Despite the pandemic, members continue to have high expectations for payers. Though call centers are experiencing surges in their normal volume, members still want rapid, accurate responses to their questions and concerns. They want to connect on their preferred channels and engage in personalized, continuous dialogue. Ultimately, they want to feel valued, understood, supported, and confident about their safety and well-being. 

This is an excellent opportunity for payers to listen, understand, and act, especially as new subgroups emerge among their members. They might include laid off or furloughed workers, or members impacted by COVID-19. While these individuals have new questions and needs, they still want the same connected and seamless experiences they had pre-pandemic. 

How can payers deliver personalized experiences? Consider these strategies for sustaining member engagement long-term.


Strategy 1: Strengthen connections

Salesforce research shows that nearly 80% of customers expect consistent interactions across departments, regardless of industry. Show members that you know and support them by ensuring everyone on your team — from call center agent to care coordinator — shares a single, 360-degree view of the member’s experience. 

An integrated customer relationship management (CRM) platform provides a single source of truth for everyone involved with the member journey. Payers can take a unified approach guiding every interaction, from intuitive self-service to personalized communications.

For example, with a CRM platform, you can create relevant, tailored end-to-end journeys guiding members to complete specific tasks or review educational content. To do this, take the following steps:

  1. Embed a listening capability to anticipate member needs and react in real time.

  2. Connect your entire experience, including digital channels, sales, and service. By bringing everything together, you get a complete view to proactively acquire, onboard, enroll, engage, and retain members.

  3. Automate your interactions at scale. Build a member journey once and then customize it to offer a unique experience for every individual.

  4. Analyze your metrics to understand what’s working and what’s not. Using the insights learned, pivot to provide the best experience.

One of the fastest-growing Medicare Advantage plans, Clover Health, integrated its data and technology with Health Cloud. This CRM platform helps payers put members at the center of each interaction. Through omni-channel coordination with Marketing Cloud, Clover Health dynamically prioritizes interactions across channels based on a members’ propensity to convert. The 360-degree view enables Clover Health to deliver the right information at the right time to members and providers with automated touchpoints across the healthcare journey. The results: coordinated and prioritized care across the continuum of member and provider journeys.


Strategy 2: Anticipate member needs

As members’ preferences change, anticipate their needs in the moments that matter with proactive communications. Can they access virtual health benefits? Who is responsible for the copay and deductible? Are they able to get a COVID-19 antibody test?

To find out, analyze your real-time engagement data. View aggregate results to measure performance and identify possible improvements. This will help you to build journeys and provide immediate information to members on their preferred channel when they need it.

From there, execute smarter email campaigns at scale with dynamic content based on the audience. Use artificial intelligence (AI) to show predictive content and to profile customers based on their behaviors. Ensure emails are mobile-first so members can read them easily on any device.


Strategy 3: Communicate on any channel

Think about how retailers approach the customer experience and mimic their best practices when communicating with your members. Retailers deliver consistent, personalized messaging across channels and devices. This includes web, email, in-app messaging, and social media — all in real time. Consider the following actions:

  • Deploy SMS, push notifications, and chat alongside other channels like email and social.

  • Deliver time-sensitive interactions with personalized webinars, appointment reminders, and alerts.

  • Drive mobile app adoption to keep your organization top of mind.

  • Target customers with geo-fences and beacons for things like reminders, logistics, etc.

  • Use AI to analyze response data and learn what tactics are working and ways to improve business performance.

Whenever a customer begins using your product or service, they also begin a relationship with you. Focus on their preferences and tailoring their experience accordingly to give them the best value that will build trust and loyalty over time.

With these strategies in mind, start taking steps to strengthen your relationships, anticipate member needs, and improve communications and service. 


An example use case: Open enrollment

Open enrollment may be one place to start. Unemployment during the COVID-19 pandemic soared to 13.3%, a rate not experienced in the U.S. since the depression era. The effect resulted in millions of individuals losing employee-sponsored health coverage and switching to alternative plans such as Medicaid or COBRA. In some cases, insurers are holding a special enrollment event for those who lost coverage during the crisis, allowing them to enroll during a limited mid-year window. Having a technology solution that helps you gain a complete view of your membership, anticipate their needs, and meet individual communication preferences is critical for adapting to the unexpected.

At Salesforce, we send open enrollment emails to employees based on past behaviors. Our metrics show exactly when and how many emails are opened, as well as click-through rate based on days and times of day sent. We can also send a follow-up email right away based on an employee’s action.

Check out our open enrollment playbook for tips on personalizing the member experience and increasing customer satisfaction.