Open Enrollment: 3 Ways the Member Care Experience Affects Conversion & Retention Rates

Open Enrollment is just around the corner which means that your staff is probably preparing for it as you read this. During last year’s open enrollment period, many health insurance companies experienced issues with their customer service that negatively impacted member retention and conversion rates. Prospective and returning members came to insurers with questions about both the complicated enrollment process and the complex details of plans they were considering. Despite months of planning, many customer support infrastructures couldn’t handle the added stress, resulting in the failure to meet business objectives and customer expectations.

To stay ahead of the surge, it’s important to understand what details, if overlooked, can impact your members and your business:

Accessible, accurate and empathetic service is key to member satisfaction. A single member interaction can have a major impact on the overall member experience your organization provides. Representatives need to accurately and compassionately answer customer inquiries, especially during stressful, high-volume periods such as Open Enrollment.

  • Are your agents able to accurately address questions about the coming year’s coverage, or do inquiries go unanswered?
  • Do your agents go a step beyond to ensure issues are resolved and questions answered?
  • Do they take members’ comfort levels with technology and overall demeanor into account during interactions? This year, provide your members with the extra-level support and care they are seeking.

Positive member experiences drive enrollment and retention. Inadequate service can result in missed revenue opportunities, specifically in the areas of enrollment and retention. After all, consumers are unlikely to enroll in a plan if their needs aren’t being met early in the member journey. Failure to assist members at this stage can bring on doubts about the quality of the service you’ll provide going forward.

  • Keep in mind that improving the service experience isn’t just about impressing potential members. Helpful, caring and positive interactions with representatives can result in significant increases in retention and enrollment rates for years to come.

A negative member experience can result in delay or avoidance of care. In the healthcare industry, providing quality support can have high stakes: It can directly impact the health and well-being of your patients. When communication is poor or call wait times are long, frustrated consumers frequently end contact without issue resolution.

  • This most frequently occurs within our highest risk populations — members who struggle with care management or who are managing multiple medical conditions and have limited access to various support channels. Uncertainty about plan components can potentially lead to delays in treatment, noncompliance, and costly hospitalizations or readmissions.

How to ensure an exceptional member experience during Open Enrollment

The good news? Adequate preparation can help ensure that members and potential members enjoy an optimal experience, even during a high-stress period. The most important steps insurers can take to get their call centers ready are:

  • Provide agents with effective, adaptive training and personal support
  • Happy and supported service agents are more likely to deliver an Exceptional Member Experience. Open Enrollment is a demanding time; leverage best practices to ensure your operating environment is meeting the personal needs of your agents.
  • Supply agents with the necessary tools and information to address member issues and improve their overall experience. Take advantage of advances in artificial intelligence and data science that are powering a new class of adaptive microlearning solutions.
  • Increase staff in anticipation of higher call volumes
  • Ensure that prospective members won’t be met with long hold times and overwhelmed agents when they come to you for answers.
  • Payers often turn to overtime as a strategy to increase agent availability, often leading to agent “burnout.” Anticipate and plan for higher volumes, rather than further stress an already maxed-out workforce.
  • Embrace multiple service channels
  • Ensure your digital strategy includes mobile and social media to acquire, grow and interact with your member base. Employ an effective program to identify, listen to, and respond to mobile and social media call outs.
  • More than 65 percent of customers aged 18-44 use mobile to seek service more than once a month.
  • Ninety percent of customers who report a poor experience seek customer support on a mobile device.
  • According to WOW Marketing, 52 percent of customers are less likely to engage with a company because of a bad mobile experience.
  • Increase accessibility through multiple, non-traditional communication channels:
    • Digital self-service
    • Social networks
    • Messaging
    • Chat
    • Communities (forums)

Open Enrollment can be a stressful time for members and prospective members, but with these tips you can create a caring, positive experience that will alleviate some of the frustration. As you prepare for another demanding Open Enrollment, contact us to find out how we can provide proactive solutions that drive positive business results through our CX portfolio.