Health plans fall short in maternity care member communication

Member communication doesn't resonate

The problem isn't that health plans aren't communicating; it's that they aren't communicating in ways that resonate with members. That leaves members feeling ill-informed and alone, which could ultimately adversely affect outcomes -- and health plans' bottom lines.

In some cases, payers and members literally aren't speaking the same language. A third of members said they don't receive communications in their preferred language, rendering messages useless for folks with limited English proficiency.

In other cases, the disconnect comes down to poor messaging. For example, only 30% of members said the resources their health plan gave them were helpful. And while 53% of members said they receive text message outreach from their health plans, only 28% said those messages were helpful.

The risks of poor member communication are real. According to the survey, 41% of members didn't feel confident taking their babies home from the hospital. Another 56% said they were at least a little confused about their health plans, as well as health risks during pregnancy.

To their credit, health plans are aware of their member communication problems and are eager to fix them. In fact, 68% of health plan leaders said member engagement and navigation is a key maternal health priority for the next 24 months.

But there's a disconnect between member needs and health plan approaches to communication.

Health plans off-base about member communication needs

Although plans identified member communication as a strategic priority, especially regarding maternity care programs, they aren't hitting on the topics members need.

For example, although health plans think items like cost-sharing, covered benefits, prior authorization requirements and eligibility or redeterminations are most confusing for members, the member survey told a different story. Recently pregnant people said they are more worried about how long their coverage lasts and what services are covered.

Health plans and members are also not in agreement about the most effective communication channels.

Health plans think live phone calls, text messages, and community outreach are most effective, but they are only somewhat correct. Members early in their pregnancy value text messages, mobile apps and printed materials. For those later in their pregnancy, they value engagement that actually supports them in taking care of their baby -- phone or text check-ins with nurses, lactation support and behavioral health support (such as for postpartum depression).

This discrepancy could be risky for health plans, 70% of which said they face significant financial pressures in maternal health. As health plans target their biggest cost centers -- preterm births, long NICU stays and high-cost inpatient stays -- they will need to consider the engagement strategies that will resonate with members and move the needle on outcomes.

Opportunities to connect with pregnant members

Health plans need to consider their members' biggest pain points.

According to the report, members are most confused about these key health plan details:

• How long postpartum coverage lasts (38%)
• What services are covered (37%)
• Copays and deductibles (30%)
• Which hospitals or providers are in network (29%)
• Pre-admission approval requirements (21%)

Health plans should ensure their member communication strategies hit on these topics, but that's not all.

Members noted that they don't feel supported, particularly during the postpartum period, with nearly a tenth of respondents saying they didn't hear from their payer or provider after being discharged from the hospital. As a result, nearly four in 10 members said they felt underconfident in taking their babies home from the hospital.

Ramping up communication during the fourth trimester -- the three months after a member gives birth -- would improve member satisfaction and prevent adverse medical events.

Finally, health plans need to ensure communication is written to actually resonate with members. This doesn't just mean adhering to members' language preferences, although that is important. It also requires keen attention to health literacy and cultural competence.

"Health plans need to rethink how, when and where they communicate with pregnant and postpartum women," according to D'Orazio. "Closing this chasm isn't about increasing the volume of communication. It's about making every interaction more relevant and actionable."

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.