Health automation specialist Ushur has introduced a comprehensive digital playbook designed to help health plans enhance member engagement, streamline care delivery, and lower avoidable costs. The “Health Plan Playbook” offers seven structured automation journeys that enable payers to improve health outcomes without requiring portal logins or mobile app downloads.
The playbook includes tailored strategies such as a member warm welcome, HRA and SDOH surveys, chronic condition navigation, medication adherence, and maternal health support.
Each journey outlines clear steps covering audience targeting, outreach channels, calls-to-action, personalisation modules, measurement metrics, and optimisation tips.
Supporting high-value member journeys
The solutions are designed to cover critical stages of the member lifecycle. For example, the warm welcome workflow ensures new members receive benefit overviews, digital ID cards, and primary care provider (PCP) selection guidance within their first 30 days.
Meanwhile, chronic condition navigation uses ongoing communications to help patients manage long-term illnesses such as diabetes, COPD and hypertension.
Maternal health navigation journeys support pregnant members through prenatal and postpartum stages, including appointment scheduling, education, and care team handovers.
In addition, medication adherence workflows personalise prompts and address barriers like cost and transportation, while SDOH surveys connect vulnerable members to vital non-medical resources such as food, transport and housing.
Compliance and speed to market
The playbook is built to help health plans deploy automation swiftly while maintaining compliance.
Ushur emphasises that its workflows are HIPAA-secure, protect sensitive health data, and feature two-factor authentication for member access.
The company highlights that pre-built, customisable workflows can be launched within weeks, enabling health plans to improve member experience without long development cycles.
Ushur also provides best-practice metrics and benchmarks, such as engagement and completion rates, call deflection measures, and quality score improvements.
By automating interactions through its Invisible App, Ushur aims to reduce call centre demand while raising NCQA quality scores and Star Ratings.
Optimising digital engagement
The playbook not only includes strategies for automation but also shares pro tips to improve performance.
Recommendations include using progressive disclosure to present quick wins first, A/B testing language for bilingual populations, and scheduling smart retries to re-engage inactive members.
It also suggests geolocation tools to simplify provider search and support services like transportation and prescription fulfilment.
Ushur positions its Invisible App as the key channel for these interactions, supported by SMS, email, IVR, and agent-assisted outreach. Members receive secure links that keep all protected health information (PHI) behind authentication barriers, ensuring both compliance and ease of use.
Driving measurable outcomes
By digitising and automating these key journeys, Ushur claims health plans can improve HRA completion rates, medication adherence, and prenatal care scheduling while simultaneously reducing costly hospital visits and administrative workloads.
The firm stresses that these outcomes create value both for members and for payers seeking to lower avoidable costs and deliver higher-quality care.
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