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Leverage Digital Strategies for Smarter Member Engagement

Every interaction with a health plan member is a chance to improve healthcare outcomes—and to make a lasting impact. For 13 years, we’ve proudly partnered with a top 10 Health Plan and long-term Medicare Advantage provider. And when they faced a major challenge with their care gap outreach—high costs on outbound calls with underwhelming results—they turned to us for a solution.

As their trusted strategic partner, we rolled up our sleeves, reimagined the approach, and delivered game-changing results. Curious about the impact? See how we turned their challenge into a success story!

Transforming Care Gaps into Care Gains

Increase in Medicare Members scheduled appointments
1 x
Lower cost of scheduled appointment than industry standard
1 %
YoY increase in inbound calls, directly attributable to omnichannel engagement strategies
1 %
Reach rate achieved via omnichannel campaigns
1 %

ResultsCX helped its Fortune 50 health plan client do more with less

Promoting preventive and maintenance care appointments empowers members to lead healthier and productive lives, reduces dependence on costly emergency care, and saves payers millions of dollars annually. Understanding our client’s challenges, we developed a tailored, empathetic solution that leveraged advanced technology and a highly skilled workforce. Our approach increased scheduled appointments year over year and lowered costs.

deliver-unbelievable

Challenges

Facilitating patient education, empowerment, and care coordination was a top priority for the health plan. However, their previous program was incurring substantial costs without delivering adequate impact.

  • Benefits, preventive, and maintenance care were underutilized.
  • Emergency care and hospitalizations were trending higher.
  • Poor member experience could potentially lower the health plan’s CMS Star Rating.
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Solutions

We collaborated with the health plan to design a targeted solution for members with pre-existing conditions, enhancing care utilization and outcomes.

  • Omnichannel communication: Low-cost outbound campaigns encouraging members to make inbound calls to schedule care appointments.
  • Right shore support: Expanded nearshore live agent support to enhance efficiency and cost-effectiveness, reducing hiring costs
  • Data-driven engagement: Implemented a segment-focused approach targeting specific member needs that ensured timely preemptive care for vulnerable members, reducing healthcare costs and safeguarding member health.
  • Targeted training: Revamped the client’s training curriculum and delivered specialized training that empowered agents to prompt members to schedule appointments at a notably accelerated pace.

Numbers Speak

YOY Increase in Appointments Scheduled

80% - 2022
57% - 2023

YoY Reduction in Cost

55% - 2022
34% - 2023

Close care gaps effectively and boost Star Ratings

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