We gathered senior leaders in consumer experience and engagement from health plans across the nation to discuss their most pressing challenges in member engagement—and how they’re approaching solutions at their organizations.

Read on for our five immediate takeaways, and stay tuned for more insights emerging from the conversations.

1. Current engagement efforts are about what plans want from members—and that needs to change

For years, plans have been investing in engagement initiatives—marketing campaigns, rewards programs, outbound calls—to guide members in using their products and managing their health.

But taking an honest look at their work, plan executives acknowledged the uncomfortable truth: most plan initiatives are about what plans want from members. Not what members are seeking from health care.

In the quest to close care gaps and steer members to the right sites of care, plans are barraging members with messages and failing to meet their immediate needs.

2. New market entrants are betting they can understand health care before plans understand members

Aetna-CVS. Walmart-Humana. Amazon-Berkshire-JPMorgan. Proposed (and rumored) mergers across the health insurance landscape are increasingly vertical—if not out-of-industry altogether.

Amid these, one thing is becoming clear: all of these potential behemoths will have enormous consumer insights in their repertoire. And they’re making the bet that they can learn insurance operations before insurers can craft a truly customer-focused enterprise.

Whether a winning strategy depends on acquiring plan expertise—or rejecting the conventional insurance business entirely—remains to be seen, but plans should prepare to up the consumer experience ante.

3. Plans can’t expect PCPs to completely manage costs for members

Primary care providers (PCPs) heavily influence the care decisions members make during a visit, and that makes them an appealing point-person for engaging members.

But many PCPs don’t have the resources or incentives to focus on the cost of care, and even primary care capitation models can encourage more referrals. And members are increasingly getting primary care from different sources such as telehealth, retail clinics, and urgent care.

The result is a membership with few long-term PCP relationships—meaning plans must step in to help members manage their care costs.

4. New service models aim to answer: should plans get out of the consumer’s way, or be top-of-mind?

Should plans acknowledge that the health care system is impossibly complicated, and shepherd members through every step of care navigation? Or are plans better served by eliminating unnecessary interactions to minimize member frustration with the health plan directly?

As plans contemplate just how to improve their influence over members, they’re still wrestling with the central question of what the “ideal” insurance experience looks like. Many plans are piloting new service models and products—from concierge-based guidance to exclusive provider partnerships—to test these approaches.

5. Plans occupy a complex intermediary position—but it means they know member pain points best

Plans are at a disadvantage as intermediaries because they’re unable to directly advise members in the moment they make a care decision.

But this position also gives plans the expertise into “hot spots” members encounter as they navigate care, such as frequent challenges in accessing care, expected mistakes in provider selection, and the commonly confusing aspects of coverage.