Welltok Reduces Medicare Disenrollment by 30% with Data-Driven Communications

Posted Jul 09, 2019

The average Medicare Advantage plan turns over about 10% of its members every year, and for a 100,000 member plan, that can equate to about $110 million in lost premium reimbursements as well as a decline in Star ratings. This is why retaining members is a top priority among health plans. Welltok's Medicare Retention Solution has helped leading Medicare plans reduce disenrollment rates by up to 30%, improve disenrollment-related Star ratings from 2.5 to 4 and retain up to $97 million in premiums.

Today's seniors have more coverage choices and higher expectations, making it essential for plans to proactively pinpoint members at risk for disenrollment and intervene. Welltok's Medicare Retention Solution does exactly that by leveraging proprietary consumer data, including social determinants of health and machine learning. The analysis identifies key predictors, including copays, healthcare services utilization, available competitive plan options and demographic factors, such as number of adults in the household, voting status and affluence. This helps determine who would be most receptive to disenrollment prevention outreach and likely to stay with the plan. The solution then delivers a one-of-a-kind, personalized and year-round member experience designed to drive retention. Welltok also helps ensure plans stay compliant with the latest guidelines and industry-leading security standards.

"To support retention, we offer a coordinated engagement model that delivers a tailored experience designed to help plans engage and activate members, starting on day-one of enrollment," said April Gill, vice president of market solutions for Welltok. "We also help plans know exactly where they stand with members, and when action is required to conduct targeted outreach effectively to retain members and improve satisfaction."

Whether it is regulatory communications like an Annual Notice of Change (ANOC) or regular reminders of plan value and available benefits, Welltok brings it all together and makes it easy to personalize, target and measure impact. The result is a seamless experience built to keep members engaged, informed and active. Specific ways Welltok's solution helps tackle disenrollment include:

Disenrollment Prevention: Start by facilitating a better welcome experience and support members with tailored communication for plan benefits and changes. Additionally, leverage predictive analytics and machine learning to identify who is most likely to disenroll and proactively reach out to them to address potential concerns and ensure loyalty before annual election period (AEP).

ANOC Best Practice: ANOC can cause stress for members, which is why it is important to ensure members feel supported and are reminded of plan value. Prepare members for upcoming changes by providing educational resources to members, personalized to their severity of change level. Leverage effective channels such as automated voice (IVR), text and email, and seamlessly transfer to high-touch customer support only when needed to keep costs down and members happy and informed.

Open Enrollment Period (OEP) Best Practice: Protect against member poaching at the most critical time of year. Cost-effectively capture member communication preferences early to streamline engagement and improve satisfaction all year long. Meet people where they are with the right message and combination of automated calls, email, interactive messaging, direct mail, web or live agent calls based on preferences and needs.

Learn more about Welltok's Medicare Retention Solution or request a demo here.

About Welltok, Inc.
Welltok is a data-driven, enterprise SaaS company that delivers the healthcare industry's leading consumer activation platform. Welltok's solutions empower leading health plans, employers, providers and public entities to connect consumers with personalized health improvement resources, making it easy and rewarding for consumers to complete actions that optimize their health and wellbeing. Only Welltok leverages a machine-learning, multi-channel approach proven to help innovative organizations power growth and retention initiatives, improve healthcare value, and streamline the consumer experience, while upholding the highest security and compliance standards. Follow us on Twitter