How MA plans can win member loyalty during the new extended open enrollment period - SmartBrief

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How MA plans can win member loyalty during the new extended open enrollment period

How MA plans can improve onboarding and patient engagement

6 min read


Woman learning about health plan benefits


This post is sponsored by Guidewell Connect.

Medicare Advantage (MA) plans are facing uncharted territory as they prepare for 2019’s extended open enrollment period. Under the 21st Century Cures Act, consumers will be allowed to switch from one MA plan to another, or back to Original Medicare, between January 1 and March 31, 2019 if they are dissatisfied with their initial choice. Only one switch is allowed, so plans must demonstrate plan value and earn member loyalty early to avoid members using their new ability to switch to go with a competitor.

That risk will be higher among new MA enrollees, as switching rates are higher among younger beneficiaries — 12% for ages 65 to 75 compared with 7% for ages 85 and older.

Along with the expanded open enrollment, there are additional factors making it challenging for plans to keep members. The MA marketplace continues to get more crowded. In 2019, the number of MA plans for individual enrollment will jump by 417 to 2,734 plans, and most seniors will have 24 plans to choose from – an increase from 21 this year.

To address these challenges, plans are taking steps to set themselves apart, such as offering new benefits. Under new CMS rules, about 273 MA plans expect to offer ancillary benefits, such as transportation, meals and home modifications. But adding benefits doesn’t help if members aren’t aware of them. MA plans need effective education and engagement to prevent disenrollment and boost satisfaction with the plan.

Health plans with strong onboarding strategies that educate and engage members will reduce fallout and plan switching. These strategies should leverage a blend of traditional and digital communications, reaching members via their preferred channels with a personalized approach.

As the Medicare Annual Election Period comes to close and health plans head into the new extended open enrollment period, they should take three significant steps to retain members.

Welcome and educate

As soon as members have successfully applied and are waiting for their effective date, payers should reach out through various channels to educate them on the benefits of their upcoming plan year. Health plans should use a combination of traditional channels like mail, welcome calls, onboarding guides and letters, in addition to online onboarding tactics such as email and personalized web portals. Interactive tactics such as leveraging videos and infographics during an online welcome and onboarding sequence allows plans to demonstrate value of their plan and create a “digital sticky factor” with their new customers, advises Raj Vavilala, Vice President of Product Strategy and Marketing at GuideWell Connect.

Educational content should reinforce efficient use of the health plan, such as staying in-network, using generic drugs and taking advantage of urgent care centers and self-service tools. Payers should make sure members know how to compare the prices of drugs, procedures and office visits, as well as how to access ID cards and pay bills online. 

Another step to promoting positive health outcomes, good plan use, and member satisfaction is making sure members know who their primary care provider is. Establishing this relationship early is important, as the provider can interact with the member and provide clinical recommendations, ongoing health care guidance, and preventive health best practices.

Strategic and well thought out welcome and onboarding interactions help establish rapport, and research shows that emotionally engaged members are 1.4 times more likely to renew, 1.6 times more likely to be satisfied with customer service interactions and have 4 times the lifetime customer value.

Not a one-size fits all

During initial outreach to members, digital channels like web and mobile can be both convenient and cost effective. These channels are becoming essential as younger, tech-savvy baby boomers age into Medicare, and Gartner predicts that by 2020, customers will conduct 85% of their transactions with businesses without interacting with a person.

Many people already prefer digital over phone or in-person communication for a variety of health care interactions, so providing good digital tools and communications is critical for customer experience.

But there is no one-size-fits all communication solution, and other channels remain important. Plans now need to support traditional mail, digital, phone, and chat communications to reach members in their preferred way. Learning these communication preferences early on, and combining direct mail, digital, and phone channels into a single program, is key to increasing reach rate throughout the year. It also drives efficiencies through reduced postage and printing costs by only sending direct mail to members that prefer it.

In addition to choosing the right channel, the message should be personalized as well. Many enrollees will be new to Medicare, and the information they need will be different from what’s needed by renewing members. For members new to Medicare or new to the plan, product and benefit education should be the focus – not just during onboarding but during the sales process as well, says Vavilala. “To keep consumers engaged, drive better health outcomes for members, and increase the Life Time Value for health plans, payers should design a seamless experience that transitions members from sales into onboarding and through the full member lifecycle.”

Survey says…

Along with education, it’s important for payers to start a two-way dialogue with the member, capturing important health information early via a simplified health assessment. Survey results can help plans improve member health, member interactions and overall processes and strategies. They can also help improve QRPM, HEDIS and Star ratings, which assess plans, in part, on the preventive services members are getting, and how well they manage their chronic conditions.

The data from these early assessments should guide preventive care offerings and ongoing health care management. This can include tailored care, such as enrolling members in programs that can help them manage diabetes or other chronic conditions. The results also allow plans to craft more relevant messages and provide educational content that is shared with the member throughout the year to drive positive health benefits.

GuideWell Connect has seen firsthand that digital welcome programs, including a health assessment survey, bring high value for payers in terms of member engagement and improvements in care. In one partnership with a health plan, information collected by the plan’s risk adjustment team resulted in a value of $12 per survey.

Navigating the new MA open enrollment period

Health plans are navigating challenging headwinds due to the new expanded enrollment period and increasing competition in the market. While they must work year-round to ensure consumer satisfaction, the onboarding process is the most important step in building a good relationship, setting the stage for the rest of the year.

A strong welcoming and onboarding strategy will take a personalized, educational approach across multiple channels and start a two-way dialogue with members early on. Good onboarding builds loyalty and illustrates value early in the relationship, resulting in members that are confident in their health care coverage, and remain healthy, happy members in 2019 and beyond.

GuideWell Connect (GWC) is a leader in integrated consumer engagement solutions that helps health plans attract, engage and retain members. GWC provides technology-enabled services across the member lifecycle to advance health plans’ financial performance and drive better health outcomes for members. Learn more at