Missed Checkups Today = Expensive Claims Tomorrow

The Key to Nudging Members Toward Better Preventive Care

Annual physicals are one of the simplest ways to prevent chronic conditions, detect health risks early, and reduce long-term medical costs. Yet nearly one-third of adults skip their annual exam, despite the fact that most commercial health plans cover it at no cost. This gap isn’t just a missed opportunity for better health, it’s a financial liability for payers and TPAs.

When members don’t engage in preventive care, small, manageable conditions go undiagnosed. This can result in costly ER visits, high-dollar prescriptions, or even avoidable hospital stays.

If the goal is to control costs while improving population health, the real question isn’t why preventive care matters – it’s how to get members to take action.

Why Aren’t More Members Getting Annual Checkups?

The barriers to preventive care aren’t always about access. Many members have the benefit, know checkups are important, and still don’t go. The reasons vary, but common themes emerge:

• It’s not urgent. With no pressing symptoms, scheduling a physical doesn’t feel like a priority.
• It’s inconvenient. Finding time, booking an appointment, and dealing with doctor’s offices feels like a hassle.
• There’s no immediate payoff. Unlike fixing a toothache or treating the flu, preventive visits don’t always show quick, tangible benefits.
• They assume they’re healthy. Many members believe they’ll only need a doctor when something is wrong.

These aren’t medical barriers, they’re behavioral ones. The solution is a strategic, well-timed nudge that makes action feel easy, relevant, and worthwhile.

How Payers Can Nudge Members Toward Preventive Care

Engagement strategies that work focus less on telling members what to do and more on removing friction, increasing motivation, and making action feel effortless. Here’s how payers and TPAs can close the preventive care gap:

• Make Scheduling Incredibly Easy – Most members won’t go out of their way to book an appointment, but they will take action if scheduling is frictionless.
• Deliver Timely, Personalized Outreach – A generic email isn’t enough. Engagement should be person and timely.
• Highlight Immediate, Tangible Benefits – Since annual physicals don’t offer instant gratification, framing matters. Instead of focusing on long-term disease prevention, engagement should tap into immediate, personally relevant motivators.

Boost Preventive Care Participation with Clarity

• Increase preventive care utilization with smart, data-driven engagement
• Reduce long-term healthcare costs by catching risks earlier
• Improve member satisfaction and health outcomes through better engagement strategies