Three Open Enrollment Trends

November 16, 2019

Health plans are discerning approaches that position the business for long-term growth and member satisfaction.

Open enrollment season is here. A time when health plans change rates and members reconsider their health insurance. This year some savvy plans are testing out new approaches to open enrollment and viewing the season as more than just an administrative function––but as an opportunity to make a great first impression, improve retention, and reduce member churn.

The stakes are high for plans during open enrollment. Without the right strategy in place, there is significant risk for revenue loss, especially for plans participating in managed care lines of business. In fact, data shows a 10% YoY member churn rate for Medicare Advantage and a 5% to 8% churn for managed Medicaid.

This open enrollment season, health plans are transforming their strategies from a “business as usual” approach to a competitive edge that drives great outcomes and experiences for members, providers, and the business.

Related: The Biggest Problems with Healthcare

Here are three approaches leading health plans are taking this year to stand out this open enrollment:

1. Members are treated as VIPs. To offset member acquisition costs, health plans are focused on building loyalty with their members. Plans that stand out to members are expediating the enrollment process, reducing enrollment file fall-out, delivering welcome packets and insurance cards quickly, and ensuring quick access to care. These plans see open enrollment as an opportunity to demonstrate the high-quality experience members can expect in the year ahead.

2. Open enrollment is viewed as a long-term business strategy. Enrollment should be viewed as a lever for competitive differentiation among plans. By implementing a standardized, automated, and modernized process to manage and retain critical enrollment information across multiple lines of business, plans have greater potential to expand member footprint and enter new markets.

3. Technology investments are paying dividends. Plans are under increased pressure to deliver results for their business while avoiding costly errors during open enrollment. This year, several health plans having invested in new technology to reduce churn associated with financial value, streamline open enrollment processes, and ensure revenue integrity. For example, by investing in a single-sourced operations technology to manage all lines of business, plans are becoming more flexible and efficiently adjusting to government and marketplace format changes, rulings, and deadlines.

Members are not alone in making big healthcare decisions this season, health plans are discerning open enrollment approaches that position the business for long-term growth and member satisfaction.

Aaron Fulner is a senior director at Edifecs. His focus spans insurers involved in commercial, managed Medicaid, Medicare Advantage, and dual eligible programs. His expertise also spans insurers of all sizes and types ranging from small, regional plans, large, national plans, and Blue Cross/Blue Shield organizations.