How to Improve Quality through Member Engagement

November 30, 2015

Ensure that your members are receiving high-quality care to defer costs, create member satisfaction, improve quality scores, and most importantly, help members live long and healthy lives. 

How can health plans improve quality? One sure way is to foster member engagement; build real relationships with members and take an active role in members' health. Great health care plans engage members, help them stay educated about preventative healthcare, and provide high value for their cost. This approach can nurture members' health through active illness prevention, education, and early detection, and also boost member satisfaction and raising quality scores. Likewise, open communication with members will keep you informed of areas of member dissatisfaction, creating opportunities for plan improvement. 

Here are a few tips to foster member engagement and boost health plan quality.

  • Offer educational content, whether through newsletters, webinars, or in-person channels. Help members stay educated and up-to-date about the health challenges associated with their age and lifestyle, so that they know how to make healthy choices and mitigate risks. In addition to information about the importance of exercise and healthy diet, let your members know about new advances in health care, and new treatments and therapies options that they might not know about. 
  • Keep members informed about gaps in their personal care. Notify members about preventative screenings, vaccines, or check-ups via text, e-mail, or phone call. After screenings, remind members to make follow-up appointments with their physician. 
  • Risk stratify members. Identify members who are high-risk, who are resistant to seeing health care providers or didn't receive a risk assessment. Reach out more aggressively to these members and attempt to engage them. 
  • Follow up after hospitalizations. The period of time after a hospitalization is very vulnerable. Without the proper care and education, members might require re-hospitalization. Prevent this by providing in-home assessments to identify risk factors, and providing education in proper care to members and any applicable caregivers. Not only will stepping in during this time prevent unnecessary re-hospitalizations -- In many cases, the sense of being cared for will lead to appreciative, satisfied members. 
  • Provide Medication Therapy Management (MTM) and Comprehensive Medication Review (CMR). Counseling members on proper medication use and the importance of adherence will help prevent improper use and related health risks. Make sure your members are getting the most benefit possible out of their prescribed medications, not creating further risk. 
  • Ask for feedback. Create regular opportunities for members to let you know what they think about their health plan, and where they think you could improve. Positive comments make great member testimonials, and not-so-positive comments offer valuable information and potential areas for program improvement. 
  • Take advantage of web-connectivity to foster engagement. Create an online community for members to help individuals stay involved, educated, and feel empowered. A moderated forum for members to share experiences, questions, concerns, and successes can build interest and engagement, and likely provide valuable information.

Fostering member engagement through programs like health risk assessments, member education, medication therapy management, and other preventative care measures offers returns on multiple levels. These programs help engage your members; they have a high potential return on investment; and they simultaneously create higher member satisfaction and quality scores. Consider fostering engaged, active, aware members in order to raise your quality scores. 

MedXM works with health plans to create an effective approach to engage and connect with members. As a national leader in the design and implementation of preventive care technology and health risk assessments, MedXM has successfully focused their sights on Risk Adjustment and Quality Solutions by providing fully customizable options to fulfill specific client needs. To learn more about innovative solutions for health plans, contact us


Previous Article
IoT and Patient Engagement: How IoT is Defining Three Es of Engagement [Infographic]
IoT and Patient Engagement: How IoT is Defining Three Es of Engagement [Infographic]

New technology is able to enable, engage, and empower members.

Next Article
3 Things to Consider When Improving Quality
3 Things to Consider When Improving Quality

Preventive Medicine should always be the foundation of a quality improvement program. The three initiatives...


Request More Information

First Name
Last Name
Thank you!
Error - something went wrong!