Active Member Engagement: A Critical Healthcare Strategy


Installment 5 of 6: “Empowering Employers in 2024: Strategies for Effective Employee Health Management and Financial Optimization”

Empowering Employers in 2024 Series

Installment 5
Active Member Engagement: A Critical Healthcare Strategy

Many employees see their health plan as a benefit that’s there when they get sick but don’t think much about them otherwise. Yet, research shows that keeping members proactively and actively engaged with their healthcare benefits can help improve decision-making, and prevent illness, worsening conditions, and adverse events.

Benefits of Engaging Patients With Decision Support

5.3%

lower medical costs

12.5%

fewer hospital admissions

20.9%

fewer “preference-sensitive” heart surgeries

According to Healthcare Finance, “Proactive efforts by health plans to engage with members – by providing advice on how to control costs or helping to coordinate care – drive significant improvement in overall customer satisfaction.”

What is Active Member Engagement?


Member needs change over time, as do utilization trends. The goal of active engagement is to meet members where they are and address their needs throughout that journey. Holding annual benefits meetings and sending emails reminding members of their benefits do not constitute “active” member engagement. While these types of communications are necessary, they do little to encourage members to become more informed consumers of their care.

Actively Engaged Member Behavior
  • Has reviewed and understands their healthcare benefits
  • Understands the trade-offs between network choice and lower costs
  • Realizes that lower monthly premiums can result in higher consumption costs throughout the year
  • Participates in plan benefits options based on their unique healthcare needs
  • Utilizes healthcare services more appropriately (i.e., using their primary care physician instead of an emergency department when possible)

Engaged members are more likely to seek information to help make better decisions about treatments, preventive measures, and lifestyle changes.

Engagement Across Generations


As the healthcare journey evolves over the years, member engagement preferences and styles evolve as well. Active engagement means different things for different stages in life, making it critical for employers to provide engagement strategies that take these changes into consideration.

Baby Boomers (Born Between 1955 – 1964)

  • Want to be engaged in their healthcare
  • Youngest beginning to think of shift to Medicare eligibility
  • Will use digital tools if encouraged by their provider
  • Will ask their provider’s opinion on information they’ve researched themselves

Generation X (Born Between 1965 – 1980)

  • Highly value engagement and education
  • Are involved in decision-making for themselves, their parents, and their children, making communication challenging
  • Actively seek health information
  • More likely to switch providers based on a single poor experience
  • Use digital tools for lab results, provider communication/scheduling, and prescription refills

Millennials (Born Between 1981 – 1996)

  • Will account for 75% of the workforce by 2030
  • 1/3 have health conditions that impact their quality of life
  • Prefer personal communication over mass announcements
  • Want more personalized guidance in connecting to their healthcare resources

Generation Z (Born Between 1997 – 2012)

  • Prefer the use of digital tools for all aspects of their healthcare, including communication
  • Are more likely to engage in preventative care and alternative care options
  • Embrace “holistic health and wellness”
  • Like being actively involved in healthcare decision-making

42% of millennials say an employer’s health insurance is a factor in choosing where to work, and 52% say their health insurance is “very” or “extremely impactful” in their decision to stay with their employer.

The Vital Role of Personal Health Nurses in Actively Engaging Members

Most health plans offer a standard set of benefit options that members can choose from. However, to be effective, these programs need to provide guidance to help members select the options most applicable to their health needs. Personal health nurses (PHNs) are an excellent way of not only providing this guidance but also supporting members in developing sustainable behaviors that lead to better outcomes, lower costs, and an enhanced patient experience.

Personal health nurses empower members with the information, support, and tools they need to create healthier lifestyle choices.

Success Story

A diabetic with lung cancer and severe mobility issues. The member also suffered from malnutrition, which impacted her health, as well as a lack of socialization that had caused her to become depressed. In addition, financial restraints caused numerous preventable and unnecessary emergency department visits.

How the Conifer Health PHN Helped

  • Coordinated with providers to help address the member’s medical issues.
  • Helped member enroll in PACE for socialization needs
  • Utilized local resources to coordinate meal delivery
  • Facilitated local charity group installing stair rider to transport the member to multiple levels of her home
  • Provided health literacy education, support, and reassessment

Member Results

  • Member is now compliant with medication and management of diseases due to increased health literacy
  • Member now has adequate nutrition, resulting in better health management
  • Member is now more socially active and no longer suffers from depression
  • Member has not had an ER visit or hospital stay during the six months of working with a Conifer PHN

Members engaged with a Conifer PHN saved $1,000 more per year on medical expenses than similar members who chose not to engage, and high-risk members with diabetes saved $1,800 a year more.

How to Choose a Member Engagement Partner


Organizations can gain extensive benefits from partnering with a stand-alone active member engagement vendor. Conifer Health is a great option. Conifer Health’s personal health nurses are registered nurses with diverse clinical experience who receive extensive education and certification. Conifer Health PHNs are able to interpret the doctor’s communication and understand symptoms that a member might overlook as irrelevant or unrelated.

Conifer Health clients have achieved the following

85%

member engagement

95%

member satisfaction

3.13:1

return on investment

Learn how your organization can benefit from an active member engagement program from Conifer Health. Let’s Talk.

Let’s Talk
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