Blog Post
Member Journey Orchestration: Moving from Roadmap to ROI
Now is a pivotal moment for health plans. There is real opportunity to drive meaningful impact for members while demonstrating clear ROI: All through member journey orchestration. Plans that are leaning in now are finding ways to make smart investments that deliver measurable results within the same year. Teams are advancing approaches that have proven impactful, that they can scale and increase value quickly.
Member Journey Orchestration
When implemented thoughtfully, journey orchestration drives ROI via medical cost savings from better engagement (e.g., preventive care, adherence), operational efficiencies (20-50% drop in service calls), and higher Star Ratings for bonus payments.
Despite the upside, adoption (and sophistication level) varies widely. When it comes to implementation, some plans have it on the long-term roadmap, some are chipping away at a future-state vision, and a small number are implementing at various scales. So, what gets in the way?
At its core, journey orchestration is the deliberate planning and coordination of messages across channels with the purpose of delivering more timely and personalized messages. It might sound easy for someone working outside of a health plan, perhaps even like a no-brainer. The truth is that we know for some organizations, it’s harder to launch than the Artemis II. Despite the known barriers (decentralized data, siloed teams, legacy processes), the experience benefits are only beaten by the financial ones. And if this doesn’t have you running towards orchestration, nothing will.
And here’s the key truth many plans miss:
Orchestration doesn’t have to be everything, everywhere, all at once.
It is About the Symphony, and a Single Movement
The misconception that orchestration must be all-encompassing is perhaps the largest barrier to plans taking meaningful steps for implementation. By helping plans execute on high-value use cases, we’ve been able to realize in-year savings that pay for future investments to scale. We’ve helped plans focus on a single experience journey or on a single care goal that directly impacts experience and medical costs. And no matter how narrow the slice, the impact can be significant.
In one effort to improve adherence for select medications, by reaching out to members through preferred channels and at the right time, the plan was able to improve adherence by 120%, which resulted in over $10 million dollars in medical cost savings for the year.
In another program, by orchestrating pharmacy and preventive care communications, the plan was able to reduce touchpoints by over 50%, and CTA completion increased by over 400%. Both of which can be tied to ROI.
In both examples, the scope was intentionally narrow, and the results were anything but. It was about understanding the opportunity, pulling in the relevant data, and addressing targets at the right time through the right channel.
Moving from Pilots to Scale
Perhaps you don’t know where to start? An accelerated immersion effort to identify the biggest pain points, largest cost drivers, and strongest ROI opportunities can provide a clear, actionable roadmap for orchestration. Instead of guessing where to start, plans can prioritize journeys where coordination will deliver the greatest impact fastest.
Successful orchestration efforts typically follow a few core principles:
- Identify high-value opportunities across key goals: Focus on pain points that cost your business money through lost revenue or increased resources.
- Pilot high-value use case(s): A single use case is all it takes to prove the model works.
- Track ROI and garner executive support- Leaders want to see results before shelling out more funds. Show them the money!
- Scale with the right tech: Ensure your tech stack supports your orchestration goals, without adding complexity.
- Measure, iterate, and continuously improve: Through continuous test-and-learn, identify what’s working well, and what isn’t, and keep getting better.
Member journey orchestration doesn’t require a massive transformation to begin delivering value. With the right focus and execution, even small, targeted efforts can unlock meaningful ROI.
