Clarity AME

Know Your Audience: Tuning Engagement Efforts to Your Market

In part one of this series, Connecting the Dots: Leveraging Member Communications to Build Engagement, we talked about the untapped opportunity for health plans to engage members through the print communications they’re already sending, and that members are already receiving, reading, and responding to.

In part two, we’ll cover how our Accelerated Member Engagement (AME) solution can work for any market or line of business you serve.

Your engagement goals will differ depending on the market, so one-size-fits-all communications are a lost opportunity for health plans. We’ve helped plans achieve improved engagement results with AME by personalizing communications content based on the line of business, member age, demographics, location, and other factors. Our AME approach goes beyond content. We’ve learned that positioning—how you talk to each cohort and the values you emphasize—also has an impact on message resonance and member response.

Here’s how AME can help you engage each market audience to make your communications more relevant and useful.


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Commercial Plans

The labor market is responding to big pandemic-related and generational shocks like the Great Resignation and increasing retirements and decreasing the pool for employer-sponsored health insurance. At the same time, traditional health plans are facing increased competitive pressure from new payer models that are grabbing market share, new digital market players and the aftermath of the No Surprises Act. Overall, the commercial market is shrinking.

In adapting communications to this audience, we start with “what does this person’s life really look like?” Within this population, it is highly likely you are talking to families with children. These are busy people with little patience for fluff, so they will appreciate simplicity and convenience in their communications and interactions with their health plan.

As tested through our AME engagements, these are the insights and behavioral science tactics we apply for the commercial audience, provided by Engagys, a leading healthcare consumer engagement consulting and research firm:

  • Optimized messaging can improve enrollment rates up to 50%
  • Families with children tend to respond more favorably to a ‘cost savings’ message vs. a ‘stay healthy’ message
  • Scarcity and exclusivity are effective behavioral science tactics for commercial populations
  • Digital registration rates increase when a QR code is added to member onboarding letters
  • Including maps with specific locations can lift call-to-action completion rates for site of care (SOC) steerage programs
  • Offering gift cards to members can increase the rate of scheduled wellness exams up to two times
  • “Positive reinforcement” messaging has been shown to drive increased opt-in rates over educational messaging when promoting preferred providers

Plans have tasked us with accomplishing specific engagement goals for this population by emphasizing preventive care and therefore cost savings. Portal registration helps move some plan-member interactions to a less costly channel. Increasing Primary Care Physician (PCP) utilization can catch preventable health conditions before they require more high‐​cost care. As members complete Health Risk Assessment (HRA) paperwork, the plan learns more about the member: how to tailor messaging and which programs to promote. HRA forms can also inform plans of services the member received for health conditions that are reimbursed at a higher rate.

While there are regulations in the commercial market that limit the scope of changes to communications to plan members, Clarity is well versed in these regulations and understands how to enhance content and messaging within the parameters.


The CMS Medicare star ratings that measure how well Medicare plans perform give consumers an idea about which plans have the highest satisfaction ratings as a way to compare plan options beyond their cost. Moving the needle on one of the rating categories (staying healthy, plan responsiveness, managing chronic conditions, customer service, and management of member complaints) by even one or two percentage points can be the difference between a Medicare Advantage plan rating three stars or four or five.

That matters because a Guidehouse analysis shows that for Medicare Advantage plans, a one-star rating improvement could, on average, lead to a year-over-year increase in plan enrollment of 8% to 12%. Meanwhile, moving from a 3-star to a 4-star rating could lead to a boost in revenue ranging from 13.4% to 17.6% through increased enrollment revenue and additional bonus payments.

The Medicare cohort is value conscious and will rely on the Star ratings in choosing a plan to ensure they will get what they’re paying for. As an older audience, they require clarity in messaging and instructions. From a positioning standpoint, if you cite a source of information the member deems credible, or a voice of authority, this population was 10-15% more likely to engage.

As plans consider the opportunities of enhanced member communications, they begin by asking “Where do we want those Medicare members to be 12 months from now? How can we lay out a ‘happy path’ to that outcome, and how can we use every piece of correspondence to nudge them along?” These are the insights and behavioral science tactics we apply for the Medicare Advantage market, provided by Engagys:

  • Senior women are more easily “nudged”
  • Seniors have higher satisfaction in multiple touch programs
  • Using multi-channel to steer seniors to in-network lifts results almost double
  • Guilt works! By calling out three missed tests, we get three times as many people to get those tests
  • Include caregivers in engagement outreach
  • Senior men need multiple communications compared to women
  • Members in NY will only drive one mile to a Medicare town hall meeting; members in Kansas will drive up to 30 miles
  • Men 65+ are more likely to enroll in a diabetes text program than women 65+
  • 91% use a cell phone; 61% use a smartphone
  • Seniors complete surveys at nearly twice the rate of those under 40

For this population, top engagements goals combine cost savings measures with continuity of care. Portal registration, as with the commercial market, shifts some plan interactions to more cost-effective channels. The same is true for mail order pharmacy use which can net the payer lucrative rebates and deep discounts from drug makers when they buy in volume. The aging Medicare cohort is also more likely to face issues with easy access to doctor’s appointments. Encouraging members to switch to in-home assessments can maintain health care momentum and allow physicians to intervene at the early stage of a health condition.


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Medicaid and Dual Plan Eligible

McKinsey predicts that by 2026, the “demographics [of Medicaid members] will be much broader than in the past. Capabilities deeply tailored to each subsegment will be required to effectively serve this population.” Communications that speak to the needs of these subsegments, and the social determinants of health impacting them, will be critical to plan satisfaction and renewal.

Because the Medicaid and dual eligible cohort are primarily children, older adults, or people living with disabilities, they can require additional help to get the care they need. It’s important that content for this audience address top concerns like healthcare access, equity, and convenience.

Many of our insights for this population overlap with the Medicare cohort, but we’ve identified a few additional behavioral science tactics and insights that focus on promoting access and action, and overall population insights from U.S. government agencies that support message testing and segmentation:

  • A multi-channel email and direct mail education approach has been shown to convert repeat ER users to urgent care centers.
  • Endowment effect is a powerful tool – by reinforcing ownership it empowers members to take charge and drives increased engagement
  • 26% of dual eligible individuals reported limitations in three to six ADLs as compared to 8% for non-dual.
  • Depression and Alzheimer’s disease rank among the most prevalent conditions for dual eligible beneficiaries.
  • Maintaining a 5th grade reading level will increase message accessibility and support engagement.
  • Mental mapping enhances simplicity. Limit actions needed to three or fewer and use simple action verbs to help the member remember what to do.​
  • The dual eligible population is more racially and ethnically diverse than Medicare-only – 48% are people of color compared to 21.6% for Medicare-only.
  • 70% of dual eligible individuals have three or more chronic conditions.

For payers, engagement goals for this cohort include ensuring access to their PCP which some plans enable by promoting physician visits via telehealth. Maintaining contact with their physician is especially important for this cohort as preventative behaviors and early intervention of chronic conditions can decrease high‐​cost care over time. Payers also know this cohort is prone to issues related to mental well-being and want to ensure members are aware of the mental health services available to them.

AME Year in the Life

To appreciate the impact of AME on member engagement, we have mapped out a year of communications, contrasting the typical interactions with the enhanced messaging and behavioral science tactics applied.

You can download a full-size version of this infographic, here.


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Insights to Engage Each Membership

Health management is becoming more of a collaborative partnership between providers, patients, and payers. Engagement is the pathway to enlisting members as active and informed participants in their own care. Each market has unique constituencies and care needs. Clarity’s Accelerated Member Engagement solution is a process that will help you investigate and identify the most effective messages and methods to bring all members in all markets on board.