Participation and Engagement Are Not The Same Thing

I gave a talk to a group of businesses on the transactional side of health care the other day. My topic was to provide my perspective of approaching “consumer engagement” for the transactional side of health care from the lessons learned from the health and wellness side.

I spent a lot of time thinking about the topic. The politically correct approach would have been to provide all of the appropriate statistics to show how incentives, benefit designs, and the other “economic” approaches were improving participation in wellness programs (47% participation in completing a Health Risk Questionnaire with an incentive and 26% without) and how innovative communication/marketing strategies improve participation, and all of the other stuff. The politically correct approach would have been to say to just take what we’re doing so well on the health care side and use it in some of the other areas.

But, my topic was engagement, not participation.

Engagement, to me, is deeper. Engagement is commitment, its understanding the context, it’s taking steps beyond the minimum necessary to get by or getting paid to do it; it’s becoming part of the solution.

As I put my thoughts research together I began to realize (actually I had always assumed) that consumers aren’t engaged in health care. Seventy-five percent don’t understand it and many continue to be frustrated by it. Yes, the participation numbers may be improving for some of the wellness/preventive components (25% on average but higher for some program areas and for some organizations in general). However with such a high confusion factor and a health care literacy rate of only around 15% we could do much better. Add to that an industry “trust ranking” of Health Insurance and Managed Care only above Telecommunications, Oil, and Tobacco I concluded we might have a problem with real engagement.

My message to this transactional group ended up being that they need to be aware that they may be “branded by a brand” in health care and the health care brand with consumers right now is not all that hot (except with hospitals and doctors). I told them that they need to be aware that consumers were being asked to play many roles in health care today (Benefit Manager, Financial Manager, Care Navigator, Legal Manager, Information Manager, Personal/Family Wellness Manager) and they need to look at consumers in the total context as they develop products or strategies impacting a single one. I told them they would need to provide the appropriate guidance to consumers to help them fill their role as an Informed Health Care Consumer. And, building trust with the consumer would be a key to building engagement.

Yes, you can certainly improve the participation numbers by paying people and designing benefits to influence what they do. For most, the participation will only be short-term and dependent on continuing to pay them or maintaining the benefit structure directing them what to do. However, if you have them engaged, the participation numbers will be longer-term and the approaches you can use are more flexible. You may not even need to pay people to get them to do the right thing.

This transactional group was only interested in participation- not real engagement. They wanted to hear how incentives and economic structures could drive people to their businesses. They wanted to hear me validate what they were doing today and how participation (how many bodies) was the real indicator- not engagement. I think they wanted to hear the standard stuff. They didn’t want to hear about reality of the consumer perception of health care today.

Well, I still believe building trust in this industry is the real key to engagement. And, building trust starts with confronting the reality of where you are today and what may need to do to change. You build trust with open communication, honesty, integrity, and partnerships. You build trust with collaboration and dialogue. Building trust is more than just a software application, an incentive program, or an HRA. It’s about building a relationship with an individual.

Transactional health care may still be focused on participation. The real solution is engagement- and that’s tougher to earn.