5 Tips for Improving Year-End Medicare Retention

As open enrollment approaches, many Medicare Advantage plans start to think about their year-end member retention strategy: how to rise above the noise and minimize voluntary disenrollment given the onslaught of health plan marketing, notification of plan changes and other member communications.


Here are 5 keys for improving year-end Medicare retention:


  1. Pick the right members. Some members are simply higher risk to voluntarily disenroll than others.  A “one size fits all” marketing campaign targeted to every member with the same message will not yield an optimal return on investment since the higher costs of the campaign will dampen the return from higher retention.  For an effective, efficient campaign, leveraging insights from a high-performing predictive model which predicts the likelihood of voluntary disenrollment is essential.


  1. Try to know why members might disenroll. Targeting the right members based on their likelihood to disenroll is a great way to zero-in on the highest risk members, but knowing why these members will leave the plan helps to personalize the communication so that that members’ barriers to continued enrollment are addressed.  Keep in mind that members don’t necessarily leave because they’re unhappy with the plan: they might leave because they don’t understand or see the value in their current plan.  These are what we call “disengaged” members – member’s that haven’t used the plan enough to understand the value. We recommend trying to impute (using your own data and understanding of the market) a member’s barriers to continued enrollment, and personalize the outreach to try to address these barriers head on.  In short, try to resolve and address issues for members that are dissatisfied, and try to get the unengaged member to better engage with the health system.


  1. Stay ahead of network changes. If a member is high risk to leave the plan and you already know that you’re going to make changes to the network in their service area, try to stay ahead of this issue and address these issues upfront.  The Annual Notification of Change communication is not enough.  For these members, it’s better to explain in plain English the reason for the change, your commitment to their service area, and the various options available to the member.  Any other type of communication to these members will result in making their flight risk higher, not lower.


  1. Try to coordinate member outreach with other plan initiatives. The end of the calendar year also signals a push for other important plan initiatives such as HEDIS care gap closure.  Coordinating with your HEDIS team helps to create more efficient outreaches to members and can potentially do more than one thing: they can help close HEDIS gaps AND they can help lower voluntary disenrollment.  The key here is to use predictive models to identify the relative risk of gap closure and the relative risk of voluntary disenrollment and choose your targets for each initiative wisely.  If there are overlap in the lists, then either prioritizing one of the communications or modifying the communication outreach to account for these multiple issues works best.


  1. Know that this is a journey. Reducing voluntary disenrollment is satisfying from both an ROI perspective and from a Medicare Star perspective.  However, it’s important to know that this is only a first step.  Now you have the opportunity to continually engage the member to create longer term loyalty with the plan.  We’ve found that it’s most effective when these higher risk (for disenrollment) members are identified and communicated with throughout the year, not only during open enrollment.  Year-round “touches” and check-ins with these members signals an understanding of the member’s challenges, and begins to transform the plan from a “claims payer” to a “trusted source of information” in the eyes of the member.


By Saeed Aminzadeh, CEO

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