Health plan executives tend to think of growth via two primary avenues: membership growth and asset diversification. Health plans must excel against strong existing competitors and established, yet evolving, market dynamics.

• Plans continue to chase member growth in their insurance lines of business, with Medicare Advantage receiving outsized attention given historic profitability and growth trajectory.
• Many health plans are expanding their offerings to include diversified healthcare service divisions.
• Plans must understand their market-specific demographics to understand opportunities for greater membership growth.

The term "provider relations" refers to the relationship between health plans and providers, particularly physicians. Collaborative providers play a crucial role in advancing health plan strategic goals and improving healthcare outcomes. To build these plans must:

• Foster strategic alignment with providers to minimize administrative burden and make progress on shared goals like progressing value-based care and behavioral health integration.
• Prioritize physician-led initiatives and leverage data-driven approaches to enable providers and enhance overall performance.

Health plans must empower beneficiaries by helping them access the best, most appropriate care available — which often means access to transformative, innovative models or treatments. To do this plans must:

• Support pioneering approaches that strengthen the patient experience, improve patient outcomes, and reduce cost of care — even as medical volumes continue to grow.
• Continuously monitor and evaluate innovations in various areas, including pharmacy, virtual-care, and behavioral health, to ensure the delivery of high-quality care.

Member engagement is the process of building, nurturing, and managing relationships with members to drive behavior change. Access our member engagement resource library, which includes tools, case studies, cheat sheets, infographics, to learn more about improving member engagement.

• To build and manage relationships, health plans must deliver a good experience — both live and digital.
• Resulting behavior change enables health plans to increase revenues or manage medical spending.