Five Pitfalls Health Plans Should Avoid When Designing Gaps in Care Campaigns

1. Not Segmenting on Past Behavior 

Health plans are flush with consumer data including demographic, attitudinal, and behavioral. But one of the most predictive data points is often overlooked - past screening behavior. When it comes to driving healthcare behaviors, the best predictor of future completion is prior completion. 

Members who completed their screenings last year or the year before are far more likely to complete them again with minimal prompting. Conversely, members who have skipped screenings for several years, or never completed them at all, need different, more intensive outreach. 

Failing to segment by past behavior means plans miss an easy opportunity to: 

• Prioritize low‑effort, low‑cost touches where they work
• Allocate higher‑touch resources to members who need more support
• Avoid wasting outreach dollars on people who will act with minimal prompting 

Using past behavioral data works. For example, behavioral analysis and personalized messages led to a 30% jump in screening completion in a previously unengaged population.  

2. Ignoring Channel Preference 

Members have been telling health plans how they want to be contacted for years, but it’s only recently that plans are consistently acting on it. 

When designing gaps in care campaigns, always begin with a member’s preferred channel, then adjust based on engagement data. For example: 

• If members say they want calls but never answer, it’s time to test another channel.
• If members prefer SMS but PHI restrictions apply, start with compliant digital channels such as email.
• If there’s no channel preference data available, adopt a cascading, multichannel approach that moves from low‑cost (portal notifications, email) to higher‑cost (automated calls, then direct mail). 

Honoring preferences can increase results. For example, in a behavior change program, matching segments to the right channel doubled program results.  

3. Including One‑Off Incentives 

Using incentives is tempting, after all, who doesn’t love a gift card? But for annual screenings, incentives can create more problems than they solve. 

One‑off incentives often: 

• Spike completion in the first year
• Depress completion in subsequent years when the incentive disappears
• Train members to “wait for the offer,” delaying care 

It’s the same psychology behind waiting until Black Friday to buy a TV. Why act now if you know the deal is coming? 

For screenings that occur annually or biannually, incentives can unintentionally reset expectations and hurt long‑term performance. Sustainable strategies focus on personalization, behavioral science, and clear barrier‑breaking communication, not transactional motivation alone. 

4. Using One‑Size‑Fits‑All Messaging 

Even the best segmentation strategy fails if everyone receives the same message. Members who are typically up‑to‑date may only need a quick reminder such as, “You’re due for your mammogram - schedule today to stay on track.” 

But members who haven’t completed a screening in years need something different: 

• Personalized references to their last completed screening
• Barrier‑specific support (prep concerns, cost questions, logistical challenges)
• Emotional motivators aligned to their profile (e.g., moms responding to family‑oriented framing) 

And the results speak for themselves. Engagys’ personalized messaging (with member-specific details and tone) led to a 30% improvement in closing cancer screening gaps as compared to a generic message group. 

5. Skipping “Test and Learn” 

Even for long‑running gaps‑in‑care campaigns, testing new elements can produce big gains. Small changes matter, such as: 

• Email subject lines: Behavioral science‑based framing can drive higher opens and conversions.
• Caller voice: One Engagys test showed a male voice improved colorectal screening completion among a Hispanic member segment by nearly 90%.
• QR codes: Adding an easy way to access digital scheduling tools can increase appointment rates. 

Plans that avoid experimentation risk missing the exact insights that could move their HEDIS scores. 

Bottom Line 

Designing gaps‑in‑care campaigns is both science and strategy. The biggest pitfall is failing to zoom out. Effective campaigns require a clear understanding of member behavior, preferences, and motivations, not just a list of members who are “due.” 

The plans that excel are the ones that: 

• Start with the member experience
• Deliver through the right channel
• Match content to need
• Personalize relentlessly
• And never stop testing 

When health plans build campaigns that support sustained engagement, not just one‑time action, they see the difference in outcomes including better screening rates, improved quality scores, and healthier populations. And ultimately, that’s what National Cancer Prevention Month is all about.