The Multi-Million-Dollar Value Behind Member Engagement Programs

By David Veroff

A question I often hear from health plan executives is “does member engagement deliver financial value and results?” After extensive research, I discovered that the answer is a solid “yes.”

Most plans have built business cases for specific engagement efforts. However, very few have an all-inclusive sense of the financial value of their efforts. We endeavored to fill that gap and to enable plans to have a consistent yardstick available to make tradeoff and prioritization decisions possible. Our research shows that by becoming better at engaging consumers, health plans can achieve significant financial value.

How much financial value is possible for health plans?

New evidence suggests that moving consumer health engagement rates up by 10 percentage points could potentially double the net income for most health plans. A one million-member commercial health plan in the individual marketplace can produce over $130M ($134/member) in new value by engaging 10% more members with specific needs. This value is comprised of key medical and administrative cost reductions and revenue increases resulting from an array of specific actions that consumers take in response to being more engaged.

This impact on a per member basis was even higher in Medicare Advantage plans. For example, a 100,000-member Medicare Advantage plan can accrue over $30 million ($302/member) in value. See the table below for the financial value per plan type.



Download the comprehensive report, The Business Case for Consumer Health Engagement, to get the full picture. The report goes into depth and explains:

  • How to measure the financial value of engagement
  • Actionable strategies for achieving higher engagement
  • Initiatives that provide the most financial value


What about the financial value for employers and businesses?  

As a follow-up to this research, I also dug deep into the value employers can gain from engaging their employees in their health. My research uncovered that by increasing engagement levels with employees by 10%, businesses with 10K employees and 9K dependents could generate almost $3 million in new financial value. This value is comprised of key medical and administrative cost reductions and productivity gains. Read the full report and learn the real value of engaging employees in their health.