MEMBER ENGAGEMENT
The Payer’s Guide to COPD Management
3 Approaches to Smarter Engagement
Managing Cardiopulmonary Disease (COPD) within a health plan’s population isn’t just about treatment – it’s about keeping members out of the ER and engaged in their care. COPD-related hospitalizations cost the U.S. healthcare system over $24 billion annually, with inpatient costs accounting for $6.3 billion. Additionally, 19% of COPD patients are readmitted within 30 days of discharge. These numbers aren’t just staggering… they’re avoidable.
For payers and TPAs, the challenge is clear: traditional outreach methods don’t work for COPD members. A reactive approach, where engagement only happens after a hospitalization or worsening symptoms, leads to higher costs, more complications, and frustrated members. The solution is a smarter, more proactive engagement strategy that reaches members before their condition spirals out of control.
Here are three proven approaches to improving COPD management through better member engagement.
1. Spot High-Risk Members Before Their Symptoms Worsen
Many payer-driven COPD programs rely on claims data and past hospitalizations to identify members in need of support. But this approach reacts to crises rather than preventing them. By the time claims data is processed, members have often already experienced a severe exacerbation.A smarter approach involves predictive analytics that flag early warning signs, such as:- Missed medication refills
- Declining inhaler usage
- Frequent respiratory infections
- Inconsistent primary or specialist visits
2. Move Beyond Generic Outreach – Personalization is Key
Traditional engagement methods often take a one-size-fits-all approach: automated calls, standard appointment reminders, and mailed pamphlets. The problem? COPD members need different types of support based on their disease progression, health literacy, and lifestyle factors.- High-risk members may require one-on-one nurse coaching to assess symptoms, adjust treatment plans, and provide hands-on care coordination.
- Moderate-risk members can benefit from digital check-ins, targeted SMS reminders, and virtual pulmonary rehab referrals to keep them on track.
- Lower-risk members still need engagement—preventive education on symptom tracking, lifestyle changes, and proper inhaler techniques can keep them stable.
3. Make Engagement Continuous, Not One-and-Done
COPD isn’t a condition that can be managed with occasional check-ins. It requires ongoing support to help members stay engaged with their care. Yet, many outreach programs focus only on acute episodes instead of long-term disease management.Effective engagement should:- Follow members through their entire care journey—from early diagnosis to daily disease management.
- Use real-time data to adjust outreach strategies—if a member stops refilling their inhaler, the system should trigger targeted engagement.
- Meet members where they are—text-based reminders, app notifications, and live calls should be tailored to their preferences.
Take COPD Management to the Next Level
At Clarity, we help payers and TPAs proactively manage COPD populations with smarter, more personalized engagement. Our Member Engagement platform uses predictive analytics to identify at-risk members and deliver targeted outreach that prevents unnecessary hospitalizations.With Clarity, payers can:- Reduce readmissions by reaching members before symptoms worsen
- Improve medication adherence with timely, personalized reminders
- Engage members in the right way—via SMS, live calls, digital tools, and more
Take Charge of COPD Engagements
Find out how with Clarity Performance Solutions.