Today’s healthcare consumers are rapidly shifting toward digital-first interactions, creating significant opportunities and challenges for health plans looking to create and sustain meaningful connections with their members. Organizations like CareSource, one of the largest Medicaid health plans in the U.S. has embraced innovative technology to scale and redefine their member engagement strategy.
Here’s how self-service technology, purpose-built for healthcare communications, is redefining member interactions, why it matters, and the critical best practices for successful implementation based on CareSource’s proven success.
Powering Health Plans with Self-Serve Member Engagement
The Digital Revolution in Member Engagement
Healthcare communication is becoming increasingly digital, with member preferences clearly reflecting this change. Our research reveals compelling data: 80% of members prefer digital channels such as texting and email to interact with their health plans. This shift isn’t limited to younger generations. In fact, the adoption rate among adults aged 65 and older has increased nearly fivefold since 2012.
With Medicare’s expected expansion increasing from 63.6 million members in 2022 to 76.4 million by 2031, digital engagement isn’t just a preference, it’s a necessity.
Today’s seniors rely on digital communications for critical health updates, including appointment reminders, medication adherence prompts, and health education.
A striking 90% of health consumers report some dependency on digital communications for managing their health care, with 20% identifying as “very dependent.” The convenience, immediacy, and reliability of digital messages improve both member satisfaction and engagement. This reliance underscores the urgency for health plans to adapt and leverage digital communication effectively.
Why Self-Service Engagement Matters
When it comes to crafting member engagement strategies, there are a variety of approaches health plans can take depending on their goals, resources and organizational structures. Some health plans prefer to leverage proven digital engagement programs, designed and delivered on their behalf while others prefer to take a do-it-yourself approach for creating their own digital outreach – or a mix of both. Self-service engagement technologies offer health plans the flexibility needed to meet member expectations while scaling internal resources.
Such agility is particularly valuable during unforeseen emergencies. For example, during recent natural disasters like wildfires or hurricanes, health plans have used self-service digital tools to inform affected members about available resources, maintaining continuous care and minimizing disruptions.
Real-World Impact: CareSource’s Digital Engagement Success
CareSource, an industry-leading, multi-state, nonprofit managed care organization serving over 2 million members, showcases the immense potential of self-service engagement. CareSource delivered over 9.7 million emails and 5.1 million text messages in 2024 alone, marking significant increases over previous years.
Key campaigns driving this growth included:
- returned ID card notifications
- health and wellness reminders
- prescription alerts
- and important health assessments.
Additionally, CareSource transitioned from mailing newsletters to exclusively digital formats, enhancing engagement efficiency and reducing costs. Text-based communications, especially during emergencies like chemical spills and severe weather events, demonstrated a vital role in proactive member support.
For instance, during a recent chemical spill event, CareSource utilized text messaging to quickly inform members about safety precautions, alternative locations for medical care, and pharmacy accessibility. This rapid communication was critical in ensuring members maintained continuous access to necessary medications and healthcare services, significantly mitigating the potential health impacts of the emergency.
Another impactful initiative was the interactive flu vaccination campaign. CareSource used two-way text messaging to engage members actively, increasing flu vaccination rates by providing real-time reminders and facilitating appointment scheduling directly via SMS. This personalized interaction not only improved vaccination rates but also strengthened the trust between CareSource and its members.
By automating and streamlining processes internally, CareSource successfully managed millions of targeted messages with a small, dedicated team. This operational efficiency allowed the organization to allocate more resources to strategic initiatives, further enhancing their ability to deliver member-centric care.
Strategies for Optimizing Self-Service Engagement
Drawing on their extensive experience, Soleil Verse, Digital Product Manager for CareSource, outlined essential best practices for maximizing digital engagement:
Know Your Members Intimately
Understanding your audience is foundational. Leverage available data such as emails, phone numbers, and mailing addresses to deliver messages via preferred channels. Tailoring campaigns to specific member groups ensures higher engagement rates and better outcomes.
Centralize and Streamline Processes
A structured approach, such as CareSource’s Communication Request Process (CRP), streamlines campaign management. With clearly defined Service Level Agreements (SLAs), typically 10 business days at CareSource, communication remains timely and consistent. Centralizing deployment through a dedicated team also ensures accountability and operational clarity.
Prioritize Effectively
Prioritize outreach based on urgency and regulatory requirements, business growth opportunities, and care gaps. Regulatory compliance is always highest priority, followed by strategic growth initiatives, then routine engagement efforts such as preventive care reminders.
Maintain Compliance and Flexibility
Adherence to compliance standards like TCPA (Telephone Consumer Protection Act) and CAN-SPAM is critical. Always provide clear opt-out options in digital communications and remain flexible to evolving consent rules, which can vary significantly by state.
The Future of Self-Service Engagement
As digital health engagement evolves, ongoing innovations are expected to enhance member interactions further. mPulse’s Program Manager future features include:
- Dynamic Engagement Journeys: Messages adapt based on member interactions, optimizing outreach effectiveness.
- Advanced Subscription Preferences: Members will manage preferences on highly granular communication topics, enhancing user satisfaction.
- Integrated Mobile Surveys: Easily deploy surveys via mobile web, including crucial mock CAHPS surveys, directly within digital platforms.
- Enhanced Compliance Features: Streamlined content export and approval workflows, ensuring easy regulatory compliance and faster state approval.
These upcoming enhancements and additions demonstrate the commitment to keeping health plans ahead of digital engagement trends.
Seizing the Self-Service Opportunity
Leveraging self-service member engagement technology isn’t merely a trend; it’s an essential part of health plans’ enterprise engagement strategy to achieve operational excellence, agilely respond to member needs and improve member outcomes. CareSource’s experience highlights the considerable benefits, from higher engagement and reduced costs to improved member satisfaction.
Embracing best practices such as targeted, compliant outreach and streamlined processes enables health plans to not exceed member expectations. By adopting innovative and scalable self-service tools, health plans can remain agile, responsive, and deeply connected with their members in the digital age.
The future of healthcare member engagement is digital. Self-service engagement technologies represent an efficient and effective way forward—enhancing communication, improving health outcomes, and transforming member relationships for the better.
Visit mpulse.com to learn more about our suite of engagement offerings including our self-service engagement product, Program Manager.
