HIT Consultant August 21, 2024
A health plan’s success rests on many factors: improving health outcomes, controlling costs, optimizing risk adjustment, and encouraging member adherence to a specific care plan. Member engagement is foundational to all of these goals.
Health plans have struggled to close the loop on engagement for various reasons. This is especially true among Medicaid enrollees, who report more problems with prior authorization and provider availability compared to people with other insurance types, and are less likely than their peers to describe their own health as “excellent.”
The Department of Health and Human Services regulates what types of communications health plans can send to their members. Other regulations limit the frequency of communications with members. By limiting communication, the relationship between...
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