and their community healthcare resources.

Last, United simplified the primary care provider selection process for Richard. They specially assigned him to a PCP that met his unique needs as per data provided in the enrollment process, including factors such as his PCP history, immediate family member’s PCP history, geographic proximity, age, gender, language and more.

In applying these methods, Richard’s on-boarding experience was made stress-free and simple, and he was left feeling more confident about his health and future.

Personalized & Targeted Communications:

Highly targeted communications were created for Richard by leveraging the data from his Health Risk Assessment. They used his assessment data to enroll him in disease and care management programs that match his unique healthcare needs and to send him targeted care management and wellness communications.

Two-way Dialogue Engagement:
Two-way dialogue was created by inviting Richard to join the Member Advisory Council. The Member Advisory Council is an advisory group that ensures UnitedHealthcare Community Plan of Ohio actively engages consumers, families, local advocacy groups and other key stakeholders as partners in the complex care program design and delivery system. UnitedHealthcare Community Plan members, family, representatives from the community and consumer advocacy groups are all welcome to participate. Through the Council, people are able to share ideas and feedback for improvement with the United Healthcare team, join a monthly call with UnitedHealthcare leaders, attend meetings and sign up for free advocacy training.

Motivating Vulnerable & High-Risk Populations:
Richard was motivated to lead a healthier lifestyle by United sending him a “Kickoff to Good Health” catalog, which features a listing of the network of partners he can redeem healthy incentive points from and what actions are eligible for different reward points. Upon enrolling in the program, Richard quickly was able to reach 100 points. He earned $50 in benefit credits for visiting his PCP within 90 days and $25 for visiting his vision doctor and then his dentist within six months of enrollment. The Good Health app, part of the Good Health program, not only helped Richard track and his healthy activities, such as brushing his teeth and exercising, but sent him reminders about upcoming appointments.

Optimizing Service Levels:
Richard received optimum level of service in instances such as when he called United’s 24-Hour Nurseline, which allowed him to speak with a registered nurse at no cost, who was able to help him make health-related decisions, like how to stay healthy and fit, find a doctor or hospital and understand treatment options.

In addition, United assigned him a Care Manager to work with him. United Care Manager’s are community-based RNs or social workers who conduct assessments and develop specialized care plans for members. United groups these teams by geography and has them coordinate plan-covered benefits in collaboration with local medical and behavioral health providers. The support of the Care Manager was further supplemented by giving Richard access to My Advocate—an online tool supported by live advocate support. My Advocate allows members to view and access healthcare services, living cost assistance resources and other services, including legal aid, childcare, nutrition assistance and income replacement to support comprehensive well-being beyond the confines of the doctor’s office.

Through the following member experience enhancements, United was not only able to transform their member experience into a retention continuum, they were able to achieve the following results:

• Reduction in disenrollment from over 6.7% to less than 2%
• Increase in Member Advisory Council attendance from 3-5 attendees per meeting to 75-125 for each meeting
• Executive Leadership Team meetings held within 48 hours of Member Advisory Council meeting with all executive leaders engaged and activating teams for solutions
• The development of a small, internal advisory group to inform meeting content, leadership and location in addition to launching a Peer to Peer program in 2016
• Reported increased member satisfaction with the Health Plan, even when things aren’t perfect operationally, because the Health Plan showed a willingness to listen
• Expansion of advocacy training offered to all members

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