Jul 30, 2024
Uncovering the value of a modern member portal
5 min read
Health plans today are navigating a complex landscape while facing tremendous pressure to modernize and improve their member experience. In an environment of heightened consumer expectations, rising healthcare costs, economic uncertainty, and rapid technological advancements, driving increased member and business value is vital. To address these challenges, innovative payers are undergoing a critical initiative to modernize their member portals.
A modern member portal goes beyond driving basic self-serve transactions—it is so much more. Unlike traditional portals, a modern member portal creates a highly connected and engaging experience. It dynamically adjusts to each member’s needs based on demographics, claims, and behaviors, creating a personalized and proactive journey that keeps members coming back.
Payers that have made the shift to a more modern member portal have unlocked tremendous value for both members and the business. Early adopters are gaining a distinct competitive advantage in the market. This forward-thinking approach not only delivers a superior member experience but also yields substantial operational efficiencies and cost reductions, positioning these organizations for long-term success.
Driving business value
Quantifying the value of an initiative of this scale is not always easy. To help leaders kick-start this transformation project, we’ve created a helpful framework to identify and measure the value associated with modernizing your member portal.
“It’s important to be able to articulate the ROI associated with the digital transformation, and to be able to attribute measurable value drivers to a new member portal or digital experience.”
Matt Kaye
Principal, Deloitte Digital noted in our latest white paper with Becker’s Healthcare
Value Metric 1: Operational Efficiencies
Improving operational efficiencies is one of the main benefits payers can expect with a more modern member experience. By enhancing digital communication and automating manual processes, modern member portals empower members to access information (e.g., claims, benefits, and eligibility) and perform tasks (e.g., update personal information, view EOBs, choose providers) at their convenience. This translates to reduced call volumes, improved self-service, and significant operational cost savings while enhancing the overall member experience.
Potential measures of success
| Leading indicators: | Lagging indicators: |
|---|---|
| – Call deflection – Task automation – Increased self-service | – Reduction in operational costs e.g., reduction in call center staffing costs and technology costs through app rationalization – Decrease in legacy IT costs |
Value Metric # 2: Member Satisfaction and Growth
A modern member portal will increase member satisfaction and growth by enhancing the member experience. By providing a unified digital entry point for care and benefits through a personalized portal that anticipates member needs and delivers engaging content, health plans will not only foster member satisfaction, but drive retention and acquisition, and create a competitive advantage—ultimately contributing to sustainable growth and profitability.
Potential measures of success
| Leading indicators: | Lagging indicators: |
|---|---|
| – Increased member engagement – Increased digitally activated members – Increased member satisfaction | – Increased member retention – Increased member acquisition – Increased brand perception |
Only 42% of commercial health plan members are highly satisfied with their health plans.1
Value Metric # 3: Utilization of Services & Cost Reduction
A modern member experience promotes awareness of benefits, encourages engagement with value-added services, and drives optimal utilization—all while reducing unnecessary costs.
Potential measures of success
| Leading indicators: | Lagging indicators: |
|---|---|
| – Increased benefits awareness and utilization | – Reduction in unnecessary costs – Increased in-network usage – Increased utilization of value-added services |
Value Metric # 4: Health Outcomes
Modern member portals contribute to better health outcomes by facilitating proactive health management, personalized care journeys, and seamless care coordination. They empower individuals to take charge of their health journey and enhance their well-being.
Potential measures of success
| Leading indicators: | Lagging indicators: |
|---|---|
| – Increase in preventative care and care management | – Decrease in cost of care and medical spend – Decreased gaps in care – Increased long-term health outcomes |
Transforming the Member Experience: A Must-Have for Health Plans
In today’s rapidly evolving healthcare environment, the pressure to enhance member experiences and drive increased business value has never been more critical. A modern member portal is no longer just a necessity but a strategic imperative for health plans to stay competitive in the complex landscape they’re currently operating in.
To learn more about how a modern member portal can improve your member experience and drive business value, read our latest report with Becker’s Healthcare.
Sources
New research from Becker’s
Learn how leading payers are modernizing their member portals to drive personalized member experiences, higher satisfaction, and lower business costs.