{"id":15091,"date":"2025-06-13T09:30:00","date_gmt":"2025-06-13T14:30:00","guid":{"rendered":"https:\/\/www.premisehealth.com\/?p=15091"},"modified":"2025-06-11T09:40:53","modified_gmt":"2025-06-11T14:40:53","slug":"a-health-plans-guide-to-better-member-experience-and-more-accessible-care","status":"publish","type":"post","link":"https:\/\/www.premisehealth.com\/resources\/blog\/a-health-plans-guide-to-better-member-experience-and-more-accessible-care\/","title":{"rendered":"A Health Plan\u2019s Guide to Better Member Experience and More Accessible Care"},"content":{"rendered":"\n
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From the makeup of their workforces to where they operate to their expectations around healthcare benefits, no two employers are the same.\u00a0<\/span>\u00a0<\/span><\/p>\n

Health plans are in a unique position, looking to address challenges that are as different as the employers they serve, while also solving one underlying problem that\u2019s important for them all: poor member experience.<\/span>\u00a0<\/span><\/p>\n

Healthcare remains frustratingly fragmented. Most people are familiar with long stints in the waiting room, limited appointment availability, rising out-of-pocket spend, and shortages of primary and behavioral health providers. It all results in dissatisfaction\u2014and, too often, delayed, or abandoned care for members. Meanwhile, health plans experience difficulty looking to deliver member-centered care, manage costs, control premiums, and improve access, all at the same time.<\/span>\u00a0<\/span><\/p>\n

However, there’s good news: Health plans don\u2019t have to solve the member satisfaction problem alone. By partnering with a <\/span>direct healthcare provider<\/span><\/a>, payers can improve access, boost outcomes, and create a seamless, high-quality experience for their members – all without breaking the bank.<\/span>\u00a0<\/span><\/p>\n

Enhancing access through convenience and integration<\/span><\/b>\u00a0<\/span><\/h3>\n

Direct healthcare models are built to overcome the access issues that plague many parts of the healthcare system. This is especially true of direct healthcare solutions that leverage an <\/span>advanced primary care<\/span><\/b> model,<\/span><\/a> which is designed to meet members where they are in a way that conveniently fills gaps in care.<\/span>\u00a0<\/span><\/p>\n

Here\u2019s an example: When virtual and in-person care is available through an integrated platform, members can get care however works best for them. At an onsite or nearsite wellness center, they can get same-day and next-day appointments in-person with their care team, including primary care providers and licensed counselors. Or, if they need care overnight, away from home, or after hours, digital health solutions make it easier for members to get the care they need from wherever they are.<\/span>\u00a0<\/span><\/p>\n

As a result, members no longer face long waits and can start feeling better, faster. And because virtual and in-person services can be delivered through a single system with one electronic health record (EHR) like Epic, the experience is seamless across all touchpoints, meaning members don\u2019t have to recite their medical history at every appointment.<\/span>\u00a0<\/span><\/p>\n

Member engagement has to start early\u2014and stay steady<\/span><\/b>\u00a0<\/span><\/h3>\n

Engaging members isn\u2019t something that can happen after the fact \u2013 after all, if members don\u2019t know about their benefits, they can\u2019t use them properly. When health plans begin a partnership with a direct healthcare partner, they collaborate to develop a tailored member engagement strategy that educates members about the care model and builds trust from day one.<\/span>\u00a0<\/span><\/p>\n

Member experience teams work with health plans to ensure the <\/span>right messages reach the right people<\/span><\/a>, using tools like personalized email outreach, health center events, and integration into existing tools, like health benefits portals.<\/span>\u00a0<\/span><\/p>\n

Members aren\u2019t just told about the services available; they\u2019re shown how to access and use them in a way that feels relevant to their needs and receive ongoing education about the kind of care available to them. It\u2019s this kind of intentional communication that turns eligible members into active participants in their health, prompts them to seek preventive care, and improves health outcomes down the line.<\/span>\u00a0<\/span><\/p>\n

A team-based approach to proactive, personalized care<\/span><\/b>\u00a0<\/span><\/h3>\n

Improved access is important, but creating a <\/span>better member experience<\/span><\/a> also means empowering providers to work together for the good of their members. Direct healthcare brings together the entire care team – primary care providers, counselors, pharmacists, care navigators, and more \u2013 so they can work together to support a member\u2019s whole-person health and minimize opportunities for gaps in care.<\/span>\u00a0<\/span><\/p>\n

Technology makes this possible: Providers share information through the same EHR, which eliminates duplicative care and streamlines the referral process. If a member needs specialty support, they\u2019re guided to affordable, high-quality care, reducing downstream cost.<\/span>\u00a0<\/span><\/p>\n

Rather than waiting for members to seek care, care teams can also use population health data to identify high-risk individuals \u2013 like those managing or at risk of developing chronic conditions – and reach out proactively to offer resources. As a result, members can build trusted relationships with providers, and have conversations to address critical health concerns before they emerge or worsen. And by getting high-risk members engaged early, these providers are then able to reduce expensive emergency department and hospital visits, improving outcomes while controlling healthcare spend.\u00a0<\/span>\u00a0<\/span><\/p>\n

Delivering value where it matters most<\/span><\/b>\u00a0<\/span><\/h3>\n

When members are satisfied, healthier, and more engaged, everyone benefits \u2013 from their family members to the health plans that serve them.<\/span>\u00a0<\/span><\/p>\n

When health plans partner with direct healthcare companies, they lower out-of-pocket costs for members by offering low- or no-copay visits to services like <\/span>primary care<\/span><\/a> and behavioral health. And when members have longer appointments with their providers learning ways to improve their lifestyles and prevent costly conditions, they spend less time in the hospital or urgent care and more time doing the things they love.<\/span>\u00a0<\/span><\/p>\n

Meanwhile, employers see better health outcomes among their people, reduced absenteeism and presenteeism that can impact productivity, and lower turnover from employees who love their benefits. Plus, that same reduction in costly conditions, ER visits, and inpatient stays results in lower overall healthcare spending for employers, too.<\/span>\u00a0<\/span><\/p>\n

Create a better healthcare experience for your members<\/span><\/b>\u00a0<\/span><\/h3>\n

In today\u2019s evolving health plan landscape, the ability to offer <\/span>integrated healthcare<\/span><\/b> that\u2019s accessible, affordable, and member-focused gives plans an innovative edge over the competition. When health plans embrace advanced primary care, they gain a powerful ally in their mission to improve outcomes and control costs while boosting satisfaction for their members.<\/span>\u00a0<\/span><\/p>\n

At <\/span>Premise Health<\/span><\/a>, we partner with health plans to create smarter, more personalized healthcare solutions that elevate member engagement and satisfaction. Ready to expand access, improve care coordination, and design more impactful benefits? <\/span>Get in touch today<\/span><\/b><\/a>.<\/span><\/b>\u00a0<\/span><\/p><\/div><\/section>","protected":false},"excerpt":{"rendered":"

From the makeup of their workforces to where they operate to their expectations around healthcare benefits, no two employers are the same.\u00a0\u00a0 Health plans are in a unique position, looking to address challenges that are as different as the employers they serve, while also solving one underlying problem that\u2019s important for them all: poor member […]<\/p>\n","protected":false},"author":3,"featured_media":15092,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"12620,4812,13404,13608,11500,11469","_relevanssi_noindex_reason":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[9],"tags":[],"class_list":["post-15091","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-our-services"],"acf":[],"yoast_head":"\nA Health Plan\u2019s Guide to Better Member Experience and More Accessible Care - 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