Updated: Jan 11
Everyone is talking about the evolution of health plan engagement: Eliminating scripted calls.
And why not? Conversational approaches bolster member satisfaction scores and increase member retention by double-digit. Plus, call center staff who dread another day of reading scripts actually enjoy the varied dialogues.
Engaging, member-centric conversations are topic-specific, whether they aim to welcome new members, collect SDOH data or recruit D-SNP enrollee advisory committee members.
In the past, training and scalability have been the downfalls of unscripted engagement. Becoming fluent in a new topic can take a lot of time, and not everyone is a natural conversationalist. That means scaling can be slow and expensive.
How Technology Has Changed the Game
Today, call centers are using technology that guides Customer Success Representatives through enjoyable interactions. Think of the potential of having a virtual assistant that is fluent in all plan benefits and details, aware of the purpose of each engagement, and fully informed on compliance requirements.
As technology monitors conversations in real time, callers are alerted to benefits that match each beneficiary's lifestyle and aspirations. Instead of reading a script, they guide the conversation toward topics curated by their virtual assistant, all based on the goals of the call.
The Gold Standard for Data Collection
Conversational approaches are redefining SDOH data quality. Yes/no surveys do not identify social determinants; they measure the beneficiary’s perception of their situation. (“I have plenty of food. I’m happy with my diet. I’ve done fine with one meal a day for over ten years.”)
What’s needed is context. Context comes from conversations, not checklists: chatting about a member’s favorite recipes, how often they make them, who they spend their time with, and how they live in their home. Interactive technology monitors the context gained and flags the caller when more focused discussions are needed, for example, related to food insecurity, social isolation, interpersonal safety, churn risk or other topics.
A conversational approach to member engagement enables the call center to deliver an optimized call every time. And for beneficiaries, the engaging, personalized interaction is a pleasant surprise: “For the first time I feel like my health plan actually cares about me.”