The healthcare industry isn’t exactly known for being on the cutting edge of embracing change. Whether it’s adopting new technology (think smartphones, electronic health records), shifting payment models, or figuring out the best ways to reach consumers, many healthcare organizations struggle to adapt swiftly. But adapt we must, and health plans are wise to keep an eye on the trends that are altering not only how care is delivered, but also how hospitals, health networks, and plans interact with people.

Several well-known industry giants have been steadily shaking things up in recent years, continuing to test new strategies during the COVID-19 pandemic. Amazon, CVS Health, Walgreens Boots Alliance, and Walmart are all working toward important goals such as improving access to care, reducing costs, and simplifying the increasingly convoluted process of obtaining treatment. Walmart has even become a licensed insurance broker.

So how do these changes and the overall macro trends they embody affect the way you should approach member interaction? Let’s explore these 6 macro trends to find out.

1—Data-Driven Healthcare

We are living in a data-driven world, from the ads we’re served online to the flyers we receive in the mail to the shows our streaming services recommend. Yet, when it comes to data in healthcare, the stakes are far higher. Our lives are on the line.

Many companies are pairing artificial intelligence (AI) with the increasing troves of personalized data to make an impact through more refined approaches to outreach. Just as precision medicine is customized to an individual’s unique case, the concept of precision health engagement factors in available data to create a highly relevant and tailored experience more likely to incentivize someone to take a needed action. Likewise, dynamic targeting (thinking again of those recommended Netflix shows) crunches all the numbers related to the response of previous outreach methods, so we can create a more meaningful and customized experience.

2—Member Experience & Satisfaction

As consumers in general now expect a top-notch experience in virtually all aspects of their daily lives, this concept is critical to remember in healthcare. Member satisfaction drives higher scores on CAHPS surveys and Star Ratings, so every effort should be made to connect effectively and regularly with members, starting with a streamlined health risk assessment. Unfortunately, health plan members consistently report that they don’t feel like they’re being heard. When this happens, a wall goes up between the member and your health plan, making engagement efforts—and movement toward improved health—all the more difficult.


We’re all growing to expect a certain level of personalization in our daily interactions. Companies that treat us as the individuals we are will typically win us over and incentivize us to take action, whether it’s to buy a pair of shoes or select a hospital for a procedure. For health plans looking to improve member engagement, this means delivering the right message at the right time via the right channel.

Using data, and more specifically, leveraging the powerful insights of behavioral science, can help you understand the attributes of the member cohorts involved. This means Margaret gets a short text about scheduling an Annual Wellness Visit on Monday morning while Kenny will find a graphical email in his inbox mid-day Tuesday reminding him to make an appointment.

At the end of the day, personalization is about wiping away long-held assumptions about the people you’re trying to reach and establishing an effective relationship with each one of them on some level. Test and learn strategies can help you determine what will move the needle on getting members to take critical health actions.

4—Virtual Care & Digital Health

The pandemic has taught us many things, but one realization is that quality care doesn’t always mean an in-person visit in a doctor’s office. The Kaiser Family Foundation found that between the summer and fall of 2020, more than 1 in 4 Medicare beneficiaries had a telehealth visit with their provider. Virtual care and digital health interactions are clearly here to stay, in some form or fashion, with notable convenience and efficiency benefits for both patients and providers.

Members are also increasingly comfortable with using digital tools to send questions to their providers, request prescription refills, and schedule appointments and screenings. Caveat: Although many of your plan members have likely embraced telehealth, remember the impact of the digital divide; some people lack either the computer skills or the technology (or both) to participate in a virtual visit.

5—The Impact to Social Determinants of Health

Although technology advancements can make healthcare feel futuristic in some ways, there remain significant barriers to health and wellness for many in the U.S. It’s urgent for the industry to acknowledge and address challenges like food insecurity and the aforementioned digital divide. Fortunately, CMS issued a roadmap in January to help states address this pressing issue.

For health plans, the first step is understanding the difficulties individual members face in their daily lives. Are they safe? Hungry? Do they have transportation? Are there language or literacy barriers? Can they get online?

The list of real-world hardships goes on and gaining a clear view of the specific social determinants of health (SDoH) preventing an individual from accessing care and improving their health is key. Sending a perky reminder email about an overdue colonoscopy is useless—and even callous—if the recipient doesn’t know where their next meal is coming from.

6—Rewards & Incentives

Humans are hardwired to respond to rewards & incentives, and we increasingly expect a pat on the back for completing activities we’d prefer not to do. Whether the goal is having someone complete a health risk assessment, schedule an Annual Wellness Visit, or get a COVID-19 or flu vaccination, programs that can determine what will entice a member to take action is one of the secrets to success.

For example, Ohio’s million-dollar lottery drawings for vaccinated residents led to a 28% jump in vaccine rates. For health plans, incentives could include vouchers to local restaurants, free exercise equipment, or $25 gift cards (unless of course you want to pony up for a major lottery drawing too!).


The ways each of these macro health trends will shape healthcare in the months and years to come isn’t clear. The important thing to remember is that they should be considered in your outreach strategy as you work to increase member engagement and help people take needed steps toward better health. 

Because at the end of the day, it’s all about taking positive, meaningful health action so we can achieve better outcomes and live healthier lives.