Throughout the last year, the way people have chosen to seek healthcare has turned on its head. While there have been great strides and innovations to give people more options, such as telehealth, it’s no secret that healthcare utilization has been trending downward—and closing critical care gaps was already a challenge for health plans before the pandemic.

And now, we’re entering new territory as we begin to learn the long-term effects of delayed preventive health visits like cancer screenings, immunizations for children, and even routine visits to the dentist. In fact, 40% of parents report that their children missed vaccinations during the pandemic and many parents skipped the routine back-to-school immunizations when they learned remote learning would continue. 2021 is the time for renewed focus on preventive screening to keep members healthy, despite the ongoing pandemic.

As we work to climb out of COVID, and with the promise of the vaccine rollout, targeted health action programs are critical to help health plans shift focus to engage and motivate members to close preventive care gaps. Here are 3 things you need to know to drive the best results.

#1—People Are Concerned About Costs

Understanding why people are foregoing care is the first step to figure out how to motivate them to re engage and come back. In the beginning of the pandemic, people were avoiding care because they had to—offices were either closed or the clinics themselves were encouraging people to reschedule. Others skipped routine visits because they feared getting COVID-19. 

According to a Johns Hopkins COVID-19 Civic Life and Public Health Survey, 29% of survey respondents reported missing a preventive care visit during the pandemic. Further, 58% who had a scheduled preventive care appointment missed the appointment.

This was not only a result of COVID fears, but a larger trend emerging over the course of the last year—the burden of paying for healthcare. Many that lost their jobs or didn’t understand their benefits feared how they would pay for the visits. Consumers also reported that navigating how to access and pay for healthcare activities was a challenge saying, “not one healthcare activity was described by consumers as effortless.” That’s a problem.

How to Overcome the Cost Challenge

Effective communication. Make it clear what members are responsible for up-front and how you will be supporting their care. If the preventive screening you are trying to drive is 100% covered, let the member know in plain language.

Understanding member motivations and attitudes about healthcare will also serve you well when communicating with members. In fact, Icario drove a 44% increase in claims in a recent health action program using behavioral research as the foundation of the outreach. In addition, offering a reward or incentive to the member for completing the health action is a proven way to drive visits. 

#2—Member Experience is Paramount

It’s no question that people are overly cautious about seeking care right now. Whether the reason is fear of contracting COVID-19, financial, or otherwise—a shift in focus to providing excellent member experiences is needed to keep trust and engagement at the forefront of healthcare.

While we did see significant cancer screening utilization decline at the beginning of the pandemic, we did begin to see utilizations return to normal levels over the summer. However, according to the same research, “a colonoscopy and mammogram deficit occurred between January and July compared to the same time period in 2019. This will likely lead to later diagnoses of breast and colon cancers, which will contribute to higher medical costs and worse outcomes”. Meaning, we will have a lot of work to do to return to normal screening levels (while also encouraging those that typically skip these visits, pandemic or not) to achieve early detection and save more lives.

This is where the importance of member experience and satisfaction comes in. A positive member experience can make all of the difference when someone is deciding whether to take action or not. As a result of the pandemic, CMS recognized this by temporarily relaxing some of its quality measure reporting requirements to account for the decrease in healthcare utilization and instead shifted focus to member satisfaction.

CMS has magnified the focus on, and importance of, member experience and satisfaction through significant changes to the Stars Rating—with member satisfaction and experience accounting for 40% of Star Ratings going forward.

How to Enhance Member Experiences

While utilization is critically important for a number of reasons, many of which are mentioned above, we can’t ignore the importance of member experience and its relationship to utilization. The best way to drive positive member experiences is to understand your members as people. Learn about their healthcare attitudes, how and when they like to communicate, and what messages are most likely to resonate.

Icario runs health action programs designed to drive cancer screenings, resulting in high engagement. In a particular breast cancer screening program, we were able to reach 94% of members with 72% engaging with the outreach. Further, it only took 2.2 outreach attempts to spark action from the members engaged. We’ve learned that it only takes one messaging sequence to make a difference and save a life. When you understand member preferences, you’re much more likely to achieve desired results and member satisfaction.

Member Gaps in Care eBook

The Great Divide: 5 Strategies to Bridge Healthcare Member Gaps in Care

Learn Icario’s secrets to move any population to take healthier actions and close more gaps in care, no matter how unreachable they seem.

Get eBook

#3—Drive More Visits with Personalized Outreach

Personalization is key to connecting with members meaningfully, and tricky to get right if you don’t have the appropriate resources in place. The last thing you want to do is send the wrong message to a member during such a volatile time. That’s the way to drive dissatisfaction, not get more members to complete important preventive health screenings.

It’s also important to note that members want this! According to a new Icario survey conducted online by the Harris Poll, 86% of members want their health plan to personalize communication, care, and services. If this is what your members want, what will help close critical care gaps, and boost preventive care screenings during a pandemic, now’s the time to strategize.


While people may be satisfied with their current plan, and understand their benefits, there is a desire for greater personalization around their care. Icario often experiences plans generically engaging members through the same message, modality, and approach which doesn’t universally resonate or inspire health action. The directive for greater personalization is consistent with Icario’s experience where member engagement is directly correlated to a member’s personal and sentimental association with the message, and calls to action that are aligned with a member’s values.

How to Meaningfully Engage

Successful personalization that drives health outcomes can look different depending on the member. Some members will take action because a message resonates. Others will respond because the call came in at the right time. And some people will schedule an appointment because the incentive is too good to pass up. All of these are important and deserve consideration—that’s why a multi-channel approach is the only way to drive real results. 

By intelligently matching the right messages, channels, and outreach sequences, along with knowing what rewards and incentives will resonate (if any), each individual, will receive something unique to drive the right health actions.

Bottom line—focus on preventive screenings. With COVID-19 dominating headlines, it’s easy to place all of your efforts into the pandemic bucket. While it’s important, it shouldn’t be the only focus. If we continue to ignore the decline in utilization trends, we’ll have a much bigger healthcare crisis on our hands down the road.