Removing Data Silos for A 360-Member Journey

Payers are seeking new ways to enhance member engagement and drive long-term retention.

This podcast explores a powerful new-to-market strategy for transforming how health plans design member journeys to create a seamless experience in a combination of offline and online environments.

Don’t miss the insights in this episode that will redefine how your plan approaches member engagement.

Host: Welcome to today’s episode: Removing Data Silos for A 360-Member Journey. If you’re tuning in today, you’re in for an insightful conversation with Barb Ody. Barb is a payer consultant and expert in member experience solutions, implementations, business intelligence, data modeling and analysis, and workflow optimization. Today, we’re discussing how we can future-proof healthcare by improving member engagement and retention. Barb, thanks for joining us today!

Barb: Thanks for having me. I’m excited to be here!  

Host: Barb, tell me about your career: at what point did you realize that the member journey in healthcare was outdated and jeopardizing both member and plan outcomes?

Barb: I’ve worked in healthcare in some capacity for over 30 years and before coming to the delivery team at UST HealthProof, I worked in clinical business informatics where our primary goal was to drive member outcomes using healthcare data. We know healthcare is a complicated system that can lead to confusion and frustration. Right now, healthcare is in a somewhat reactive mode. Member engagement can be sporadic based on the member’s health status and how frequently they engage with the healthcare system. In the past, members didn’t think about their health until they absolutely had to—until they got sick or needed a procedure. But now, we’re seeing a shift toward proactive member engagement to support the proactive healthcare model. It’s all about developing a relationship with the member, not just when they’re in crisis mode but throughout their entire healthcare journey. That means fostering an ongoing relationship, not just a transactional one.

Host: So, it’s about giving members the tools to take charge of their health long before they need urgent care. That’s a much-needed shift in the healthcare mindset. But Barb, we all know individualized healthcare is complicated with a wide range of services available for both current care and proactive care. So, what’s the biggest challenge we face when it comes to engaging members?

Barb: One of the biggest challenges is the fragmentation of operating systems. You've got multiple systems, various data sources, and different channels that rarely sync up. So, members are getting inconsistent experiences. For example, one day a member checks their benefits on the app, and then they call customer service only to get a different answer. This creates a lot of frustration and distrust.  

The goal has to be to make things easy on the member. What are their pain points? Evaluate the channels that are available. The member journey is a combination of different channels. It’s not just going to be all human interaction or all digital. Nope, it’s a combination of online and offline interactions like in-person, call centers, email, apps, and portals.  

Also, plans need to consider who the stakeholders are that affect the members but who are outside of the plan itself, like providers, brokers, and employers. All of these touch points have to be integrated into one unified member journey.

That’s where a connected ecosystem comes in. Plans need to integrate all the pieces—the data, the technology systems, the touch points—so that members get consistent, reliable information no matter how they interact with the plan. It’s about eliminating silos. The way I see it, the industry needs to create a Netflix experience for healthcare. You know, identify member preferences over a series of interactions and then serve members the information they need and want in the way that suits them best. If you look at Net Promoter Scores for other industries, it’s much higher than healthcare. I think the technology sector is 30+, whereas healthcare is 10-20. As an industry, we can do much better.  

Host: If I’m a plan with a disconnected, fragmented member experience, what’s the first step in understanding how to thoughtfully redesign the journey?  

Barb: It’s necessary to look at each step a member takes with the plan—from their initial enrollment to how they interact with their benefits, and what happens when they need support. These key touch points are the moments that matter. If we can identify where members are most likely to drop off, we can design an intentional experience to resolve critical areas of dissatisfaction. It’s not just about the member’s first interactions, although first impressions are important. But beyond that, once a member is engaged, there has to be a strategy for keeping the member engaged. And retention comes down to the value the plan provides.  

If members feel like they’re getting real value—whether it’s easier access to care, more straightforward digital tools, or just a more consistent experience—they’re much more likely to stick with you. It's about more than just responding to needs when they arise. It’s about making sure that when members do interact with the health plan, they’re getting an experience that’s easy, reliable, and supportive. This ongoing engagement drives loyalty.

Host: You’re talking about providing value beyond the basics. And, you’re right, when members feel valued, they’re more likely to stay with the plan. Now, let’s talk a little more about those key strategies. How do we go about creating a better member experience, and ultimately, better retention, using the tools available to us today?

Barb: Well, it’s all about designing an experience that makes sense for the member and removing the friction in their interactions with the plan. This can only be accomplished with a connected ecosystem where all the systems and channels are connected—and sharing data.  

Host: So, data isn’t just important for the health plan to function smoothly—it’s essential for providing that tailored, personal experience for the member. So, the system stays ahead and anticipates the member’s needs, and ensures all channels are consistent with the information it’s serving the member. That way, whether the member speaks to call agent or chooses a portal chatbot—it’s providing the member the same information.  

Barb: Exactly. Data isn't just about tracking things for the sake of tracking. It’s about using that information to create a more personalized experience. If we know what a member needs or prefers, we can make sure we’re delivering that to them—whether it’s a simple notification, personalized advice, or even a follow-up on care. Think of data as the foundation of everything. The recipe for a 360-member experience is data that flows seamlessly throughout a connected ecosystem. Once we have that ecosystem in place, we can layer on automation to handle the simpler tasks, leaving the more complex interactions to human agents.  

Host: Can you provide an example of how automation plays a role in the ecosystem?  

Barb: Automation helps streamline routine tasks and interactions, meaning members don’t have to wait on hold for simple inquiries like checking their claim status or even ordering an ID card. It’s about taking care of the easy stuff with automation so that human agents can focus on more complex, value-driven tasks. But also, the design of automation is critical. You want to make sure that handoffs from chatbots to agents are so smooth that it doesn’t feel like a separate channel. It has to be thoughtfully designed and executed. Plans need to be using AI and chatbots to help members get simple and fast answers. From a plan perspective that’s the most cost-effective option, and from a member perspective, it’s the most efficient use of their time. The ecosystem enables this journey and makes this possible for members through a unified data environment.

Host: That connected ecosystem really is the foundation. But when you layer in automation, AI, and chatbots, you start to see how this can be a game-changer. Now, here's the big question: what's next? If a health plan is just getting started, how do they ensure they’re headed in the right direction?

Barb: A connected ecosystem being fed by a data hub is absolutely essential. It powers everything we do. If we don’t have accurate, up-to-date data on a member’s journey, how can we possibly provide a meaningful experience? Whether it’s understanding a member’s health history, preferences, or just their basic benefits, data is the backbone of personalized care. The better we connect the dots between that data and the member’s experience, the better the outcome for both the member and the health plan.  

Host: That sounds like a win-win for everyone. Barb, this has been a great conversation. Thank you so much for sharing your insights. It’s clear that improving member engagement and retention is about more than just meeting immediate needs—it’s about creating a lasting relationship.

Barb: Thanks again for having me! It’s been a pleasure.

Host: And thank you to our listeners for tuning in today! We hope this episode gave you some great insights into how you can start building a better, more engaged relationship with your members. Remember, it’s all about connecting the data, streamlining the process with automation, and providing value at every touchpoint. Thanks for listening, and we’ll catch you next time.