Personalize the Experience for Your Members
Meet Jessica. She’s a 55-year-old woman with type 2 diabetes living in rural Texas. She just registered for her member portal. Immediately, she’s inundated with emails about getting her mammogram and gets profiles of doctors in Houston – a 6-hour drive from her home. She logs into her member portal hoping to find resources and support for managing her chronic condition, tailored to her needs like she would when she’s shopping online. She calls support to find doctors in her area to help her keep her A1C in check but waits on the line for 20 minutes before growing exhausted.
From the beginning, Jessica is turned off by the generic portal experience and communications from her plan, and she soon tunes it all out. Jessica’s experience is far too common. Health consumers don’t want to feel like a number or be put on hold endlessly. It’s their number one complaint.
These member frustrations, however, are a major opportunity for health plans to seize on untapped potential to transform healthcare for the better.
Why Personalization Matters
In a recent mPulse survey asking health plans their priorities for their member portal in 2025, 51% of respondents answered that personalizing the member experience was their top priority for 2025.
Personalizing the member experience supports both the member and the health plan in achieving their goals, including:
- Portal registration
- Building trusted relationships with their members
- Member enrollment in chronic care and other diagnosis-specific programs
- Reducing call center volume
- Portal adoption of key features, such as:
- Reading and understanding benefits
- Watching educational health content to learn about their condition
- Communication with their providers and care teams
- Medication management
Personalization is not only a top priority for health plans, but consumers rank providers and health insurance at the top of their list of organizations needing to deliver personalized experiences. According to Gartner’s 2024 Healthcare CXS Survey, they found that 81% of consumers believe that personalization by their health insurance providers is “very important” or “extremely important”, compared with just 45% who felt the same about social media providers. 
Personalization is Important Across All Population Segments
The desire for personalization isn’t just limited to younger populations or only to members of commercial plans. An mPulse survey found that 62% of Medicaid and 60% of Medicare beneficiaries would be more engaged with their health plan if their experience was more personalized.
The Future of Health Portals: Creating Outcome-Driven Experiences
Watch this on-demand webinar to hear about proactive strategies to boost portal adoption and how health plan portals are transforming through automation, integrations, and personalization.
Creating More Personalized Experiences for Your Members
The member portal is a critical part of the health journey, and an essential experience for setting the foundation for relationships members have with their health plan. A key step in effectively personalizing the member experience is with a portal that can categorize members, apply conditions and rules by which to set parameters for personalization, and can feature various forms of content to each member.
Categories
Categories define members based on their unique demographic characteristics and health needs. These include:
- Age, gender, and zip code
- Diagnosis codes
- Procedure codes
- Members with open gaps
- Displaying providers in specific specialties
Conditions & Rules
Conditions and rules are used to apply parameters to various categories highlighted above. Conditions specify the members for any given content piece or member experience while rules are created to further define when content should be displayed for specific conditions. For example, a condition can define members over the age of 55 while a rule would define when to display content based on certain scenarios, such as a time frame like October through December ahead of flu season.
Targeted Content
Health plans can configure their member portals to display targeted content based on health plan segments – such as Medicaid, Medicare Advantage populations, individual healthcare needs, and demographic data. This could take shape in the form of condition specific content, relevant wellness and benefit programs that fit their profile, notifications and communication about important screening reminders based on each member’s unique demographic profile.
Member Self-Service for Personalization
Rather than maintaining static information within the member portal, health plans can offer interactive tools to empower members to further tailor experiences for themselves. Creating a user experience that allows members to set preferences in the provider search and cost transparency tools empowers them to seek quality, cost-effective care that meets their unique needs. Allowing members to update their profiles and communication preferences also empowers them to receive the information they seek while building trust in their plan to deliver on their specific preferences.
A Better Future with Personalization
Putting all of these functions together in the member portal will allow members to have more trust in their health plan and take action based on that trust. Personalizing the experience gives members the feeling that their health plan knows them and is a partner in their health, makes it easier to find information relevant to them, and empowers them to take advantage of what their plan has to offer.
In addition to the member portal, health plans have an opportunity to get to know their members on a deeper level through rich insights and make predictions based on analytical data and then intervene to engage members with personalized outreach based on that data. Member analytics can be used to inform a targeted member engagement strategy and get ahead of negative health outcomes. Proactively engaging members through personalized digital outreach, such as through SMS text, is another way that plans can create tailored experiences at scale, improving satisfaction, health outcomes, and reducing inbound calls to call centers. mPulse’s Health Experience and Insights (HXI) suite built for health plans empowers plans to bring together previously disparate technology into a cohesive and personalized member experience.
To learn more about personalizing the member experience, watch mPulse’s latest webinar on portals strategy featuring our product and member engagement experts.
Maximizing the Value of Your Member Portal – Part 3
Stay tuned for Part 3 of our 3-part series on maximizing the value of your member portal!
The Future of Health Portals: Creating Outcome-Driven Experiences
Watch this on-demand webinar to hear about proactive strategies to boost portal adoption and how health plan portals are transforming through automation, integrations, and personalization.
