Member Outreach Agent

The new member enrollment period presents many opportunities to start fresh for the new year. You only get one opportunity to make a great first impression and begin building member satisfaction and loyalty. SPH Analytics can support your efforts to engage these members through several outreach programs:

• New Member Welcome Calls
• Health Risk Assessments
• New Member Understanding/Satisfaction Surveys

New Member Welcome Calls

The enrollment period is a critical time to ensure satisfaction and begin building loyalty among new members. Research has indicated that members who understand their plan design, options, and coverage give higher satisfaction ratings with the health plan. New Member Welcome Calls can be designed to meet the following goals for your organization:

• Welcome all new members and provide important plan information
• Build member satisfaction and loyalty
• Meet state and/or CMS requirements
• Provide timely follow up when members need additional assistance
• Conduct Health Risk Assessments (HRA)

SPH Analytics offers a number of New Member Welcome Call options to help ensure your members are informed, receive a warm welcome, and are satisfied with their coverage.

New Member Health Risk Assessment (HRA)

The Health Risk Assessment is designed to identify new member health risk status and expedite effective healthcare management or wellness initiatives. Our professionally trained agents help identify member health risks. Once identified, members can be directed to appropriate programs including care/disease management to support positive health outcomes, minimize risk, and reduce healthcare costs. HRA’s are critical for assessing the needs of your members by:

• Supporting compliance requirements of Special Needs Plans and the Patient Protection and Affordable Care Act (PPACA)
• Providing the ability to stay ahead of claims data helping to improve HEDIS measures
• Helping members choose their PCP / schedule appointments
• Transferring members to plan representatives when needed

By identifying new member needs based on health risk status, health plans can be proactive in providing care that improves performance and satisfaction measures and reduces overall cost of care.

New Member Understanding/Satisfaction Survey

All members can be easily overwhelmed with the amount of information they receive during the enrollment period. Health plans need to educate members about how to access information, locate in-network physicians/facilities, and contact member services. Research shows that low health plan member satisfaction is driven in part by a lack of member understanding of the plan’s coverage, cost of care, and how to successfully access benefits. The New Member Survey is designed to welcome new members and evaluate the member’s understanding of benefits, while health plans gain important member insight regarding:Member Satisfaction Cycle

• Health plan materials
• PCP selection and appointment scheduling
• Member’s ability to access information
• Member’s understanding of how they have to pay

High performing plans typically track new member satisfaction using feedback to drive organizational improvements in the following areas:

• Collateral
• Plan design
• Customer service
• Access to care

SPH Analytics can act as an extension of your health plan to support your initiatives that ensure every member has a positive experience when joining your health plan. The opportunity for organizational improvement and overall member satisfaction can help minimize risk, meet state and federal requirements, and reduce the costs associated with member churn.

Make the most of the new year and new member enrollment with New Member Outreach from SPH Analytics!


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