Keeping up with the “new wave:” How exchange-enrolled members are changing the game

Millennials are embracing the opportunity to engage with traditional health insurance. Forty percent of the 11.7 million enrollees from the latest open enrollment period of the Affordable Care Act are Millennials, which means they bring their preferences with them for company engagement. The ease with which exchange members can switch plans now poses challenges to health plans to increase member satisfaction and retention – and keep their younger members engaged.
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A tsunami of 11.7 million members enrolled in health plans through the nation’s health insurance marketplaces during the past open enrollment period and health plans are wrestling with the needs of their new customer base to increase satisfaction and retention.

A tsunami of 11.7 million members enrolled in health plans through the nation’s health insurance marketplaces during the latest open enrollment period, and health plans are wrestling with how to deal with the marketplaces’ success. This wave of new members has a big impact on health plans’ business. It not only increases the number of customers with whom they now interact, but also influences the types of interactions, as many of these members are new to traditional health insurance. Call centers have become overwhelmed with inquiries, increasing hold times and longer handle times – endangering member satisfaction and retention.

In addition, the increasing number of members who have individual plans ­– and that may easily switch plans each year – increases the importance of quality customer service. A positive member experience now makes all the difference in member retention.

A Kaiser Family Foundation analysis found that 40 percent of new exchange members were between the ages of 18 and 34, precisely what we define as Millennials, and fully enveloping the range that we in healthcare have come to know as the “Young Invincibles.”

So, how do we efficiently and effectively handle this new wave? There are several approaches and technologies that payers are using with success: improving the IVR experience with better routing and improved voice user interface design, implementing virtual web assistants that can handle everything from benefit to provider network questions and automating voice, text and email messages that proactively communicate with members about upcoming enrollment deadlines and claim status, thus deflecting calls.

To drill down on the topic of proactive engagement, Nuance commissioned a survey of American health consumers and health plan executives to learn the most effective ways health plans can reach and engage members. The results showed consumers want proactive outreach from their health plans, with Millennials preferring automated channels at three to five times the rate of Baby Boomers.

Our research found more than 69 percent of health plan members desire proactive reminders. Amongst Millennials specifically, automated channels compare very favorably to the expensive, traditional channels: mail and live agent calls. Email is preferred by 44 percent of the younger generation and automated voice (18 percent) and text messages (17 percent) are also among preferred communication channels.

As consumers rely more and more on technology to keep track of everything from birthdays to when their favorite band’s tickets are going on sale, proactive reminders are becoming the mandate for keeping consumers on track and health plan executives have realized this. When asked in which areas their organization was most likely to add automation or self-service technology in the next 12 months, the top answers had a clear and important theme:

  • Population health program enrollment – 51 percent
  • Health coach or screening appointment confirmation – 50 percent
  • Smartphone push reminders – 50 percent
  • Chronic management tips – 49 percent

I received a very timely text when Morrissey tickets went on sale and I was able to easily evaluate my options and purchase them online (mystery solved – I’m a Gen Xer). I’m seeing many progressive payers make great strides in addressing the preferences of their members, but several plans I’ve worked with still have a ways to go. With two-thirds of consumers saying they have cancelled a service or ended a relationship with a company because of a poor customer service experience, there’s too much at stake to take that very expensive shortcut.

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Vance Clipson

About Vance Clipson

Vance Clipson, senior principal, industry solutions for Nuance Communications, focuses on vertical-specific marketing and strategy with an emphasis on healthcare. Clipson brings 25 years of experience translating industry needs and data into market strategy and programs for Milliman, PacifiCare Health Systems and the American Cancer Society.