Today I came across something that made me wince.
I went to TPA website and was stunned to see 14 different portal links to choose from. Immediately, my eyes began to glaze over, but I attempted to focus and understand the options available. I learned that 5 of the portals were intended for members, 3 were for providers, 4 for employers, and 2 for brokers. That’s a lot of portals for stakeholders to navigate.
My mind then flooded with other questions. How do members know which portal to use? Are these 5 member portals even being used? And if not, then how effective is the health plan in reducing healthcare costs?
Unfortunately, this confusing multi-portal dynamic is an all-too-common issue for TPAs.
It’s no secret that the health insurance industry is struggling with member engagement. I have a pretty good understanding of health insurance, but that’s only because I’ve been working in this industry for 15 years. The same may be true for you. However, most plan members don’t understand health insurance, are intimidated to try, or would prefer to avoid it (and bear the health consequences).
The sight of 5 portals will not entice members to explore their health plan benefits. Not only must members navigate multiple portals; every additional login, credential, and user interface increases friction. And friction reduces engagement. When engagement falls, preventive care declines, avoidable claims increase, and both member satisfaction and employer perception suffer.
Negative employer perception plays out beyond the performance of the health plan. Employers are increasingly evaluating health plans and TPAs based on member experience. A fragmented digital experience doesn’t just confuse members—it reflects on the employer who selected the program. According to JD Power, one in five employers identifies low employee satisfaction as a reason for changing health plans. [jdpower.com] As digital experiences increasingly shape member perceptions, user-friendly access to benefits information is becoming a competitive differentiator rather than simply a technology initiative.
Ultimately, the burdens of member disengagement are felt by the TPA as well. When members struggle to find their health plan information, their confusion often manifests itself in the form of higher call volumes, escalating administrative costs, and even more difficulty for TPAs to sell the value of their services at renewal.
How can TPAs remove member engagement obstacles so that they can drive better health plan utilization, health plan performance, and better operations overall? The answer lies in simplicity and personalization.
Put health insurance aside for a minute, and let’s learn from our friends in online retail. A study by Cornell found that if consumers had the ability to make an online purchase with 1 click, retail sales increased by 28.5%. [Cornell] That translates into lots of money for retailers, but when we apply that to health insurance, it can translate into lots of savings for health plans.
Think about it. We want members to understand their health insurance, live healthier lives, and prevent unnecessary healthcare costs. But if to understand their health insurance members must figure out which portal to use, how to use each one, and create 5 different login accounts… well, you can only imagine how few members will do that. On the other hand, if we gave members a simple “one login” experience for their health plan, imagine how much member engagement would increase.
We in the health insurance industry must be acutely aware of another consumer expectation: personalization. Consumers expect their favorite shopping websites to know their interests, favorite color, and previous purchases. They expect to see available products based on their location. They expect the website to know when they’re running out of something so that they can get a reminder to purchase again.
If personalization is what consumers expect, then it must be the standard in our health insurance technology. We should already know what provider network the member belongs to and display information accordingly, rather than leaving the member to figure it out himself. We should already know what benefits the member enrolled in last year, so he doesn’t have to figure it out all over again this year. We should already know how long it’s been since the member’s last preventative screening so we can remind him when it’s time to go again.
When integrated digital experiences like this occur, members are more engaged with their health plan, more actively involved in their health, and the positive effects only ripple from there. JD Power research also indicates that among members who have positive digital health plan experiences, 58% are likely to feel more positively about their employer. [Business Wire] Positive member experiences contribute to positive employer experiences, and both ultimately factor into renewals.
The true value of integration is not just fewer portals. It’s the ability to create a unified understanding of the member experience and deliver meaningful guidance at the right moment. But that level of personalization won’t work if members must log into multiple platforms to get it.
Yes, health insurance is intimidating to members. And yes, from an administrative perspective, there are many systems and vendors involved in making a health plan function successfully. However, better engagement starts with simplifying the member experience. Instead of giving members 5 platforms and creating friction, we must integrate them into 1 portal that knows who they are, centralizes their health plan information for them, and delivers the personalized experience they’re expecting.
Health insurance is a complex topic, but which portal to use shouldn’t be. The future of member engagement may not depend on adding more digital tools but rather on making the many tools we already have feel like one experience. In an industry where every interaction matters, simplicity may be one of the most powerful engagement strategies available.