4 best practices to prevent rapid disenrollment for Medicare Advantage plans

With the 2022 Annual Election Interval (AEP) for Medicare Benefit (MA) plans starting subsequent month, MA plans are within the last levels of getting ready to enroll new members in addition to retain returning members to the plan. Quickly, the Annual Discover of Change (ANOC) will likely be in members’ mailboxes, informing them of adjustments in value, protection, and extra. That is additionally the time for MA plans to revisit their member retention methods to make sure they don’t lose their members through the Open Enrollment Interval (OEP) window from January 1–March 31.

Why is that this crucial? As a result of MA members don’t have any scarcity of choices obtainable to them and received’t hesitate to buy round for a greater worth, higher protection, or most necessary of all, a greater member expertise. In accordance with the Kaiser Household Basis, the common Medicare beneficiary now has entry to 33 Medicare Benefit plans, whereas general MA enrollment has greater than doubled previously ten years, rising from 12 million to 26 million complete members.

In the case of stopping disenrollment, first impressions matter—for many members, which means their expertise with a plan’s pharmacy profit, prior authorizations, or transition of protection. These processes may have a big affect on their determination to reenroll or disenroll with a specific plan through the OEP.

For returning members, plan adjustments may end up in disenrollment. Which members will likely be most impacted by formulary adjustments? Which member cohorts are at highest danger for leaving the plan? Upon getting recognized these members, attain out and be clear concerning the adjustments. This communication could be delivered with automation, answering profit questions proactively, redirecting members to the ANOC letter, and decreasing name middle volumes throughout this significant time. It’s crucial for MA plans to solidify their technique for the OEP simply as a lot because the AEP, resolving issues shortly and making fast changes when name volumes and buyer complaints have a tendency to extend.

Listed below are 4 confirmed greatest practices to recollect as you construct or enhance upon your disenrollment prevention technique.

  1. Proactively determine and interact. Make sure that your returning members are conscious of upcoming plan adjustments. Proactively interact them, ship FAQs, and use on-line sources and automation to scale back frustration and confusion to your members. This helps your members and your name middle employees, who’re targeted on AEP.
  2. Evaluation your first contact with the member. This doesn’t simply imply your welcome package. Evaluation your plan’s pharmacy, care administration, and authorization processes and procedures. Work along with your member providers crew by listening to calls, monitoring time to decision, and training your brokers on customer support and de-escalation abilities.
  1. Be an extension of the care crew. Members who’ve a major care supplier have higher medical outcomes. Proactively talk along with your members to make sure they’re getting the care they want and determine any points or adjustments along with your supplier community.
  2. Ask for suggestions. Each interplay along with your members is a chance for suggestions. All the time attempt to search out out how one can make their expertise sooner and higher. Sponsor disenrollment surveys to greatest perceive why enrollees are leaving the plan and use these surveys to tell what’s subsequent to your plan.

Whereas plans don’t get a second likelihood to make a optimistic first impression, a year-round, proactive strategy to member engagement can considerably enhance member retention and plan progress through the subsequent six months.

By deploying Cotiviti’s Eliza multi-channel member engagement resolution, one Medicare Benefit payer achieved:

  • 2x year-over-year member retention price
  • 65% lower in complaints throughout AEP
  • 40% discount in inbound calls throughout AEP and Q1
  • 110% of operational value financial savings purpose achieved by name deflection 

Obtain our Eliza for Medicare brochure and learn to begin conversations along with your members that enhance retention and Star Scores.

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