Diving into member experiences to drive improved health outcomes

The report was very well received. Escalent pushed us to think beyond what the members should do to change their behavior, and to think about how we can change service delivery to make it easier to comply.

Business Issue

Insurance carriers and their health program partners are growing more interested in understanding the lived experience of their members relative to health practices and interactions with providers. One healthcare company wanted to understand why an insurance carrier’s members weren’t getting the healthcare screenings or taking the medications they should be. Its goal was to build strategies that would close gaps in care among the member population and improve HEDIS scores.

What We Did

People are complex, and the reasons they don’t do things they should are multifaceted. Escalent dived deep into attitudes and behaviors toward healthcare, including environment observation and projective exercises around behavior change. Through a series of in-home ethnographies and in-depth interviews, we outlined individual rationales for non-adherence to reveal ways our client could reduce obstacles to compliance. Simultaneously, we tested concepts aimed at behavior modification to increase adherence.

Result

One of the major findings Escalent unearthed was that our client’s strategies needed to target member behavior indirectly, sometimes through provider assistance to remove basic obstacles patients found burdensome. Our client has since revamped its strategies and is now communicating more effectively. It is also building plans to work with provider organizations to reduce obstacles to patient compliance and increase desired patient behaviors.

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