Create a personalized member experience with data analytics

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Not that long ago, member experience was not even a consideration for healthcare insurance organizations. Customers have more options in the marketplace resulting in greater price sensitivity and less stickiness to plans and providers. In the ever-increasing competitive landscape of the global health insurance market, payers need to offer patients services they want by moving to a value-based approach. In value-based models, payers strive to reduce claim times, resolve member inquiries efficiently, and automate to eliminate paperwork and unnecessary follow-ups with care providers.

Create a personalized member experience with data analytics


Analytics can help health insurance companies compete in a shifting healthcare landscape by providing insights to improve patients, families, and care teams’ healthcare experience.

Healthcare insurance organizations can reap multiple benefits from using analytics, creating an atmosphere favorable to retain, acquire, and manage members. Providers must foster an analytics-driven culture that can minimize administrative costs required to develop strategic member acquisition plans from various sources such as EMRs, claims, social and web data. Knowing and acting on the resulting data-driven insights are critical to any healthcare insurance system’s commitment to managing member experiences for retention, acquisition, and recapture.

Big data analytics is the key to sustainable engagement initiatives in payer healthcare systems. First, there is a need to understand member experience gaps and assess every member’s experience at every touchpoint between various departments. Member interactions happen on the phone, in emails, online, on social media, on blogs, in help forums, and several other channels. The next step is to measure response and resolution time by channel. Employee satisfaction also matters for those employees who are in direct contact with members. Finally, a reflective analysis of member retention helps understand when and why members are leaving.

It is more crucial than ever to reach out and help members who need assistance navigating the new world of healthcare by leveraging & adapting information that addresses the member’s changing level of interest and needs. Effectively engaging the entire member population and improving the member experience is no simple task.


With the help of cutting-edge data analytics techniques, healthcare payers can derive data-driven insights from various data sources such as email, sensors, web site, social media, mobile devices, call centers, surveys, etc. that will help them identify key member concerns, create optimal strategies for each hospital’s unique demographic base, and improve the overall member experience. Using analytics platforms, healthcare payers can deliver an enhanced member experience across the entire journey by enhancing the experience for a new and existing member, helping members manage their health, resolving member complaints, and adapting to member’s evolving needs.


5 Tips for a successful member engagement strategy:

1- Recognize member engagement as more than a Government mandate.

2- Create a cohesive member engagement strategy

3- Avoid the use of technology for technology’s sake

4- Compare vendors, consider interoperability

5- Analyze, measure, and adapt the approach for continued success


Additional Reading

Would you like to learn more about this topic? Here are some articles we suggest:

Creating Sustainable Member Engagement

Advanced Claims Analytics with Big Data

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