First Impressions Count: How Onboarding Affects Member Engagement

July 26, 2023 - According to Christopher Lis, managing director of global healthcare intelligence at JD Power, if payers refined their onboarding processes, it could reform payers’ track record on health plan satisfaction.

Specifically, he promoted a welcoming process that leveraged multi-channel outreach. The onboarding information should help members understand their health plan benefits and their out-of-pocket healthcare costs. It should also direct members to helpful resources and contact information for health plan staff who can answer members’ questions.

“Establishing a relationship as a trusted health partner right from the start is a big opportunity to advance forward,” Lis explained to HealthPayerIntelligence in an email.

Payers that perform well on health plan satisfaction measures have implemented these strategies.

It turns out that the adage “the first impression is the last impression” applies to health insurers as well. The member’s first impression of their new health plan during the onboarding experience can sway their overall satisfaction with the plan.

In the JD Power 2023 Commercial Health Plan Member Study, health plan satisfaction dropped 13 points. Customer service performance was the main culprit. Member satisfaction with health plans’ customer service fell 33 points on a 1,000-point scale.

After a significant boost in health plan satisfaction in 2021 and a year of flat growth in 2022, payers find themselves falling out of grace with their members once again. What can insurers do to turn this pattern around?

Capital District Physicians’ Health Plan (CDPHP) was a highly ranked plan in the JD Power 2023 US Commercial Health Plan Member study, achieving the highest score in New York (773 points) and continuing its winning streak.

But the health plan’s onboarding approach was not always stellar. Before the coronavirus pandemic, the payer merely sent new members a letter that may or may not have had an ID card attached to it. In the years leading up to the coronavirus pandemic, however, it became clear that the payer needed to refine its approach.

CDPHP learned many of the lessons that Lis named when the payer revamped its onboarding process in the years leading up to the pandemic. The effort required buy-in from teams across the company including internal operations, membership and billing, sales, and clinical programs with CDPHP’s communications and marketing teams at the helm.

Jodi Haskin, vice president of marketing at CDPHP, shared with HealthPayerIntelligence how CDPHP reshaped its onboarding strategy to improve health plan satisfaction and engagement.

Pursue these three characteristics in first point of contact

In health insurance, a great first impression starts with a great first point of contact.

When members approach their health plans with questions or issues to address, health plans should demonstrate three key characteristics: effectiveness, timeliness, and empathy. The goal should be to resolve the issue at the first point of contact.

“What differentiates the exemplary health plans from others is timely and effective problem resolution during that first point of contact, regardless of the issue,” Lis said.

Health plan satisfaction declines when the member must reach out more than once about the same issue, JD Power data showed.

For health plans that excel at onboarding, encouraging a consumer-centric culture is top of mind. As a result, the company culture reinforces pursuing these three characteristics of a strong first point of contact exchange.

“We are very focused on helping our customers and finding ways to make their lives easier in this crazy matrix of healthcare. And so, in everything we do, the focus of CDPHP is on our customers,” Haskin said.

Design a personalized welcome package

A useful, personalized welcome package can go a long way in creating a positive onboarding experience.

To Lis, a strong welcome package should include a personalized welcome letter, a member ID card, a clear explanation of coverage and benefits, and instructions about where to direct questions.

Understanding out-of-pocket healthcare costs should be highlighted in the welcome package materials. This is an area in which health plans may already have a strong start: three-quarters of JD Power survey respondents shared that they understood their out-of-pocket costs.

However, for the remaining quarter of individuals who did not understand their costs, that gap in knowledge can have a significant impact on overall satisfaction.

“Lack of clarity and unexpected costs are a leading cause of health plan member dissatisfaction,” Lis explained.

Additionally, payers should use the welcome package touchpoint as an opportunity to learn members’ communication preferences and what kinds of healthcare information members want to receive from their plans.

Ultimately, the key metric for welcome packages is usefulness. Lis noted that as members’ perceptions of the usefulness of welcome package information improved overall satisfaction climbed 100 index points.

“While it seems obvious, providing useful and insightful information matters, and many health plans can improve in this area,” Lis stated.

"While it seems obvious, providing useful and insightful information matters, and many health plans can improve in this area."

For CDPHP, personalization initially meant creating specific welcome packages for new members based on their coverage type, Haskin explained. Medicare beneficiaries received different materials than commercial members. Moreover, commercial members in preferred provider organizations (PPOs) received different materials than members in exclusive provider organizations (EPOs).

Each message, regardless of the member’s product, included two similar calls to action. It advised new members to set up a portal account and schedule an appointment with their doctors.

These callouts were very general, but even at this initial stage of personalization, the payer saw results. The effort produced up to a 20 percent boost in member engagement goal completion, based upon the call to action.

Build the health plan’s identity as an educational resource

The onboarding process is the moment when health plans can build their identity as a trusted resource for members. To do so, they might provide educational resources on members’ healthcare needs. This is especially important for individuals with complex conditions.

By pointing members toward existing educational resources in their welcome materials, payers can help establish that identity.

For example, self-service tools allow members to take ownership of their health and find the information they need quickly. This is often associated with high uptake among Millennials and Gen Z, but other generations are also gravitating toward this experience, JD Power found. Payers who offer such tools can highlight them in the welcome materials to underscore their identity as a resource.

For CDPHP, the personal health assessment (PHA) is a critical tool guiding the payer’s efforts to connect members with the right resources, specifically for renewing members. The assessment takes 15 to 20 minutes to complete and covers a wide range of basic member information.

The renewing members’ responses in their PHAs might repeat some information that the payer already knows, but it could lead to a greater understanding of the members’ interests. These assessments help CDPHP determine which programs might be most beneficial for each renewing member. It also gives members insight into how their lifestyle and actions impact their health status.

By promoting its PHA in the renewing members’ onboarding materials, CDPHP reinforced its identity as an educational partner and resource. Moreover, the payer saw an uptick in completed assessments.

Leverage digital tools, simple messaging

Ultimately, the role of digital tools in a payer’s onboarding strategy may depend on members’ communication preferences.

Members may prefer communicating through an online portal, apps, a chat, text, email, or other channels. Payers should document and accommodate those desires to ensure a positive onboarding experience and better member engagement in the future.

Self-service tools are a great option for many members and JD Power data shows that consumer interest is growing. But sometimes these tools are not enough to satisfy members’ questions, Lis noted.

When self-service digital tools cannot resolve a member’s concerns, health plans must ensure a seamless transition to live customer service. When transferral to a live representative is complex or prolonged, health plan satisfaction declines.

"AI has lots of potential to optimize performance in new member onboarding."

“AI has lots of potential to optimize performance in new member onboarding and there are many pilot projects underway in this area to understand communication preferences and member needs, and then deliver on that in an individualized way,” Lis added.

As CDPHP refined its approach, it began to use personalized stickers with simple messages on their new and renewing member ID cards to point members toward certain actions.

Borrowing from the banking industry’s approach of placing an “activate this” sticker on a new credit card, the CDPHP member ID card stickers directed members to accomplish something that previous payer efforts failed to motivate them to do. For example, a member who has not yet picked a primary care provider might receive an ID card with a sticker reminding her to do so.

The approach uses clear messaging to direct members toward trackable actions.

Track results, pursue member feedback

Offering channels for member feedback is a productive practice for any business. Health plans are no exception.

Lis recommended implementing closed-loop measurements and management systems.

Marketers use closed-loop measurements to gather consumer data from multiple channels to assess trends and hone targeting. It may involve analyzing a user’s search history when they visit the company’s website to determine which outreach strategies would be most attractive to them. Management systems organize data, condensing customer information into one platform.

For a payer that uses such strategies to guide their member engagement efforts, the onboarding process allows them to ask members simple questions that will inform the payer’s member engagement approach.

Tracking results is easiest in the digital-to-digital framework. When CDPHP sends out materials asking members to download a pharmacy benefit manager app, the payer can easily see whether someone clicked on the link, downloaded the app, and registered for the program.

The most friction—or the most deceleration of the member’s journey through the marketing campaign—occurs when payers use paper materials or even phone calls.

“We do track the whole journey. Our goal is really based on that end. But we'll track that journey to try to figure out: how do we make it frictionless in the middle to make it easier for [the member]?” Haskin explained.

To avoid losing track of the member’s journey, CDPHP directs members to URLs in the onboarding paper documents. Once members are on the website, CDPHP can receive sufficient data points of their experience.

Looking to the future, Haskin anticipated that CDPHP would tackle consumer data siloes next in its personalization efforts. Each consumer touchpoint creates its own siloed data set. Haskin would like to see these touchpoints become more connected through a consumer data platform or customized analytics technology.

“Instead of marketing for a campaign, how do we market for a customer?” Haskin asked.

“Our ultimate goal is really to make sure that…we're as smart as we can be and we're collecting that information to be able to give [members] exactly what they need to make their journeys as frictionless as possible.”