For a not-for-profit health maintenance organization, growth was bringing both new members and new challenges. While enrollment was climbing across Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), the ability to engage with members effectively was falling behind. Leaders recognized that without a unified engagement platform, they risked missing opportunities to strengthen relationships, improve collaboration, and retain members in a competitive market.
The Challenges
A growing membership without a unified engagement foundation
The client has been serving members for more than three decades. Today, it provides high-quality, free and low-cost health insurance through Medicaid, Medicare, and CHIP. With more than 280,000 members, the organization had grown into one of the few hospital-owned Health Maintenance Organizations (HMOs) in the nation.
Yet, despite its success and reputation, the client faced a critical challenge, engaging members effectively across multiple touchpoints. Member demographics, enrollments, call logs, plans, claims, and requests were scattered across different systems. Agents had to jump between screens, manually enter repetitive details, and work with legacy systems that didn’t talk to each other. Without a single, consolidated platform, collaboration was limited, decision-making was delayed, and the opportunity to provide a seamless member experience was slipping out of reach.
The Turning Point
Building a 360-degree engagement view with Persistent
Recognizing that engagement is central to member trust and retention, the client partnered with Persistent to build a modern Member Engagement Platform. The goal was not only to consolidate interactions but also to simplify workflows for agents and unlock better insights for business teams.
Persistent designed and implemented a 360-degree view of every member, pulling together data from demographics, enrollments, claims, requests, plans, and even call logs. Agents could now access everything in a single consolidated interface. The platform supported both inbound and outbound call interactions, giving staff the ability to engage members in real time without toggling between systems.
To further improve efficiency, Persistent introduced standardized, pre-defined screen flows and call scripts. These allowed agents to insert predefined text with minimal typing, cutting down on repetitive back-and-forth and ensuring consistent communication. Multiple workflows across member relations whether through calls or emails were streamlined, while integrations with legacy systems ensured continuity and avoided disruption.
The Outcomes
Unified access, smarter collaboration, and higher retention
The impact was immediate and measurable. A single unified member access channel was established, eliminating the silos that had previously hampered engagement. Interoperability and integration across multiple systems created a seamless 360-degree view of every member, empowering agents with the information they needed at their fingertips.
With a consolidated engagement platform, collaboration within the workforce improved, enabling faster decisions based on data insights. The enhanced ability to engage meaningfully with members also supported market growth, driving higher acquisition and retention across Medicare—including Prime, Special, and DSNP plans—Medicaid, and CHIP.
By building this Member Engagement Platform with Persistent, the client transformed a fragmented and inefficient process into a unified, data-driven foundation that strengthens member relationships and positions the organization for continued growth.
