StrategicMemberJourney.pdf

Strategic Outreach Plan for Member Journey

INTRODUCTION

First Learn about the Program

Potential Member Needs:

� What is the WTC Health

Program?

� Why do I need it?

� Am I eligible?

� How will it benefit me?

� How can I get more information?

Communication:

� Initial Outreach Packet � Outreach PowerPoint � Partner Awareness

Campaigns � Social Media Outreach

Campaigns

Desired Results:

� Awareness gain � Percieved need � Inspire to seek info

INTEREST

Looking to learn more

Potential Member Needs:

� Tell me more about the

Program.

� Am I eligible?

� Can I contact someone?

Communication:

� One-pagers/Webpages:

� Eligible Groups defined and compared � “What’s Next?”

� Intro to Program differences � Q&As � FAQs � Rights/Benefits/Covered

Conditions � O&E Partner Assistance/

Events

Desired Results:

� Determines eligibility group � Seeks “Next Steps” � Review Program materials, and application

PREPARATION

Getting ready to apply

Potential Member Needs:

� How do I start the process?

� What is next?

� What is needed?

� How do I benefit?

Communication:

� Enrollment/education products, PPTs. & Web-based info

� What do you need for the application

� Certifications � Detailed benefits explanation � What’s Next � Not Insurance � What’s in it for me?

� Preventive care for

Responders, etc...

� Step by Step Application process

Desired Results:

� Potential member starts application � Gathers required documentation � Next steps/timelines � Medical document/ review/benefits/covered conditions

APPLICATION

Completing and Submitting Application

Potential Member Needs:

� How do I complete and submit the application?

� Where can I get assistance?

� Touchbase (likely critical here to keep process moving)

� What should I expect?

Communication:

� Application Walkthroughs � Application assistance resources � Self/Witness Attestation

Template � Proactive touch-base � Material Gathering � Assistance/Networking � What’s Next � Status Letters

� Recieved � Approved � Denied � Need More Information/

Incomplete Application

Desired Results:

� Complete and submit application � Confirmation contact of application submission status/update

ENROLLMENT

Learning about next steps, waiting enrollment decision

Potential Member Needs:

� How do I find the status of my application?

� What benefits are available now? How do I start accessing them?

� When do I have my IHE?

� How do I find my CCE/NPN provider?

� How do I get in touch with the Program if I need help?

Communication:

� Welcome Letters/Packets � CCE New Member outreach for initial appts � Detailed member benefits � Social media channels communications � Member enrollment experience assessment/ survey (if possible/ applicable)

Desired Results:

� Active member � Contact CCE/NPN for first appointments (if best) � Access benefits � Develop loyal/active member � Tells others

MEMBERSHIP

Member engages in Program benefits

Potential Member Needs:

� How do I get certified?

� How do I find out about the status of my certification?

� How do I access ongoing benefits?

� Where can I stay up-to-date?

Communication:

� Member driven social media campaigns/posts � Program member communications (i.e.

letters, certifications, etc).

� Fact Sheets and Program � Information (Member

Handbook, Covered Conditions, Pharmacy, etc).

� Surveys/member experience assessments if applicable)

� Newsletters, updates, etc.

� CCE/NPN

communications/contact with members

Desired Results:

� Active, loyal member � Positive member � Tells others � Knows how to access benefits

INACTIVE MEMBER

Member does not use Program benefits

Potential Member Needs:

� How do I reengage with the program?

� How do I use the program?

� What is available to me?

� Who can I contact?

*CCE/NPN will manage

Communication:

� Assess inactive membership (most relevant for responders and monitoring appointments)

� Assess member awareness status

� Provide resources from appropriate stages

� What’s changed document/talking point for partners

Desired Results:

� Reengage member

� If needed, IHE and AME scheduled

Stages of the Strategic Outreach Plan for Member Journey

INTRODUCTION

Potential members are individuals who may be eligible for the World Trade Center (WTC) Health Program. In this stage, they will learn about the WTC Health Program for the first time. Products and efforts in this stage focus on general information about the Program as well as Program benefits and eligibility. The goal of this phase is to inform potential members about the Program’s existence, educate about its benefits, assess initial eligibility, and generate interest in the Program. This stage will eliminate some individuals who find they are not eligible from moving on to the next phase. However, it may encourage these individuals to share information about the Program with someone they know who may be eligible. This stage will move potential members to the next phase, Interest.

INTEREST

As potential members move to the Interest phase, they will have more questions related to their personal situation. This stage requires more personalized attention and discovery of the potential member’s 9/11 experience. This also involves a full assessment of a potential member’s eligibility and their eligible group—WTC Survivor, WTC General Responder, FDNY, or Pentagon/Shanksville Responder. In this stage, outreach should include providing resources for a self-assessment and may involve help from the Program’s partners. Products and efforts in this stage should focus on educating the potential member depending on their specific situation and provide more detailed explanations and expectations for the next steps (e.g., responder path versus survivor path), and whether now is the best time to apply. The goal is to provide the potential member with a more detailed explanation of the Program, more specific eligibility information, a path forward, and details on first application steps to help them move through the Preparation stage.

PREPARATION

During the Preparation stage potential members get everything ready for their application.

This stage goes over the required materials, answering any questions about the application and the application process, and providing personalized guidance and assistance. The products and efforts of this stage provide detailed explanations of the application and supporting documentation requirements, expectations of timelines, and assistance to gather and organize their required documentation. The goal of this stage is to set up the potential member to successfully complete and submit their application and required supporting documents. Eligible Survivor applicants who do not have symptoms or conditions that could be WTC-related should be encouraged to prepare and gather the required documents to apply, but wait to submit their application and enroll if/when they experience WTC health-related symptoms or conditions.

APPLICATION

At this stage the potential member is ready to apply! The previous stages have educated the applicant about the Program and prepared to complete and submit their appropriate WTC Health Program application. At this point the goal is that the applicant should be able to submit their application with minimal assistance. However, this stage may require ongoing assistance for the potential member to answer detailed or nuanced questions. Products and activities focus on assisting the potential member to complete and submit their application and any supporting materials that they have already gathered in the previous stage. This will also include any application status notifications. They should already be very aware of the Program, its benefits, and their eligibility group. The goal is to have the potential member successfully complete and submit their application, establish or reiterate expectations (e.g., process and timeline) and provide information about any next steps once an enrollment decision is made.

This stage starts the handoff from O&E partners to Program Member Services and to the

CCE/NPN.

ENROLLMENT

This Enrollment stage is all about the new member experience. This includes the welcome letter to the Program that signifies enrollment. Once an applicant is notified that they are enrolled, there is an opportunity during this stage to review the Program benefits, educate the new member how to navigate the benefits, and go over other resources available to them to access their benefits. In this stage, the Clinical Center of Excellence (CCE) or Nationwide Provider Network (NPN) will reach out to the new member to welcome them to their clinic or network and give them information about accessing care in the CCE/NPN. Products and efforts of this stage should transition the new member from O&E partner resources to their CCE/NPN, provide information on specific Program benefits and any first steps for new members including and not limited to how to schedule their initial health evaluation. This could be a great stage to send out a member enrollment survey as well to gauge the individual member experience with enrollment from Intro- Enrollment stages. The new member should also get information on social media channels and member support numbers. The goal is to help the new member be as self-sufficient as possible and to provide them with all necessary resources to access the full catalog of Program benefits.

MEMBERSHIP

Once successfully enrolled and introduced to the Program, this is the stage of an active member.

The CCE/NPN takes over the role as primary communicator with the individual member at this stage. Products and efforts of this stage focus on ongoing contact and communication with the member about Program processes such as WTC-related condition certifications, available benefits and coverage and their limitations, as well as Program news/updates. As needed, member surveys and feedback may be solicited as well. The goal of this stage (and ongoing) is to develop, support, and retain an active and satisfied member.

INACTIVE MEMBER

This potential stage is about reaching the enrolled, potentially certified member who has stopped (or never started) using Program benefits. Inactive members should be actively re-engaged and supported; the CCE/NPN will handle this reengagement. This may mean that CCE/NPN and/or the Program need to find the member again if they have moved, developed new illnesses, lost employment or other coverage, or any other life changes that may contribute to their inactive status. An inactive member may be in any of the various outreach stages described above. The goal of this stage will be to first identify any lapsed/inactive members, successfully re-engage them to discover underlying reasons for their inactivity, identify the member journey stage that they are in, and ultimately to move them back into an active membership with the Program. This stage includes all work the CCE/NPN do to engage with their inactive members and the work of the Retention workgroup.