5 ways health plans can boost retention

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A male doctor shows a female patient the Pyx Health app on an iPad.Is your health plan struggling with member retention? Your members have a choice, and losing them can impact your plan in many ways. It’s best to be as proactive as possible, and the most important aspect of boosting retention is improving member engagement. 

Disengagement sows seeds of disenchantment. If members don’t feel connected to your plan, they may not use the resources and programs available, leading to worsening conditions and more frequent use of costly health care resources. So how can your plan develop new strategies that boost retention, strengthen member engagement and decrease avoidable ED admissions? 

We have some insights and ideas to share:

Why does retention matter?

According to data, acquiring new members can cost between $400-$800 per member. If you’re unable to retain these members after the first year, up to half your investment is gone. 

To put this into deeper perspective, consider calculating the cost of disenrollment:

Cost of disenrollment = Total plan members x disenrollment percentage rate x average annual premium per member.

Disenrollment can become a considerable source of lost revenue. Retention is an even bigger concern for members struggling with loneliness, who often don’t manage their care effectively or comply with healthcare recommendations. With all of this in mind, your plan must have a retention strategy that aligns with your member engagement efforts.

What is the link between member engagement and retention?

Many plans link member satisfaction to member retention. However, the reality is that satisfaction isn’t always an indicator that a member will stay. A better gauge is member engagement, which comes with a unique set of challenges and opportunities. 

Often, you can engage members through personalized communications that educate them about their plan, provide them with online tools and address social determinants of health (SDOH). Consistent engagement strategies can help you connect with members, improving their health outcomes and lowering costs. However, there will be outliers to this. After all, the most disengaged members—often those suffering from loneliness—will require unique solutions for retention. 

In considering engagement and the importance of retention to your health plan, you’ll want to consider these 5 retention strategies:

1. Understand why people disenroll and make changes.

For those that disenroll voluntarily, the big question is “why.” You may be able to capture some root causes through member surveys and one-on-one conversations. It’s essential to pinpoint what’s making them seek another plan, outside of costs or access. If you can find the “why,” you can begin to make changes to the plan that benefit all members. 

For example, you may find members expect more from their health plan when finding providers, especially specialists. Most plans have directories of in-network providers, but they need members often need more support to find the right care and make an appointment. The process can be stressful for some members. If you can assist—or employ a vendor who can assist—they’d be more inclined to remain loyal. Making adjustments like this moves your plan to be more member-centric. 

2. Analyze member data and use it to make communication decisions.

You have heaps of member data from various sources. You know about their chronic conditions, risk of loneliness, SDOH needs, historical engagement and much more. This information helps you identify those who are highly disengaged, have barriers to care and need help managing diseases. 

Determine how you would score a member’s risk of leaving, then devise specific communications and resources to address the gaps. With highly customized communications across many channels, you have a better chance of reaching, engaging and keeping them.

3. Start off right with member-focused onboarding.

Retaining members starts from the moment they choose your plan. Defining and refining your onboarding program is a must. It should be easy, frictionless, convenient and friendly. You’ll need to meet members where they are, whether that’s online or offline. Virtual tools are growing in adoption, and it’s not just digital natives. Seniors are using them more now than ever. Technology is key to the member experience. It just needs to be accessible and friendly. 

With onboarding, creating bite-sized, ongoing communication regarding benefits, processes, resources, tools and programs can help members feel less overwhelmed with information. As they gain knowledge, they may also become more engaged and loyal. 

Need a better way to reach Medicare members? Discover how the right member  engagement program can improve health outcomes.

4. Identify opportunities for preventive care.

Another tactic to consider for retention is encouraging preventive care and incentivizing members to have annual checkups and screenings. Communicating benefits for preventative care is key to engaging members who are unaware of their benefits.

Then, offer support services for finding providers for these appointments if members don’t have one. With programs like this, members could live healthier lives through early detection. They will also see your plan as one that cares about their well-being. 

5. Offer unique solutions for the most disengaged and at-risk members. 

The last strategy is new to the health care landscape. It tackles a pervasive problem that has become a public health emergency. It’s loneliness, and it’s a driver of disengagement and frequent flyers that leads to disenrollment.

Such a complex condition requires a robust program. The program should address loneliness as a disease rather than a symptom of depression or social isolation. Friendly tech and human connection can help you identify the lonely, provide resources, improve engagement and reduce costs. 

Learn more about member retention and engagement 

These strategies can help your plan retain members and reduce disenrollment. Member retention and engagement require a deliberate approach, but you can turn the corner and support your plan and its members.

Learn more about the new horizon of member engagement by reading our e-book, “Member Engagement Conundrum: 5 Issues in Medicare and Medicaid Plans and How to Solve Them.”

Cover of Key Considerations for Choosing a Medicare Member Engagement Program