The rules are changing in healthcare, and the shift away from a wholesale orientation creates a need for health plans to think and act like retailers — but with a healthcare perspective.
As a result, building loyalty with members has never been more important. How you engage members, develop products, and leverage your brand will all change, especially given the constraints of market reform and the cost pressures plans are under today. Four opportunities to build loyalty stand out:
engaging consumers in critical moments of truth
personalized messaging for distinct segments
collection of insights to improve program results
Win-Back & Transition Management
Coordination of Benefits
The pharmacy business is becoming increasingly complex with new plan designs, direct-to-consumer programs, consumer-driven healthcare, value-based design, and client customization. Adding to the complexity are mounting pressures around price, regulation, and the need to demonstrate value, service differentiation, and health outcomes.
To address this, Pharmacy Benefit Managers (PBMs), pharmacies, and health plans are all looking to scale their businesses by employing innovative technology; targeting consumers more effectively; and driving health outcomes and reducing pharmacy trend. Understanding when to reach out to consumers, how to engage them, and what messaging compels them to act requires insight-driven data and coordinated channels of communication.
Medication Therapy Management
Health plans and population health companies have three primary objectives this year: control costs, improve quality of care, and increase efficiencies. At the same time, healthcare consumers are being asked to take on more personal responsibility for managing their own health.
It's never been more critical to provide members with education and support. This means engaging individuals in lifestyle and disease management programs; informing them of the importance of medication adherence and preventive screenings; and giving them support during critical care transitions. These are just a few of the critical programs that health plans and population health companies should be looking to implement to improve the health of their members and reduce costs.
Post Hospital Discharge
Population Health Management
Care Plan Adherence
The Medicare landscape is ever changing. Reimbursement is dropping and plans need to do more with less. Acquisition and retention of members remains a key challenge, but now we are seeing an emerging focus on quality and performance.
These dynamics are driving strategies around Medicare star ratings, medical management, and revenue optimization. It's essential that plans maximize every opportunity to capture revenue and achieve differentiation. Plans that strategically leverage objectives will gain a competitive edge this year and beyond.
Member Satisfaction & Disenrollment Survey
Private Fee for Service Migration
Pre & Post ANOC Communications
Star Power™ (Medicare Star Rating)
Post Hospital Discharge
HCC/Risk Score Optimization
Coordination of Benefits (COB)
The Medicaid population continues to grow due to the expansion in coverage for certain populations under healthcare reform and the poor economy. Yet, chronic disease and healthcare costs are on the rise. Communications innovation is a critical success factor to stretching limited federal and state budget dollars to improve health.
To engage and motivate this often hard-to-reach population, health literacy, cultural beliefs, language preference and other components to personalization should be taken into account. Programs that support the Medicaid lifecycle — including the member welcome process, driving HEDIS outcomes, reducing health disparities, and redetermination education — will be what sets plans apart.
Population Health Engagement
ER Utilization Management
Health Risk Assessment Surveys
Learn how to create rich member profiles and communicate with your members the want they want you to.
|75%||of members were reached|
|17%||provided an email address & opted into email communications|
Reduce administrative costs by proactively outreaching to members, through multiple channels, to gather information about other coverage.
|25%||increase in COB savings|
|15%||reduction in administrative costs related to COB|
Driving refill and adherence rates while trying to shift focus toward improving the member experience continues to be challenging in the world of pharmacy. Discover scalable strategies designed to drive cost savings, operational efficiencies, and increased revenue.
Learn what others are doing and the key areas of opportunity to improve value and health outcomes.
Learn how Silverlink helped a leading health plan identify significant and often-overlooked adherence barriers to successfully improve adherence.
|85%||improvement in statin adherence|
|27%||of members not planning to refill did refill after hearing an educational adherence message.|
Drive increased screenings and reduce gaps-in-care through personalized, innovative automation.
|23%||of population expressed intent to schedule a test (10,000 tests)|
|5pt||increase in colorectal cancer screenings|
improve the reach, efficiency and results of a care transition process using innovative campaign management technology and analytical capabilities.
|53%||of commercial members engaged in a discharge survey|
|5%||reduction in 30-day all-cause readmissions among commercial members|
Silverlink delivers outcome improvements across HEDIS, CAHPS/HOS, and adherence measures.
|3||and 7 point improvement on HEDIS measures|
|15%||reduction in 30-day all cause readmissions among commercial members|
Leverage a data-driven strategy and innovative member engagement to achieve a 5-star rating.
|5%||improvement in rate of kept appointments for HEDIS screenings|
|3.6%||improvement in emotional health in HOS survey respondents|
Learn how you can support members from prenatal to early childhood care through multi-channel outreach.
Proactive, mobile outreach to activate consumer healthcare engagement
Scalable technology to efficiently address dynamic market needs
Reach members, using preferred communications channels, on important matters such as well-child visits and immunizations, preventive screenings, health risk assessments, and prenatal and post-partum support.
|7pt||increase in HEDIS scores for adolescent well-care visits|
|4pt||improvement in cervical cancer screening for those hearing the message|