Solution Brief
Engagement is the New Cost Lever
The Challenge: Rising Costs, Disengaged Members
Health plans are under mounting pressure to rein in rising medical costs. The nature of the business appears to be changing: new medications are turning cancer into a costly chronic condition, additional specialty medications are driving costs for rare diseases higher, and chronic diseases are becoming more frequently diagnosed. At the same time, tensions among providers and payers are fueling an automated coding battle.
Amid these forces, one major cost driver often goes overlooked: low member engagement. Missed preventive care, avoidable ER visits, medication decisions, and site of care choices don’t just affect outcomes—they impact the bottom line. Without thoughtful analysis and proven member engagement and behavior change techniques, costs may continue to spiral out of control.
The Solution: Strategic Engagement to Bend the Cost Curve
Engagys helps health plans tackle cost of care through proven member engagement strategy, analysis, design, and execution support. From identifying high-risk disengaged members and high-utilization populations, to optimizing outreach channels and messages, we use data-driven actionable segmentation, hyper-personalization, and behavioral science to guide the choices of consumers that lead to both better outcomes and lower costs. Whether your goal is preventing readmissions, reducing medication spend, closing care gaps, or shifting utilization to lower-cost sites of care, we support plan operations and drive action.
Cost of Care Reduction Capabilities
Engagys will identify the drivers of cost that can be remediated and take the following steps to achieve a significant reduction in medical costs:
Actionable member segmentation and targeting
Identify and prioritize outreach to members most likely to benefit from preventive or cost-saving interventions. Our methodology not only highlights high cost members, but identifies the barriers and levers that drive real behavior change.
Multichannel engagement definition and design
Design and implement coordinated communications across text, phone, mail, and digital to maximize reach and relevance.
Engagement initiative implementation support
Configure software to implement campaign and program designs, lead systems and user testing, and provide oversight of client teams and execution vendors to bring engagement strategies to life.
Ongoing engagement operations
Lead day-to-day ongoing engagement operations by monitoring performance, flagging issues, optimizing performance, and reporting results.
Performance measurement and continuous improvement processes
Develop and manage comprehensive reporting across all member interactions and create dashboards tailored for both operational teams and executive stakeholders.
Training and building workforce capacity
We’ll train your team to engage more effectively, while freeing up clinical staff to work at the top of their license.
Training Includes:
• Behavioral science techniques: Teach frontline staff how to apply proven behavioral science principles and nudges to boost response rates and drive meaningful behavior change.
• Hyper-personalization: Train teams to tailor messages and timing based on individual member needs and preferences to increase relevance and effectiveness.
• Empathy in action: Guide staff on how to communicate with compassion while motivating members to take action. ow to
incorporate empathy while still moving consumers to change
• Artifacts education: Show how to use simple, everyday materials to empower members to take greater control of their health
Client Results
- $20M in incremental bottom-line savings through improved targeting and reduced unnecessary communications.
- $1M in annual cost reduction associated with a single gaps in care.
- $1.5M in identified savings in prioritized medication concordance/conversion to biosimilars.
- 15% reduction in Medicaid readmissions YOY from implementation of automated call program supported by nurse.
- 2X improvement in PAM scores, achieving higher scores for significantly less cost in a side-by-side test of Engagys trained CSR’s versus motivational coaching-trained licensed nutrition coaches.
Why Engagys?
Unlike traditional consulting firms, Engagys combines strategy with execution. We don’t just build playbooks—we deploy them. Our healthcare-exclusive team brings decades of experience across Medicare Advantage, Medicaid, and commercial lines of business. We align our work to your goals, be it reducing unnecessary utilization, improving Stars performance, or managing total cost of care, while delivering measurable, fast-impact results.
Drive Down Costs by Driving Up Engagement
If your cost-containment strategy doesn’t prioritize driving member behavior change, it’s incomplete. Let’s talk about how Engagys can help your plan reduce spend by connecting with the right members, in the right way, at the right time.
