Understanding and Managing Member Behavior at Scale: A Key to Enhancing Member Experience and CAHPS Results
As technology and innovation continue to advance, we find more ways to delve into the human mind and the motivations that drive our behavior
At MedOrion, we are on a quest to understand what motivates and engages members and to define and address their barriers at a granular levelBy leveraging AI and behavioral science, MedOrion’s SaaS platform can help health plans not only identify but also address these barriers effectively and at scale.
The Importance of Understanding and Addressing Individual Barriers
Member experience is intricately linked to engagement and compliance with treatment plans. In today’s healthcare landscape, understanding and addressing individual barriers is not optional—it’s a necessity for health plans seeking to excel.
Despite a robust body of research in health behavior and communication theories, these insights remain underutilized when implementing new technologies and interventions to enhance member engagement. MedOrion bridges this gap.
MedOrion’s Innovative AI Solution
MedOrion’s platform stands out in the industry by using behavioral science models combined with AI to identify the specific barriers each member faces. Whether it’s knowledge gaps, self-efficacy or access to specialty care issues, MedOrion’s Electronic Behavioral Record (EBR) technology provides a clear picture of what holds members back.
Here’s how MedOrion helps address member barriers more effectively:
- Data Harmonization: the platform integrates various data sources—claims, social determinants of health (SDOH), demographics, and more—to create comprehensive EBRs. This harmonization process identifies specific barriers
- Automated Barrier Identification: MedOrion’s solution automatically detects barriers at an individual level, allowing health plans to prioritize interventions based on real-time insights.
- Personalized Engagement Strategies: Once barriers are identified, the platform generates tailored persuasion strategies for each member. These strategies are delivered across multiple channels, ensuring that communication is as effective as possible in engaging members.
- Continuous Improvement: By measuring the impact of interventions against control groups, MedOrion continuously refines its strategies to enhance effectiveness, leading to sustained improvements in CAHPS measures such as Getting Needed Care and Getting Appointments and Care Quickly.
Impact on CAHPS Scores and Member Experience
MedOrion’s innovative solution has proven to significantly reduce Access to Care complaint rates by up to 47%. This impressive result highlights the platform’s ability to identify and address the genuine barriers that hinder members from accessing the care they need. By effectively resolving these issues, MedOrion not only enhances CAHPS scores but also fosters trust and loyalty among members, providing health plans with a distinct competitive advantage.
A Partner You Can Trust
Since 2017, MedOrion has been at the forefront of using AI and behavioral science to improve health outcomes. Our platform has been trusted by leading health plans, managing millions of members, and addressing numerous quality measures. By partnering with us, health plans gain a powerful ally in their quest to close care gaps and enhance member experience.