In a time when healthcare is becoming more patient-centric, member experience isn’t just a trend, it’s essential for long-term growth. How health plans interact with and treat their members is a matter of success or failure.
According to a survey conducted by Healthcare Finance, only 45% of healthcare consumers are fully satisfied with their health insurance. A staggering 55% want more from their respective health plans, including more personalized care. This decline in trust and satisfaction is commonly referred to as member abrasion.
Understanding member abrasion and implementing ways to combat it will help health plans better understand how to provide tailored care to members and ultimately improve outcomes.
What is member abrasion?
Member abrasion is the deterioration in the relationship between health plans and their members, often caused by poor communication, impersonal interactions, and misaligned or excessive outreach.
Take for instance a member with diabetes who first receives a call from their health plan’s pharmacy benefit manager (PBM) to discuss medication adherence. Shortly after, they’re contacted by a disease management program to talk about lifestyle changes related to their condition. Later, a third-party medication therapy management (MTM) service reaches out to schedule a comprehensive medication review. Although each call is well-intentioned, the lack of coordination among these outreach efforts can leave members feeling overwhelmed, confused, or upset with the number of calls they’re receiving about similar topics.
When engagement feels like a burden instead of a benefit, this can manifest as:
- Disengagement from plan communications or services.
- Decreased satisfaction with care experiences.
- Worsening health outcomes due to confusion or nonadherence.
- Lower Star Ratings and CAHPS scores, which directly impact funding and plan competitiveness.
If the patient mentioned above had received the information in a more streamlined manner, then perhaps their engagement and satisfaction may be higher.
3 strategies to reduce health plan member abrasion
Given the current state of healthcare, where the member experience is closely tied to Star Ratings, CAHPS scores, and overall plan performance, minimizing abrasion is essential. Health plans must walk a delicate line between staying connected with members without overwhelming or frustrating them.
At Aspen RxHealth, we believe there’s a better way. With thoughtful design, smart technology, and pharmacist-led engagement, health plans can reduce abrasion, improve member satisfaction, and drive better outcomes, all without increasing touchpoints.
Tip #1: Personalize outreach with health data and member insights
Generic messages and impersonal interactions are the fastest route to member disengagement. On the other hand, personalization can improve engagement by up to 80%, according to a McKinsey study. The shift from a one-size-fits-all communication style to tailored outreach is more closely aligned with what patients want.
Using clinical, demographic, and behavioral data to segment members and match them with pharmacists who understand their unique needs can improve patient engagement and keep abrasion at bay. This includes preferences around:
- Language: Connecting members with pharmacists who speak their preferred language fluently, removes communication barriers and creates a sense of trust and familiarity from the very first interaction.
- Cultural norms: When personalizing interactions with patients, practicing cultural competence is a must. Understanding and respecting cultural practices, from health beliefs to dietary customs, helps pharmacists provide care that aligns with members’ values and lifestyles.
- Communication style: Whether a member prefers detailed explanations or concise summaries, face-to-face video calls or phone conversations, tailor your outreach to meet their comfort level and communication preferences.
- Social determinants of health (SDOH): Addressing social determinants of health is crucial in closing the gap to healthcare disparities. By accounting for factors like access to transportation, economic stability, education level, and housing conditions, health plans can make sure that care is not only clinically appropriate but also practically accessible and supportive.
Here are some examples of how health plans, pharmacists, and in-house teams can personalize patient care:
- A Spanish-speaking member is paired with a bilingual pharmacist and receives culturally relevant educational materials.
- A member struggling with medication adherence receives a call focused not just on compliance, but on understanding and addressing barriers like cost, side effects, or daily routines.
- A member who is unable to travel for consultative services utilizes telephonic appointments from remote pharmacists.
Aspen RxHealth provides this kind of personalization at scale, leveraging real-time data to match members with pharmacists based on location, language, and clinical expertise. With our BeWell and Alliance SaaS software solutions, pharmacists, health plans, and in-house pharmacy teams can seamlessly integrate personalized outreach into their workflows, whether through comprehensive medication management or one-on-one telephonic consults. This approach creates a more meaningful, relevant experience and ultimately, stronger member relationships.
Tip #2: Optimize outreach to avoid member fatigue
Too much communication can be just as damaging as too little. When members are bombarded by uncoordinated messages from pharmacy, care management, wellness, and other departments, communication fatigue sets in… and with that, so does member abrasion.
To prevent this, health plans must:
- Synchronize outreach across teams: Coordinated communication strategies prevent redundant messaging and make sure that each touchpoint is valuable. Centralized systems or shared care plans can help align pharmacy and care teams so that members receive cohesive, timely support. Our BeWell solution helps pharmacists avoid overlaps in communication, centralizes care outreach timing, and creates a thoughtful patient journey.
- Map the member journey: Understanding the full experience, from onboarding to medication management, allows plans to visualize where outreach occurs and identify opportunities for streamlining.
- Leverage analytics for timing: Using data to identify high-impact moments, such as post-hospital discharge or when a new medication is prescribed, helps to signify when and how to engage. For instance, a pharmacist's medication reconciliation consultation timed several days after a hospitalization, may help clarify discharge instructions, prevent readmissions, and support recovery more effectively than a generic wellness call made at random.
By aligning outreach with a member’s journey and needs, health plans are better quipped to reduce the noise and increase the impact.
Tip #3: Build member trust with high-value conversations
The most effective engagement doesn’t come from automated messages or checklists; instead, it comes from human connection. Meaningful, trust-building conversations can shift a member’s health trajectory in powerful ways.
At Aspen RxHealth, our clinical pharmacists use motivational interviewing (MI), a proven method that blends empathy, active listening, and problem-solving to drive behavior change. This training encourages pharmacists to coach rather than instruct, helping members set personalized health goals and take ownership of their care. MI has even been shown to improve medication adherence and patient outcomes.
Consider these real-life examples:
- A pharmacist educates a member on statin therapy and works collaboratively to manage side effects, turning resistance into adherence.
- Another helps a member define a manageable goal for blood sugar control, validating their challenges instead of prescribing a rigid routine.
This human-led, pharmacist-powered model is the opposite of call-center-style outreach. Pharmacists trained on MI don’t just read from scripts; they deliver empathetic, clinically informed conversations that create trust, motivation, and long-term engagement.
The path toward health plan member engagement
Simply put, the solution to disengaged members is focused in quality, not quantity. To reduce member abrasion and increase member engagement, the health plans shouldn’t turn to more communication, but better, more strategically timed and highly personalized communication.
At Aspen RxHealth, we specialize in pharmacist-led engagement that combines clinical expertise, cultural awareness, and advanced technology to deliver better member experiences at scale.
Fewer, smarter, and more thoughtful touchpoints are both a best practice and a competitive advantage. By reducing member abrasion and strengthening the pharmacist-patient relationship, you can unlock higher satisfaction, improved health outcomes, and better plan performance.
Ready to rethink your outreach strategy and avoid member abrasion?
If you’re looking to evaluate your current member engagement strategy or partner with a team that brings pharmacist-led, data-informed engagement to life, Aspen RxHealth is here to help.
Let’s work together to create smarter, more strategic communication that respects your members and drives real results. Contact us today to schedule a demo on our Alliance and/or BeWell applications and learn how our solutions can help your in-house teams and patients.
