Redefining Personalization - New Health Plan Research Shows the Future of Member Engagement, Superior Outcomes, and Improved Consumer Experience

National survey of health plan leaders finds there is broad recognition that enhancing member personalization will boost engagement and ultimately improve trust.

, /PRNewswire/ -- Lirio, a pioneer in the union of behavioral science and artificial intelligence to deliver better health outcomes, has released new industry findings on the significant impact that advanced health plan member personalization will have on creating a more sustainable healthcare ecosystem and ultimately, improving outcomes.

The report, titled (Re)defining Personalization, is based on independent, commissioned research conducted by healthcare consultancy Sage Growth Partners in Q1 2025. Sage surveyed 70 national and regional health plan leaders to directly learn about initiatives to improve member experience, identify artificial intelligence investment priorities, and gain perspectives on how AI will continue to shape the healthcare industry.

Enabled by innovation, health plans now have the opportunity to deliver truly personalized, N-of-1 outreach. This approach goes beyond standard prompts—such as bill payments or benefit explanations—that drive episodic actions. Instead, it fosters long-term behavioral change, influencing members longitudinally when it comes to adherence to diabetes care plans, or participation in wellness programs, for instance.

"Our research shows that health plan leaders recognize the importance of personalization across all touch points of the member journey in order to cultivate a foundation of trust," said Marten den Haring, PhD, CEO, Lirio. "To drive immediate and long-term impact, plans and providers must tap into what motivates members and help them overcome challenges that are preventing them from taking control of their health. When members trust their plan, they feel empowered and are more likely to use their plan benefits, engage in healthy behaviors and follow through on treatment plans -- all of which results in better health outcomes, lower costs, and higher member satisfaction."

Key findings of the new research report include:

• Of the health plans surveyed, 84% say the most significant barrier preventing their members from taking action following plan outreach is that their members are unmotivated to change—despite being aware of necessary actions.
• 60% of responses cited "difficulty engaging members to improve their quality of care" as a top challenge.
• 40% of survey respondents rated their current solutions as "not well at all" in terms of providing adequate machine learning and AI tools to optimize workflows for increased engagement and improved outcomes.
• The majority indicated that population health analytics will be their most likely near-term technology investment, despite broad recognition of the impact AI can have on member personalization and experience. 
• 77% of respondents stated that it is "very important" to incorporate personalization for chronic care outreach, such as diabetes care management.

"Behavioral prompts can sustainably improve outcomes, especially for people managing a condition as challenging as diabetes," said health plan chief consumer experience officer Paul N. Long. "Today, delivering an enhanced, personalized experience in healthcare is extremely manual, and requires hours of message generation and technology configuration, with little to no understanding of outcomes or optimization. But N-of-1 behavioral prompts will make a huge difference to drive down costs and enhance outcome sustainability. AI can generate nudges to help people make better healthcare decisions, and continue to refine messaging based on new knowledge and actual behaviors."

As health plans' strategic priorities shift from mergers and acquisitions toward improving the consumer experience, there's a monumental opportunity to impact change that goes beyond immediate operational and clinical savings.

"Our research found that while barriers to member engagement range from financial to technical, the most significant challenge identified was cultural. Leaders rated engaging with members who have low trust in health plans or healthcare systems as being more difficult than factors like age or risk status. It is time that we all begin to realign the dedication of resources from focusing on the organizations funding care toward those receiving care. That is a significant step in re-establishing trust," said Dan D'Orazio, CEO, Sage.

For more information of the research, or to download a complete copy of the report, visit lirio.com.

About Lirio
Lirio's personalization engine for digital health combines behavioral science and artificial intelligence to automate and scale unique consumer health journeys through its Precision Nudging^® interventions. Lirio has received multiple awards for its excellence in applied artificial intelligence, was named an Inc. Magazine Best Workplace, and is HITRUST^® CSF certified, SOC 2 Type II compliant, and NIST certified. For more information, visit www.Lirio.com. 

About Sage Growth Partners
Sage Growth Partners is a healthcare advisory firm with deep expertise in market research, strategy, and communications. Founded in 2005, the company's extensive domain experience ensures that healthcare organizations thrive amid the complexities of a rapidly changing marketplace. For more information, visit https://sage-growth.com.

For more information
John Gonda
616.309.4888
[email protected]

SOURCE Lirio