Health Engagement Management

8 Reasons to Pre-Board your Members Before the New Year

Have you ever thought about “pre-boarding” your members?  Why not reach out early to engage members before their effective date, especially if it means you can identify transition of care needs.

Pre-boarding new healthcare members before January 1 preps them for a smooth transition to their health plan in the new year. Timely, personalized outreach goes a long way in the minds of your members.  Behavioral research demonstrates that little things make a big difference when it comes to social interaction.[i] Let them know that you are thinking of them and are ready to take care of them in the New Year.  A warm welcome can help ease any anxiety and supports them into new benefits.

Don’t wait until January to educate members on plan benefits, collect critical contact and consent information or identify transition of care needs when you can do it now. Pre-boarding can reduce costs, improve satisfaction and retention in the long run.

Here are eight reasons to pre-broad your members:

  1. Identify transition of care needs  
  2. Collect critical contact and consent information including email addresses, cell phone numbers and permission to contact via text and email
  3. Ease anxiety for new members by reassuring them they have coverage starting the first of the year
  4. Educate members on their plan benefits
  5. Remind members to be on the lookout for their new ID cards
  6. If applicable, make sure members understand how to make premium payments
    {15% of Marketplace enrollees fail to make their first premium payment and never effectuate their enrollment. Get ahead of this problem by welcoming members to the plan before their benefit year starts and remind them to make that first payment to ensure they’re covered on January 1.}
  7. Reduce the burden on your call center's anticipated January 1 volume
  8. Member loyalty and retention starts with your welcome message 

Contact us today at, 844.343.1441, so we can create your pre-boarding program so you can successfully onboard your members for a healthy 2018.  

Contact us

[i] Psychology Today, Mar 06, 2012, Sam Sommers PhD.


Oral Health Is No Laughing Matter


Oral Health Is No Laughing Matter 

There is no debating that oral health is linked to physical health. Poor oral health is linked to a host of problems, including heart disease, endocarditis, premature birth and low birth weight. Even mental health can be affected as it did to this mother of three from Wisconsin, who hid her smile and pain from her children for years.
Unfortunately, low-income populations are more adversely affected by oral health problems, due to the lack of coverage and access to care. While Medicaid provides preventive dental services for children, not all states provide oral health benefits for non-disabled adults. Dental programs are often on the budgetary chopping block because they're not required benefits and even when benefits are provided, it’s hard to find a dentist who will accept Medicaid patients. An issue brief by the Kaiser Commission on Medicaid and the uninsured reported that in 2013, only about 1 in 5 adults with income below 200% FPL had a dental visit in the past year, compared to 1 in 2 adults with income above 400% FPL. (fig.3)

Inform, Remind and Persuade 

It is critical to help engage those individuals who do have access to dental coverage. Eliza helps health plans boost member compliance with annual preventive dental visits by intervening with education, reminders, and appointment scheduling services through a variety of channels including automated phone, email, text and live agents.  

Eliza’s unique engagement engine is fueled by over two billion interactions and allows us to determine when and how to best reach and motivate individuals to take action. Sometimes it is as simple sending a text reminder to see their dentist, or educating members that oral health is more than having a nice smile. It could mean helping a member find a dentist or scheduling an appointment. Our conversations uncover barriers to care, providing health plans with valuable insights and members with real-time help to get the care they need. 

Something to Smile About

Eliza’s dental programs have resulted in a 25% improvement in the number of scheduled appointments for one plan, 15% higher than program goals. We improved another plan's preliminary Annual Dental Visit HEDIS rate by 5.5% for those members we reached. In a separate year-end gap closure outreach program, Eliza facilitated over 1,500 preventive dental appointments, an improvement of 13% compared to those who were not reached. 

For more information on Eliza’s preventive care programs, contact us at or 1.844.343.1441. 



Tis' the Season of Annual Notice of Change (ANOC).

‘Tis the season of annual notice of change (ANOC).  2016 will be especially different than any year prior.  We are now a couple years into the federal exchanges, and because of this the uninsured population is shrinking, and in turn, the number of Americans entering into the US health system is rising.  Utilization has never been higher.  With this rise has come significant premium hikes.  Across the country, many plans are raising premiums.  The question is, will members and companies come back as the price goes up?

According to the Wall Street Journal, some plans raised rates because of the newly insured.  One plan “…demonstrated the hefty increase for 2016 was needed to cover higher-than-expected claims from sick people who signed up for individual policies in the first two years of the Affordable Care Act.”

WSJ Image courtesy of the Wall Street Journal


















This week at the Connected Health Summit, companies across all industries spoke about consumerism and the power consumers have over how they want care delivered, how much they want to pay, and how long or little they are willing to wait for it.  In fact, this morning, Cigna, Doctors on Demand, MDLIVE, iTriage, and Health Spot spoke at length about cost transparency, telehealth, and access to care.  Their clients’ expectations continue to grow, and expect that to be seen this year when people are choosing who they want to cover their health insurance.

As members go online to renew coverage for Medicare Advantage plans or individual plans, expect there to be intense scrutiny of not only price, but value.  Consumers want to be informed about their plan, for example, whats the availability of telehealth providers, what are the location of clinics close by, and how much will additional services like these cost.

At Eliza, we partner with clients to deliver outcomes that make a difference- both clinical and financial.  With Eliza’s ANOC solution, our clients have recognized results such as:

  • A reduction of inbound calls to member services by 40% during the annual enrollment period and Q1
  • Over 110% operational cost-savings through call deflection

To learn more contact us at or 1.844.343.1441.


Health Engagement: One Size Doesn’t Fit All

If you spend more for something, you expect better quality, right?

According to the Commonwealth Fund’s latest view of Medicare spending per capita vs. overall quality score, the data says otherwise for many states.  For example:

  • Louisiana has 25% higher spending than the national average, but their quality is 14% lower than the average
  • In New Jersey, the per capita spending is $9,587 vs. Oregon is only $6,380

What about those states that score high (average 4-5 STARS) on Medicare Advantage STAR scores such as Michigan, Massachusetts, and Illinois?  Their overall numbers may not be as low as Texas, Louisiana, and Florida, but their costs are still high versus quality.

  • Michigan: $9,521 per capita spending with 11% higher in spending, for only 1% improvement in quality over the national average.

The overall view that combines hospitals, doctor’s offices, home health, and nursing home numbers is below.  You can see there is almost a slight tip to the south and east- a bit of a corridor. Blog - 7.16_1

It gets even more interesting when you look at the subgroups like home health.  Some of the states that had a normal rating overall, quickly slip when you look at home health on its own. See below: Blog - 7.16 (2)

When home health is viewed on its own a few staggering data points float to the top:

  • Texas: 182% higher spending and 2% lower quality
  • Florida: 148% higher spending for only 5% higher quality

How are payers, providers, and other healthcare entities changing the game?

Interestingly enough, PBS just published a series on a quiet revolution that has a goal of improving care while at the same time lowering cost.  In fact, the caregivers they highlighted focus on listening and putting the patient at the center of care from Maine to Mississippi, all the way to Alaska, and they are caring in the way that makes sense for their community.  This means house calls in small town Maine, a mixture of traditional and spiritual methodology in Alaska, and a hospitable approach in San Francisco.

Eliza takes a similar approach to solving client and patient problems.  Through conversations- whether on the phone, over email, or through a text, Eliza uncovers barriers to better quality, better outcomes, and improving costs.  We do this by tailoring our programs to meet the needs of our clients and the people they serve.

At Eliza, we know that one size does not fit all.

For example, in a recent preventive screening outreach to Medicare members, Eliza was able to not only improve completed screenings, but also uncover barriers such as transportation challenges, concerns about comfort, and even apathy.

Blog - 7.16 (2) 

By taking a conversational approach to healthcare, a laser-focus on peoples’ motivations, their concerns, and their reactions to the initiatives supported, Eliza knows what makes people “tick” – and the technology and content constantly are fine-tuned to honor consumers’ unique challenges and preferences to effect small changes in behavior across different populations. These small changes lead to better engagement and better outcomes. As a result, Eliza is uniquely qualified to deliver more granular data to clients about how people are behaving. Eliza also is able to refine recommendations and implement strategies that leverage this data in order to drive desired outcomes for clients.

To learn more about Eliza’s preventive screening solution, or any of our Eliza for Medicare solutions, please contact us at or 1.844.343.1441.


Let's Connect