Health plans know that getting some members to participate in their own care is no easy task. The challenges are even greater with a Medicaid population due to the diversity across the population and the increased impact of social determinants of health (SDoH). But that doesn’t mean it’s impossible.

Here are three commonly held myths and misconceptions about Medicaid member engagement, plus proven tips for personalizing and improving your member engagement strategy.


Medicaid members are impossible to reach.

It’s true that Medicaid members are less likely than other healthcare consumers to have stable, permanent housing, making traditional methods of communication like phone calls and standard mail less effective.

However, a Pew Research study found that a whopping 92% of people with an annual household income below $30,000 own a cell phone. Even when other circumstances of a Medicaid member’s life may change, their cell phone number tends to remain constant—serving as a modern-day proxy for a home address.

Not only are text messages more engaging and immediate than their analog communications counterparts, they’re also more cost-effective. A growing number of Medicaid plans have used text messages with great success, demonstrating improved participation and engagement.


Medicaid members are difficult to motivate.

Financial incentives have been shown to influence healthy behavior, and Medicaid populations are no exception. The key is offering incentives that members value, targeting current (not future) behaviors, and delivering the reward promptly after the desired behavior has been completed.

Let’s break each one of those principles down.

First, don’t assume all incentives are created equal. While things like free classes and health coaching might be valuable to some, Medicaid members are more likely to respond to things that help with their bottom-line expenses, like pre-paid debit cards, or gift cards for groceries or transportation. These types of rewards also help address SDoH, which disproportionately affect the Medicaid population.

Second, make sure you’re targeting current behaviors. If your engagement program is using text messaging as the primary way to reach members, remember that the messages should be specific and immediate. Keep members focused on the next activity they need to complete and follow up with a few reminders. Don’t tell them about the visit they need to schedule 6 months from now.

Third, deliver the reward promptly after the activity is completed. Consumers are conditioned for instant gratification. They’ll be willing to wait a few weeks for their reward, but not several months. Invest in an expedient reward delivery process to help ensure that the positive feedback loop of behavior/reward, and the ongoing engagement it fosters, isn’t interrupted.


Medicaid members won’t engage in their own health.

The first thing to remember when it comes to engaging Medicaid members in their own care is that health literacy can be a significant barrier to participation. According to the US Department of Education, 60% of Medicaid members have “basic” or “below basic” health literacy—which are the two lowest categories on the survey.

Many states now create Medicaid member content designed for a third- to eighth-grade reading level to help ensure comprehension. Even if you already have literacy standards in place, take a closer look at your materials and consider testing them with a select group of members to make sure they’re being understood as intended.

The second thing to keep in mind is that one-size-fits-all programs and communications don’t work, especially for a challenging population like Medicaid. What does work is personalization and relevance. When you make an ask, make sure it’s specific and timely. What’s the next thing the member needs to complete? When’s the optimal completion date? What’s the reward when they do it?

If there’s one valuable takeaway about successfully engaging Medicaid members, it’s using a targeted, member-centric strategy. While Medicaid members face very different challenges, at the end of the day, they want to be recognized and rewarded for their actions just like everyone else. They may be difficult to engage and motivate, but with the right approach, you can enhance participation, improve outcomes and reduce costs.