Understanding an engagement strategy and its role in boosting health plan member participation
A long-term solution should create a positive experience for members. Effective strategies will reach current and future members through their preferred channels.
These strategies should also provide meaningful and useful features. This includes helping members easily find information on coverage and cost-share amounts. It also means alerting them about changes in claims, prior authorization statuses, or benefits options.
Maximizing each interaction with current and potential members is crucial. However, it requires careful planning to ensure your approach is genuinely thoughtful. Below are updated guidelines, including relevant CMS policy updates for 2025–2026.
How can I enhance member engagement?
1. Provide omnichannel experiences and flexibility across various platforms
Preferences vary dramatically; digital, print, phone, and hybrid approaches will continue to be necessary. Health plans should provide seamless, cohesive experiences across channels and allow members to select communications preferences.
New CMS relevance:
CMS finalized updated marketing and communications requirement changes in its 2026 Medicare Advantage and Part D final rule. These include new rules for member ID cards and standard materials. This applies to renewal and termination notices. These changes will start on October 1, 2026.
These rules affect how plans must present key notices and require digital accessibility for plan materials.
2. Getting personal increases engagement
Personalized messages reach the right people at the right time. This makes the messages more relevant and increases satisfaction. Particularly with digital outreach, personalization should align with ADA and Section 508 accessibility standards to ensure all members can interact with content effectively.
New CMS relevance:
CMS’s ongoing rulemaking includes considerations of plan marketing and communications definitions to increase consumer protections and transparency. Proposed changes include broadening what constitutes “marketing” material and requiring more advanced review of marketing content to safeguard members from misleading communications.
Explore the CMS proposed rule on integrated communications.
3. Find the right voice
Strong communication should be clear, human, and in plain language, especially for digital channels. Conversational tone builds trust and reduces confusion about benefits or changes.
This is especially important as CMS intensifies oversight of marketing materials and the way plans communicate coverage options. Making benefit descriptions and enrollment messages clear and accurate improves the member experience. It also helps plans stay CMS-compliant.
4. Ensure members have immediate access to necessary tools
Easy access to claims, benefits, provider directories, and treatment cost estimators is important for member engagement.
New CMS relevance:
Starting January 1, 2026, CMS will enforce new rules for provider directories. These changes aim to make provider data more accurate and easier to access in the Medicare Plan Finder. This will help members find important plan information more easily.
Plans must have provider directory data uploaded and accurate to comply with regulations.
Provider Directory Data Changes details.
5. Don’t waste their time
Members should be able to find answers quickly instead of navigating confusing menus or dead-end pages. Use integrated feedback loops and data insights to refine digital journeys and proactively surface high-value content.
CMS now updates and enforces standardized communication guidelines. This includes notices and marketing materials. Health plans should improve their messaging tone, placement, and timing. This way, members get information before they need support.
6. Integrate your organization’s story into every interaction
Your organization’s value story should be woven into every touchpoint — reinforcing trust and driving retention. Consistent branding and messaging that align with member needs help differentiate your plan in a crowded market.
This is true even when plans use CMS-required notices and materials. This includes things like ID cards, standard notices, and updated Part D communications. Plan communications that support CMS compliance can also reinforce organizational value when done well.
Notable CMS policy updates affecting health plans (2025–2026)
To help contextualize the above communications strategies, here are key CMS updates that impact health plans and member communications:
- Medicare Advantage & Part D Final Rule (2026)
CMS released the final rule for the Contract Year 2026. This rule changes the Medicare Advantage (MA) and Part D programs. It affects marketing materials, member ID cards, care coordination for dual-eligible members, and standardized notice materials.
- Proposed Rule on MA/Part D Communications & Marketing
CMS wants to change the definition of marketing. They aim to review more types of communication. This will help protect members from misleading or confusing materials.
· Provider Directory Transparency
Starting January 1, 2026, Medicare Advantage organizations must provide accurate and timely provider directory data. This will help members compare plans and find care more easily.
Ready to boost your member communications strategy?
Member communications remain foundational to the success of any health plan. Engaging members, keeping them informed, and aligning communications with regulatory requirements support better outcomes and strengthen retention. With the CMS updates noted here, health plans that are proactive and member-centric are best positioned for success.
How Toppan Merrill help
Toppan Merrill offers services to improve health plan member engagement. These include document creation and management, sales support, and omnichannel communications. They also provide printing services and other options. We offer top-tier solutions that enable you to swiftly adapt to regulatory changes, client demands, and market shifts.
Learn more about how we can support your mission-critical content and member communications.
