Patient Responsibility News

How Health Payer Communication Boosts Patient Care Access

Independence Blue Cross created a health payer communication tool that informed patients of their care needs and how to access treatment within their coverage network.


Source: Thinkstock

By Sara Heath

- Patient care access and preventive treatment are hallmarks of meaningful patient engagement. However, due to insufficient health payer communications with other stakeholders, patients are often left in the dark about whether or not their payers will cover certain services.

Independence Blue Cross wanted to close that gap in payer-patient communication, equipping beneficiaries with the knowledge to make their own healthcare decisions within their coverage network.

“In a consumer-centric world, it is increasingly important to be able to create the most impactful and personalized customer experience you can, and ensure that members are able to access the information they need at the right time,” said  Paula Sunshine, Senior Vice President and Chief Marketing Executive, in an email to “And more and more, these kinds of interactions occur over digital channels.”

According to Sunshine, efforts to improve payer-beneficiary communication were not entirely foreign to Independence, but they were noticeably falling short of meaningfully engaging patients. In the past, many payers, including Independence, have utilized emails, telephone calls, and mailed printouts to deliver information to patients about their wellness and health plans.

As consumers continued to gravitate toward mobile tools, Sunshine and her team at Independence realized there was an opportunity to continue to engage patients in wellness and health plan education.

READ MORE: Payer Patient Engagement Key for Chronic Disease Management

“We were watching as consumers transacted more of their business from their mobile phones, using digital channels to manage everything from their bank accounts to their personal relationships – and we saw an opportunity to communicate with them in the way they wanted to be reached,” Sunshine said. “The forms of communication we had long relied on as an industry simply weren’t driving the same level of engagement they once did.”

Independence began working with RelayNetwork to develop IBX Wire, an opt-in tool that offers one-to-one patient engagement. The tool offers patients resources to learn about care management and how to access care within their coverage network.

“We made this change to the way we were communicating with members, and in less than one year, we tripled the response rates that we would normally see with direct mail, and also drove increased member engagement with other digital tools, such as our provider finder,” Sunshine said. “It was clear to us that shifting our strategy was working in allowing us to be better partners to our members.”

At the onset of the intervention, Independence used IBX Wire to issue broad prompts such as flu shot reminders. The payer also used IBX Wire to send very basic population-based messages.

“We saw tremendous click-through rates and open rates on these messages, so we knew the channel was working,” Sunshine said.

READ MORE: How Out-of-Pocket Costs Affect Patient Healthcare Access

As Independence continued to develop IBX Wire, it took steps leading them closer and closer to personalized health.

“We worked to make the information we were sharing through the channel more impactful and more targeted,” Sunshine explained. “Now, not only can we send general messages for people like me, we are also sending personalized messages for me too.”

For example, Independence had a high population of patients who had gaps in care. These patients needed to undergo necessary preventive tests, or fill prescriptions key for managing a chronic illness.

The health payer used IBX Wire to communicate these gaps to their patients, informing them of where they can receive necessary care and how they could do so within their health plan benefits. Thus far, personalized messages have resulted in a 57 percent closure in care gaps, Sunshine reported.

The tool also helps support better access to preventive care. Using patient population data, the tool sends patients messages about when they should access a certain screening again, or reminders for annual physicals. By including their provider finder on IBX Wire, Independence ensures patients know where they can access services covered by their health plan.

READ MORE: What Providers Should Know to Improve Patient Access to Healthcare

According to Sunshine, the success of IBX Wire relies on including wellness information in the context of a patient’s coverage. Understanding health plan information is critical to ensuring patients can access care. By putting all of this information in one central location, Independence makes healthcare access and plan navigation simpler for patients.

“The tool helps members maximize their health plans by keeping them better informed about their medical benefits and how to use them,” Sunshine said, noting that a deeper understanding of health plan benefits helps patients make their own decisions about care.

As healthcare increasingly becomes consumer-centric, it will be important for health payers to follow suit. Increasing patient communications will help patients understand their healthcare and how they can access it through their payers, ultimately driving better care utilization and, ideally, outcomes.

“Effective and personalized communication between businesses and customers is rapidly becoming the norm across industries,” Sunshine concluded. “In the healthcare industry particularly, these communications can have a real, measurable impact on people’s health, making it even more crucial for us to continue improving and innovating around the way we’re connecting with our customers.”


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