4 Health Plan Member Engagement Solutions

Health Plans

4 Health Plan Member Engagement Solutions

Ash Team

Effective member engagement is essential for promoting better health outcomes and satisfaction. In this blog, we delve into the significance of tailored communication and education initiatives, exploring how health plans can leverage data analytics and member profiling to deliver personalized messaging that addresses member health needs, preferences, and goals. Additionally, we examine the role of at-home diagnostics in proactive monitoring, discussing how these tools enable health plans to identify key health metrics early on, aligning with industry standards such as HEDIS and Star metrics

1. Personalized Communication and Education

Tailored communication and education initiatives are foundational to effective member engagement. Health plans can leverage data analytics and member profiling to deliver personalized messaging that addresses individual health needs, preferences, and goals. By providing relevant information about preventive care, chronic disease management, and wellness initiatives, health plans can empower members to make informed decisions about their health. Additionally, interactive educational resources such as webinars, videos, and mobile apps can enhance engagement by offering valuable insights in a user-friendly format.

2. At-Home Diagnostics for Proactive Monitoring

At-home diagnostics allow health plans to proactively monitor member health by sending kits home. These diagnostics, ranging from blood tests to urine tests, offer insights into key health metrics, enabling health plans to flag expensive diseases early on. This proactive approach to healthcare helps health plans meet HEDIS and Star metrics with at-home diagnostics targeting specific verticals, such as those for colorectal cancer, diabetes, kidney health, and chlamydia.

HEDIS measures at-home diagnostics target

  • Diabetes: Comprehensive Diabetes Care for HEDIS requires HbA1c testing for adults 18–75 years of age with diabetes.
  • Chlamydia: HEDIS contains a measure which assesses chlamydia screening coverage of sexually active young women who receive medical care through commercial or Medicaid managed care organizations.
  • Colorectal Cancer: HEDIS assesses if adults 50–75 who had appropriate screening for colorectal cancer with an annual fecal occult blood test.
  • Kidney Health: HEDIS contains a measure that assesses whether adults 18–85 years of age with diabetes (type 1 and type 2) received an annual kidney health evaluation, including a blood test for kidney function and a urine test for kidney damage.
  • Lead: HEDIS tracks the percentage of children who have one or more capillary or venous blood tests for lead poisoning by their second birthday.

Medicare star measures at-home diagnostics target

  • Diabetes: Medicare Star Ratings award higher scores in Part C for plans that record patient HbA1c control and kidney disease monitoring. 
  • Colorectal Cancer: Medicare Star Ratings in Part D track colorectal cancer screenings in members. 

Read more about how health plans can increase HEDIS scores. 

3. Wellness Incentives and Rewards Programs

Incentives and rewards programs can serve as powerful motivators for encouraging healthy behaviors and driving member engagement. Health plans can design incentive programs that reward members for participating in wellness activities, achieving health goals, and adhering to preventive care guidelines. These incentives may take various forms, including discounts on premiums, cash rewards, gift cards, or contributions to health savings accounts. By aligning incentives with desired behaviors and outcomes, health plans can incentivize positive health choices and cultivate a culture of wellness among their members.

4. Community Engagement and Support Networks

Building a sense of community and fostering peer support can significantly enhance member engagement and satisfaction. Health plans can create online forums, social media groups, and community events where members can connect with peers, share experiences, and offer support. By facilitating peer-to-peer interactions, health plans can provide valuable emotional support, encouragement, and practical advice, particularly for members managing chronic conditions or undergoing significant health challenges

How Ash Wellness works with Health Plans 

Ash Wellness enables health plans to leverage the benefits of in-home diagnostic testing to enhance member care and achieve superior outcomes. We facilitate the early detection of health issues, thereby decreasing long-term care costs for both members and health plans. Moreover, at-home testing promotes greater patient engagement, resulting in enhanced adherence to treatment plans and healthier lifestyle decisions. This contributes to heightened quality ratings for health plans.

Our comprehensive at-home testing solution encompasses various services, including customizable API-first and white-label platforms, kitting services, provider network management, lab contracting, and testing. With an unwavering commitment to data security, privacy, and seamless integration with existing healthcare infrastructures, Ash Wellness emerges as the preferred partner for health plans seeking to successfully implement in-home diagnostic testing.

Schedule a time to chat with Ash Wellness about our at-home testing solution for health plans. 


In conclusion, effective member engagement is pivotal for driving better health outcomes and satisfaction within healthcare systems. Through tailored communication and education initiatives, health plans can empower members to make informed decisions about their health by leveraging data analytics and member profiling. Furthermore, the integration of at-home diagnostics enables proactive monitoring, aligning with industry standards such as HEDIS and Star metrics, and facilitating early intervention for costly diseases. 

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