Hard Truths About Your Steerage Strategies

You’ve invested in everything from utilization management to plan design to price transparency tools in your efforts to steer members toward in-network, lower-cost, high-quality care.

And you need results, since healthcare costs are rising faster for members and health plans alike.

So why is your steerage program still struggling with the member engagement you need to deliver significant ROI?

The hard truth is this: most plans are investing in the wrong moments.

At CareHive, we believe it’s time to rethink steerage strategies by leveraging advances in behavioral science and AI to guide smarter, more human-centered engagement.

Here are five hard truths pinpointing where steerage breaks down and what to do instead.

1. People Don’t Remember

If you’re reading this article, you’re probably in healthcare. Have you ever logged into your health plan member portal while you’re at your doctor’s office?

That’s typically where members are when they find out about health services they need. But in that moment, the vast majority of us have an existing routine behavior, and that’s to just go where our doctor tells us to. 

Even savvy, motivated members who log in may not be able to find the digital tools and content they need to do comparisons. 

💡 Instead

Use AI-fueled claims analysis and common care protocols to send outreach before care happens so members have sufficient time to interrupt their routine behavior and choose something new.

One easy win: Focus on people with chronic conditions, whose routine care is easier to predict since they often receive regular scans, tests, medications, and other care that could cost less  at other in-network, high-quality  locations.

2. People Give Up Because It’s Too Complex

Members fully get that costs are rising and their share of the cost is rising, too.

Plan design levers, like deductibles and cost shares,  theoretically should incentivize cost-saving decisions. 

And tools that provide price information theoretically should help members choose lower-priced care.

But members don’t do the research and math to understand the “what’s in it for me”–i.e. what portion they personally will save out of the price they see.

💡 Instead

Do the math for members. Show each member what they stand to save on out-of-pocket costs, based on their plan design, prices available to them, and likely utilization. Cost transparency must be personally meaningful.

3. Sometimes The Stakes Are Too High To Try Something New

Many steerage efforts target high-cost episodes like surgery or hospitalization—but those are precisely the moments when people are least likely to take risks. When stakes are high, people revert to the routine behaviors that feel safe and familiar. 

 💡 Instead

Think of your steerage efforts as parts of a relationship that builds trust, new behaviors, and habits over time. Start with lower-stakes efforts first, like helping members shop for lab tests. These smaller decisions help members learn what it means to price shop, and helps them become familiar with the fact that lower costs don’t mean lower quality.

4. Traditional Incentives Can Miscommunicate

As a healthcare insider, you’ve learned over time about the disconnect between quality of care and what that care costs. But most people don’t know what you know.

Worse, when people are buying something they don’t understand well, price can be perceived as a signal of something it’s not. In the absence of knowledge, a high-priced vacuum, sweater, or sofa can feel like a safer bet. In behavior science, that’s called the price-quality heuristic.

So, for example

• A member may choose higher care tiers or out-of-network care because they think they’ll get higher quality.
• Cash incentives to choose lower-cost care settings may make members think, “If they’re paying me to do it, it must not be in my best interest.”

💡Instead

Do careful, in-depth user research on your plan designs. And start with steerage opportunities that are naturally rewarding to members because the member saves on their out-of-pocket expenses. Communicate constantly along the way about care quality, so members can learn as they go. 

5. It Can Fall Apart During The Follow-Through

Even when savvy members try to make a change, their efforts may fall apart if they can’t reach the right people at their clinic to help them make the change.  

Physicians and staff members want to do the right thing and not penalize members with high costs. But their time is limited. So members who are trying to coordinate with their clinics about a new order often feel like they’re swimming upstream.

💡Instead

Don’t stop at helping members compare costs and locations. Offer support all the way through. Deploy digital tools or even human navigators that help members with the follow through, especially in members’ early experiences with healthcare shopping.

The ultimate hard truth: Steerage isn’t easy. But it’s doable.

By pinpointing the right moments, catching members when they’re ready to act, and equipping them with what they need, member behaviors do shift. 

So start small. Build over time. And give CareHive a shout if we can help you do it.

At CareHive, we help payers deliver successful steerage that builds member relationships.

We provide proactive, personalized recommendations, careful guidance, and support that progresses as members learn more about how cost comparisons in healthcare work. 

Members build trust as they find more affordable, high-quality care, and payers control spend while providing a rich, positive member experience.

Want to learn more? Let’s talk about how to make cost-savings feel natural—not forced.