Health plans have invested heavily in engaging members. Text messages, mobile apps, outbound calls, direct mail and digital portals have created more opportunities than ever to connect with people throughout their healthcare journey. Yet many organizations continue to face persistent challenges with medication adherence, preventive care and chronic disease management.
The issue isn’t that members aren’t being reached. It’s that their lives don’t stand still.
Healthcare often treats behavior change as a milestone: identify a barrier, intervene and move on. But behavior change doesn’t work that way. A member who successfully overcomes one obstacle today may face an entirely different challenge next month. Financial pressures emerge. Caregiving responsibilities increase. Transportation becomes unreliable. A new diagnosis changes priorities. Healthy behaviors that once felt manageable can quickly become difficult to sustain.
This is why improving health outcomes requires more than successful engagement. It requires the ability to continually recognize when members’ circumstances change—and adapt support accordingly.
The biggest challenge isn’t starting—it’s staying on track
Most people understand the importance of taking medications, attending preventive screenings and managing chronic conditions. Information alone is rarely the primary obstacle.
The greater challenge is that healthy behaviors compete with the realities of everyday life.
Behavioral science has consistently shown that health decisions are influenced by far more than knowledge. Habits, competing priorities, environmental factors, cognitive overload and social circumstances all shape whether people are able to act on good intentions. The World Health Organization has increasingly emphasized the importance of applying behavioral science to improve health outcomes because health behaviors are influenced by cognitive, social and environmental factors—not simply awareness.
Medication adherence illustrates this challenge well.
A member may become adherent after resolving transportation barriers that made pharmacy visits difficult. Months later, rising prescription costs may force difficult financial decisions. Later still, caregiving responsibilities or changes in employment may disrupt established routines. Each barrier requires a different response, even though the desired behavior remains the same.
Members often don’t struggle because one barrier wasn’t addressed. They struggle because new barriers continually emerge throughout their health journey.
Static outreach can’t solve dynamic problems
Many engagement strategies are still built around discrete events: closing a care gap, reminding a member about a refill or encouraging completion of an annual screening. These interventions are valuable, but they often assume that the problem being addressed remains unchanged.
In reality, members’ needs evolve continuously.
A reminder may be effective when someone simply forgets to refill a prescription. It is far less effective when the underlying issue is affordability, transportation or fear of medication side effects. Similarly, a communication channel that works today may become less effective as member preferences, health status or daily routines change.
Supporting long-term behavior change requires moving beyond episodic outreach toward an approach that continuously learns, adapts and responds to changing circumstances.
Building systems that adapt as members’ needs evolve
Organizations making meaningful progress are shifting their focus from reacting to today’s barriers to anticipating tomorrow’s.
That begins with predictive analytics. Rather than waiting until adherence declines or preventive care opportunities are missed, advanced analytics can help identify members whose circumstances suggest they may soon be at greater risk. Earlier intervention provides more opportunity to address emerging barriers before they become measurable gaps.
Behavioral science is equally important. Every member’s challenge is different, and successful interventions recognize that people make decisions based on a complex combination of motivation, emotions, interpersonal, psychosocial and environmental influences. Applying behavioral principles helps reduce friction, personalize communication, overcome barriers and reinforce healthy behaviors over time, rather than relying solely on reminders or education.
Effective support also requires meeting members where they are. Communication preferences are rarely static. Some individuals respond best to text messages, others to phone conversations, digital tools or provider interactions. An omnichannel approach allows health plans to engage members through the methods most likely to fit their needs and preferences at any given point in time.
Perhaps most importantly, successful organizations recognize that behavior change requires longitudinal support. Each interaction should build upon previous conversations, creating a continuous understanding of the member’s journey rather than a series of disconnected outreach events. Solving one problem should naturally lead to identifying and preparing for the next.
From closing gaps to sustaining progress
This represents a meaningful shift in how health plans think about member engagement.
Rather than asking, “How do we close this gap?” organizations should also ask, “What might prevent this member from succeeding next?”
That simple change in perspective transforms engagement from a reactive activity into an ongoing process of supporting healthy behaviors throughout a member’s life.
It also better aligns with healthcare’s continued movement toward value-based care, where long-term outcomes—not outreach volume—define success. As payment models increasingly reward measurable improvements in quality and health outcomes, organizations must look beyond completed interactions to sustained behavior change.
Adapting is the key to lasting outcomes
Improving health outcomes has never been about solving a single problem. It’s about recognizing that members’ lives are dynamic and designing support systems that are equally dynamic.
Behavior change is not a one-time achievement. It is a continuous process of responding to changing circumstances, reinforcing healthy habits and helping members navigate new challenges as they arise.
The health plans that achieve the greatest long-term success won’t simply identify today’s barriers. They’ll build the capabilities to recognize tomorrow’s—and adapt before those barriers become missed opportunities. In a healthcare system increasingly focused on outcomes, that ability to continually evolve alongside members may be the most important capability of all.
About Dr. Chandra Y. Osborn
As Chief Experience Officer at AdhereHealth, Dr. Chandra Osborn leverages over 25 years of experience as a behavioral scientist and business leader, specializing in patient engagement, medication adherence, digital personalization and behavior change strategies. Prior to joining AdhereHealth, Dr. Osborn was previously Chief Behavioral Officer at Lirio and VP of Health and Behavioral Informatics at One Drop and has held multiple leadership positions at Vanderbilt University Medical Center.
