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Case Study - New Member Satisfaction

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Case Study: IndiGO Patient Predictive Modeling Copyright© 2015 SPH Analytics Page 2 Challenge: One of the nation's top health plans and a large health plan in Hawaii both had similar concerns surrounding their new members to the health plan. These plans were challenged with educating new members, ensuring understanding of plan benefits and information, and developing positive relationships and communications for long-term member satisfaction and loyalty to the health plan. Research has indicated that low health plan member satisfaction is driven in part by a lack of member understanding of the plan's coverage, cost of care, and how to successfully access benefits. Research also indicates many members seek out information about various topics ranging from their health plan benefits to items related to their individual health care such as specific health complaints, costs, conditions or diseases, drugs, nutrition, and fitness. For these members, getting information quickly can be a significant component of getting care quickly, which emphasizes the importance of new member education for long-term satisfaction and timely access to care. Getting information quickly can be a significant component of getting care quickly These plans were also challenged with increasing new member awareness and satisfaction with the health plan. The health plans realized that their new members' perceptions could eventually impact their overall rating of the health plan and CAHPS ® scores. This was evidenced when new members, with less than 12 months' enrollment in the health plan, were asked to rate their satisfaction with the health plan. Their responses were then compared to the Consumer Assessment of Healthcare Providers and Systems (CAHPS ® ) Survey responses of the same health plan's members who had been with the plan 12 months or longer. New members of the health plan rated their overall satisfaction with their health plan lower than those members that had been a part of the plans over 12 months. Research has indicated that low health plan member satisfaction is driven in part by a lack of member understanding of the plan's coverage, cost of care, and how to successfully access benefits

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