From portals to platforms: Reimagine the healthcare experience

Summary

• Consumer demand for seamless digital healthcare is accelerating: 85% of consumers cite positive digital experiences as a reason to renew with their health plan.
• Integrated, personalized platforms are driving superior financial outcomes: Organizations that prioritize consumer experience see 6x profitability growth and over $1B incremental revenue for improvements, while unified platforms deliver higher member engagement, retention, and substantial operational savings.
• Traditional approaches like member portals are insufficient: Despite widespread availability, only 33% of consumers use portals, leading to fragmented experiences; building trust and leveraging AI-powered, omnichannel platforms is essential to earn lasting loyalty, maximize renewals, and improve ratings.

Health plan executives face a stark reality: members now expect the same seamless, personalized service in healthcare as they do when booking travel or shopping online. This isn’t just about keeping up with trends—it’s about survival in a market where 85% of consumers cite positive digital experiences as a reason to renew with their health plan.

The old playbook of member portals and episodic outreach no longer works. Smart health plans are building integrated platforms that turn fragmented touchpoints into continuous, personalized relationships. The results speak for themselves: organizations prioritizing consumer experience achieve six times higher year-over-year profitability growth.

Why Consumer-Centric Models Are No Longer Optional

Market disruptors like Surest and Coupe are raising the bar for healthcare experiences. They bring a consumer-focused experience from retail and technology sectors, forcing traditional health plans to compete on convenience and personalization. In a market where consumers seek affordable, personalized, and accessible healthcare, a strong digital experience is a critical differentiator.

The business case is clear. Companies that lead in CX personalization increase revenue by up to 15%. More telling: consumers are nearly 300% more likely to recommend a healthcare organization when they trust it.

Redefining Access Through Connected Experiences

Traditional member portals suffer from what we call “portalitis”—members juggle multiple logins for health information, labs, pharmacy, and insurance claims.

Smart health plans are moving to Digital Front Door 2.0: integrated platforms that connect all member touchpoints. This means:

Hyper-Personalized and Proactive Ecosystem: A digital front door 2.0 is an integrated, personalized, and proactive system—not just a basic portal. It unifies all digital touchpoints, from scheduling to medical records, into a seamless experience within a single platform.

AI to Guide User Health Journeys: This system uses AI and data to anticipate and guide a person’s health journey. Instead of a user having to search for information, the platform proactively sends personalized nudges, such as a reminder for an annual check-up, based on their individual health data.

End-to-End Self-Service: The platform offers complete self-service capabilities. Users can perform a wide range of tasks—like booking appointments, completing pre-visit forms, messaging their care team, and paying bills—all from one convenient location, eliminating the need for multiple apps or phone calls.

Personalizing Health Journeys With AI and Data

Healthcare generates more data than any other industry—projected 36% annual growth through 2025. The question isn’t whether you have data; it’s whether you can turn it into personalized member experiences.

Leading health plans analyze member data at the individual level rather than broad population segments. This “N of 1” approach combines clinical data, claims history, social determinants, and behavioral preferences to create truly personalized care journeys.

Predictive Engagement: AI identifies members at risk of disengagement before they churn. Platforms deliver targeted interventions—maybe a diabetes management program for one member, mental health resources for another.

Behavioral Science Integration: The most effective platforms incorporate gamification, motivational interviewing techniques, and social proof mechanisms. Members are three times more likely to participate in health programs when AI powers personalization.

Real-Time Adaptation: Modern platforms learn from every interaction, continuously refining recommendations and outreach timing for each member.

One health plan integrated behavioral science with AI-powered personalization and saw an average 54% higher health action completion rates compared to generic outreach campaigns.

From Transactional Touchpoints to Long-Term Relationships

Most health plans still operate on a transactional model: send reminders when care gaps open, then stop. This episodic approach misses the bigger opportunity—building trust through continuous, empathetic engagement.

Trust Building: 84% of health plans cite member motivation as their biggest engagement barrier. The real challenge isn’t motivation—it’s trust. Members who distrust their health plan won’t engage, regardless of how sophisticated your outreach becomes.

Whole-Person Care: Relationship-based models address social determinants alongside clinical needs. This might mean connecting members to transportation services, helping with prescription assistance programs, or providing culturally competent care navigation.

Continuous Value: Instead of reaching out only when something goes wrong, successful platforms provide ongoing value. Weekly health tips, seasonal wellness challenges, and proactive check-ins build loyalty over time.

Care Team Integration: The shift toward value-based care models supports this relationship approach. When financial incentives align around member outcomes rather than volume, health plans invest in care coordination and continuous engagement.

Why Consumer Experience Drives Growth

Strong CX isn’t just about satisfaction—it’s a growth engine. Plans with superior digital experiences see measurable business impact:

Member Retention: High digital satisfaction scores correlate with 89% Medicare renewal rates. Poor experiences drive churn, with one-third of members “very likely” to switch plans annually.

Star Ratings: CMS has doubled the weight of satisfaction measures in Medicare Star Ratings. Better member experiences translate directly to quality bonuses and competitive advantages.

New Member Acquisition: 40% of healthcare consumers use digital tools or want e-broker help to select health plans. Plans that differentiate through omnichannel experiences and personalized outreach attract members from competitors.

Operational Efficiency: Unified platforms reduce call centre volume, automate routine transactions, and enable staff to focus on high-value interactions. One health plan reported technology consolidation savings exceeding $10 million after implementing a comprehensive CX platform.rations, care management, case management, patient outreach, and digital marketing.

What’s Holding Organizations Back—and How to Move Forward

Most health plan data exists across various systems. Creating a “golden record” that unifies all member identifiers remains rare but increasingly essential.

Data Integration Challenges: Legacy systems and vendor silos prevent the data consolidation necessary for true personalization. Modern CX platforms require FHIR-native architecture and pre-built API connections to existing systems.

Trust and Transparency: Members will share data for personalized experiences, but only when they understand who receives it and what value they get in return. Clear, plain-language consent processes build trust rather than legal compliance.

Cultural Transformation: Digital transformation succeeds when organizations embrace cultural change alongside technology implementation. This requires C-suite alignment, cross-functional collaboration, and clear governance frameworks.

Build vs. Buy vs. Partner: Most health plans lack the internal expertise to build modern CX platforms from scratch. Strategic partnerships enable faster implementation while providing access to ongoing innovation and platform maintenance.

The most successful health plans start with member experience strategy, then select technology partners who can deliver integrated platforms rather than point solutions.

Power Smarter Experiences With League

The healthcare organizations winning on consumer experience share one thing: they’ve moved beyond fragmented digital tools to unified platforms that put members at the center of every interaction.

League helps health plans transform member experiences through our integrated CX platform. We combine personalization engines, omnichannel engagement, and behavioral science to drive satisfaction, loyalty, and growth.

Explore how League’s healthcare CX platform can transform your member experience strategy.

Frequently asked questions

What is a healthcare consumer experience platform?

A healthcare consumer experience platform is a unified technology solution that integrates all member touchpoints—mobile apps, websites, call centres, and in-person interactions—into one seamless experience. These platforms combine member data from claims, clinical records, and social determinants to deliver personalized, proactive engagement rather than fragmented portal experiences.

How does AI improve health plan member engagement?

AI analyzes vast amounts of healthcare data to predict individual member needs and deliver personalized recommendations at the right time. This includes identifying members at risk of disengagement, suggesting relevant health programs, and automating care gap outreach. Health plans using AI-powered personalization report an average of 54% higher health action completion rates and engagement rates six times higher than industry averages.

Why are health plans switching from member portals to integrated platforms?

Traditional member portals create “portalitis”—members must juggle multiple logins for different services, with none of their data in any single system. Integrated platforms solve this by providing single sign-on access to all health services, personalized content, and proactive member support. This approach increases satisfaction and drives the 89% renewal rates seen among Medicare members with top digital experiences.

What ROI can health plans expect from consumer experience transformation?

Health plans implementing comprehensive CX platforms report multiple value streams: technology consolidation savings, new revenue generation, and operational efficiency gains from reduced call center volume. Additionally, improved member satisfaction directly impacts Star Ratings, leading to CMS quality bonuses and competitive advantages in member acquisition.

How do omnichannel experiences impact member retention?

Omnichannel experiences allow members to interact through their preferred channels—text, email, mobile apps, or phone—while maintaining consistent, personalized messaging. Research shows 88% of members say using preferred communication channels would increase satisfaction. Plans with superior omnichannel strategies see significantly higher renewal rates, with one-third of members being “very likely” to switch plans annually when experiences fall short.