Decoding What Drives Healthcare Engagement
6× Engagement
+16% Avg Order Value
Challenge
Despite record spending, the U.S. healthcare system consistently underperforms on outcomes and engagement. Across populations—Medicaid, MA, Commercial, Employer—a core issue remains: people often don’t act in their own best interest.
Traditional approaches focus on risk scores, access, and system design. But they miss a critical layer: motivation. Without understanding what people need to feel before they act, engagement stalls and outcomes suffer.
Insights
Healthcare decisions are shaped as much by emotion as by logic. Yet most systems still treat motivation as a black box: too soft to measure, too hard to act on.
Rosemark’s belief-based model changes that.
By decoding the emotional posture and internal motivations behind health-related decisions, our approach uncovers why people engage, delay, or drop off. We’ve identified four distinct belief-based segments:
- Proactive Health Managers
- Aspirational Improvers
- Event-Triggered Reactors
- Non-Engagers
Each persona reveals a different belief system—and a different path to trust, engagement, and action.
This framework opens the door to healthcare experiences that feel more personal, more relevant, and more likely to succeed. When journeys are designed to match how peoplealready think and feel, we see:
- Stronger initial engagement
- Faster movement to key decisions
- Greater cost efficiency through targeted activation
The opportunity isn’t just to understand members better—it’s to move them, by aligning with what motivates them most.
One Belief-Based Framework. Four Market-Ready Applications
Our belief-based engagement framework adapts seamlessly to the priorities, member profiles, and regulatory drivers of Medicare Advantage, Medicaid, Special Needs Plans, and Commercial health programs.
Medicare Advantage
Success: Improve Star Ratings, retention, and preventive screenings
Barrier: Diverse health literacy, open enrollment churn
Our Edge: Align onboarding & outreach to beliefs about independence, control, and quality of life
Medicaid
Success: Boost prevention & equity, reduce avoidable ED visits
Barrier: SDOH barriers, eligibility churn, mistrust
Our Edge: Culturally relevant outreach, trusted messengers, tailoring intensity to belief + clinical and social complexity
Special Needs Plans
Success: Manage high-complexity conditions, coordinate care
Barrier: Multiple comorbidities, caregiver involvement
Our Edge: Map belief + complexity to care team touchpoints, integrate caregiver triggers & support
Commercial / Employer
Success: Reduce costs, increase preventive care use, boost productivity
Barrier: Engagement fatigue, low follow-through
Our Edge: Frame health as performance-enhancing, personalize incentives & messaging style
Shared Core Model:
Segmentation → Experience Maps → Channel & Cadence Alignment → Integration Guidance
Takeaways
Rosemark’s belief-based segmentation framework provides a scalable, emotionally intelligent approach to activation and engagement across healthcare segments.
By uncovering the motivational drivers behind member behavior, the model helps organizations move beyond demographics and risk scores to address what people need to feel before they act.
This approach is market-ready across:
- Medicare Advantage: Aligning to beliefs around control and independence to improve Stars and retention
- Medicaid: Driving equity and trust through culturally relevant outreach
- Special Needs Plans: Integrating belief and complexity to better support caregivers and coordinate care
- Commercial/Employer: Boosting follow-through by aligning incentives to mindset and messaging preference
When healthcare journeys are shaped by belief, organizations see:
- Faster activation
- Stronger ongoing engagement
- More efficient resource use
- Better outcomes, at scale
Belief-based design closes the motivation gap, turning intention into action.
Medicaid Example: Behavioral Levers That Improve Performance and Reduce Cost
Preventive Care Compliance
screenings → fewer high-cost chronic complications
Avoidable ER Visits
avoidable ED visits averted × $1,200 avg cost
Care Plan Adherence
uplift in appointment adherence
Equity Impact
Reduced disparities in preventive care use in high-need populations
These sample goals reflect realistic targets based on motivational alignment in similar populations. Actual outcomes may vary by program and implementation scope.
Meet the Belief-Based Segments
Uses digital tools when available and appreciates proactive reminders.
- “Health is my job.”
- “Knowledge = control.”
- “Catching problems early is smart.”
- “I like seeing my progress.”
Responds to encouragement, achievable goals, and support that feels personal.
- “I want to do better but need a push.”
- “Support and small wins help me stay on track.”
- “Please keep it simple.”
- “I need to feel cared for.”
Rarely seeks preventive care unless connected immediately to follow-up support.
- “I act when there’s a real problem.”
- “Routine care feels unnecessary.”
- “Get to the point.”
- “I care more about now than later.”
Traditional outreach has limited effect, requires trusted messengers and tailored, non-clinical entry points.
- “Health stuff stresses me out.”
- “I avoid this unless I have to.”
- “Too many messages = I check out.”
- “The system probably won’t help.”
Let’s Talk
Reach out to schedule a live demo and see how you can start building more relevant and engaging experiences for your member population.