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It’s a fairly simple equation with a complex—but not impossible—solution. When health plan members trust their plan, they are more likely to use their plan benefits, engage in healthy behaviors and follow treatment plans—all of which lead to improved health outcomes. Unfortunately, trust in health plans is often in short supply, creating a barrier to meaningful engagement, which in turn affects the success of value-based healthcare initiatives like CMS Star Ratings.
The engagement puzzle
Understanding why members don’t engage is crucial. The barriers are multifaceted—ranging from simple, to complex and far-reaching—and cover anything from behavioral (for example, a lack of trust, as already stated, or a lack of confidence that their efforts will have a positive payout) to social determinants of health (for example, they don’t have reliable transportation to get to appointments, they don’t have a clear understanding of why those appointments are even important, etc.). These unengaged members often have the greatest health needs and face the most significant barriers, leading to worse clinical outcomes and avoidable hospital visits.
Engagement is not just about sending a message—it’s about sending the right messaging, in the right way, at the right time. Behavioral science offers powerful tools to uncover what drives each individual and helps us reach them where they are, emotionally, cognitively and psychosocially. These strategies lay the groundwork for trust-building with every plan member—especially those who are the hardest to reach and engage.
The importance of trust
Trust is the foundation of engagement, yet it’s notoriously difficult to build. Negative past experiences, limited health literacy, sociodemographic factors and other factors can all contribute to skepticism. According to a 2024 Kaiser Family Foundation report, only 68% of those in poorer health were satisfied with their health plan, reflecting how health status influences trust levels. The same report also highlighted that 58% of people (even those who scored their plan highly) experienced difficulty using their health plan benefits and 17% were unable to receive needed care as a result—an indication that member trust is often undermined by poor communication and usability.
But the rewards of building trust are clear. When members feel valued and understood, they are far more likely to engage, follow through with treatments and actively participate in improving their health. This translates not just to better outcomes, but to higher member satisfaction, retention and even health plan endorsements.
Building member trust: a behavioral science approach
Trust isn’t just a buzzword—it’s the foundation for meaningful engagement, better health outcomes and stronger relationships between health plans and their members. Behavioral science provides actionable strategies to build and sustain trust, making every interaction count.
Let’s explore how health plans can create trust through personalization, empathy and proactive support.
1. Shift the culture: start with empathy and openness
Building trust begins with a commitment to being member-centric. This means fostering a cultural of openness, empathy and active listening. When members feel understood and supported, they are more likely to engage.
Behavioral science tip:
- Use emotional cues in communication—like affirmations and reflective statements—to show understanding. For example, “We understand managing health can be overwhelming. Here’s how we can help.”
2. Meet members where they are: personalized, omnichannel communication
Effective communication is key to unlocking trust. Health plans need to deliver consistent, preference-based messages across channels where members consume content. This includes using omnichannel outreach across channels—whether it’s a phone call, email, text or app notification.
Behavioral science tips:
- Leverage familiarity. Use a warm, human tone that reflects the plan’s mission and builds rapport over time.
- Tailor for preferences. Ask members how they want to hear from you, then stick to their preferences.
- Be predictable, but fresh. Deliver consistent messaging while adding variety to keep engagement high—like seasonal health tips and tailored reminders linked to a member’s health goals.
3. Build psychological safety: foster open and honest sharing
Trust grows stronger when people feel safe to share information about themselves, their challenges and their goals. Health plans can support an environment of psychological safety by applying behavioral science techniques to their interactions with members. Strategies such as motivational interviewing, which focuses on developing personalized goals based on the member’s needs, wants and challenges, can encourage open conversations that uncover what members truly need.
Behavioral science tips:
- Train outreach teams in active listening and open-ended questioning to understand members’ unique circumstances.
- Offer culturally sensitive interactions to ensure members feel valued and respected.
- Follow up quickly on identified needs, such as offering transportation assistance or connecting members to social support services.
4. Think proactively: support members before they ask
Anticipating member needs shows thoughtfulness and reliability, reinforcing trust. Proactive outreach—such as reminders for wellness appointments or preventive screenings—keeps members engaged and informed.
Behavioral science tips:
- Use nudges like social proof to encourage action. For example, “Did you know? Most health plan members have a wellness visit every year. Members who have one early in the year are 30% more likely to stay healthy all year!”
- Additionally, resolving barriers to care (e.g., transportation to pick up a prescription, financial strain to afford the medication) can make a significant difference in both members’ health and trust.
5. Harness the power of data: deliver personalized and effective support
Data-driven personalization helps health plans meet members’ specific needs. By integrating claims data, interaction history and risk factors, plans can prioritize outreach and avoid repetitive or irrelevant messages.
Behavioral science tips:
- Use positive reinforcement to acknowledge past successes, like medication adherence or appointment attendance.
- Implement feedback loops to learn what works best for individual members, adjusting outreach as needed.
- Avoid over-communication to prevent burnout or disengagement—focus on high-value, actionable messages.
6. Make it a continuous commitment
Building trust isn’t a one-time effort—it’s an ongoing process that requires consistent engagement and refinement. Plans should regularly analyze data, review feedback and improve their strategies to stay aligned with members’ needs.
Behavioral science tips:
- Share success stories of other members (anonymized) to inspire confidence and normalize engagement.
- Use a gain framed message to endorse a service that is small, actionable, and leads to a positive outcome, such as: “Stay on top of your health with our wellness reminders—they’re a simple step toward feeling your best every day!”
Conclusion: trust as a strategic advantage
Trust is the bedrock of healthier, happier members and stronger health plans. By using empathy, personalization and data-driven insights, health plans can create meaningful connections that empower members to take control of their health.
This behavioral science–informed approach not only builds trust, but also drives key metrics—like Star Ratings, cost savings and health equity—while enhancing the member experience.
Start today: embrace a trust-building strategy that prioritizes the member’s perspective, and watch how engagement grows, outcomes improve and relationships flourish.
AdhereHealth specializes in proven behavioral science–based techniques and personalized outreach strategies to build trust and improve engagement. To learn more about our evidence-based adherence solutions, contact us today.
Authored by:
Dr. Chandra Y. Osborn
AdhereHealth Chief Behavioral Officer
