Many payers and brokers are unaware of the detrimental impact that HRA campaigns have on member perceptions. The call center agent is polite as they read down a scripted survey. But think about the member’s side of the HRA call.
Put yourself in their shoes:
You told the agent that you are not satisfied with your overall health. You don’t eat four servings of fruit and vegetables per day, and sometimes you don’t have enough food.
The agent then responds, “Thank you, we appreciate your time. At ABC Health, members come first!”. And they hang up.
Despite the human-centric tagline, the message from the payer couldn’t be any more clear:
“We don’t care.”
PlanAllies is an interactive virtual assistant that adjusts real-time engagement scripts based on member responses. Beyond yes/no answers, technology searches for context relating to HRA topics. Once discovered, PlanAllies prompts the agent to inform the beneficiary how the health plan supports them.
Unlike a yes/no survey, with conversational engagement, the member does most of the talking. While obtaining HRA data, the goal is to get to know the member as a person and then support them personally.
Examples:
PlanAllies prompts the call center agent to ask the member why they are unsatisfied with their health. Technology updates the script, and the agent informs the member about their plan’s 24hr nurse contact line: “Let’s get you some help; you shouldn’t live with pain. Would you like to speak with a nurse today?"
Context beyond yes/no answers: The member responds, “How can you expect me to eat four servings of fruits and vegetables per day when I can’t afford bread or cereal? PlanAllies notifies the agent of the member’s nutritious food benefit delivered to their home in the blink of an eye. With PlanAllies, supplemental benefits can be requested on the spot. The member replies, “This is wonderful.”
Later in the conversation, the member answers that their hearing is fine. Technology continues to search for insights.
Following discussions reveal the member’s perceptions, “Everyone around me mumbles.” The member has never had a hearing test and doesn’t want one. PlanAllies leads the agent through a quick chat about the relationships between hearing loss and cognitive decline, convincing the member to schedule a hearing appointment. PlanAllies even points out the available medical transportation benefit.
Both the scripted and conversational calls reported HRA data to CMS. But the data obtained conversationally was more accurate. And while the first call left the member cynical, the second call instilled satisfaction and loyalty.
A scripted engagement ends by reading a member-centric tagline to the member.
With tech-enabled conversations, your member-centric focus is demonstrated to the member.
The next time the beneficiary is contacted, technology prompts that agent to pick up where the prior conversation ended. Members feel heard and known by an empathetic and human health plan. Because of the relationships built, future engagement rates increase by 30% to 50%, leading to further increases in satisfaction and retention.
Every time we communicate with beneficiaries, it is an opportunity to demonstrate your health plan’s compassion and support.
If you would like an overview of this technology, or if you would like to see a video of the workflow, click below.