This Year’s Enrollment Season Will Be Rocky. Here’s How to Get Ready

Between recent policy tweaks, regulatory shifts, and market transitions around Medicare Advantage (MA), the upcoming enrollment season will likely be a hectic one. In fact, the whirlwind is already gathering speed.

Take the recent changes resulting from the Inflation Reduction Act, signed into law in August 2022. The act stipulates that beneficiaries’ out-of-pocket Medicare Part D costs will be capped at $2,000 per year starting in 2025. It’s a move that will reduce annual medical expenditures for millions of enrollees, according to KFF — and will likely force some payers to raise premium costs to cover the resulting shortfall.

Then, in April of 2024, the Centers for Medicare and Medicaid Services released a spate of new regulations around Medicare Advantage — a “Final Rule” meant to update and enhance previous policy tweaks made to these programs. The mandates touched on several aspects of MA plans, including: 

• Cracking down on volume-based bonuses for brokers, which had the potential to sway clients toward just one carrier
• Setting new rules around the efficacy of MA plans’ supplemental benefits
• Outlining new enrollment policies for people eligible for both Medicare and Medicaid

Sweeping changes to standard operating procedure can be costly in terms of time and money, and these regulations, consumer-friendly though they may be, present challenges for payers who are already feeling stretched. This year’s reimbursement rates haven’t helped — they’ve been lower than anticipated so far, dropping by 0.2% since last year.

While this destabilizing time has everyone in the industry talking, it should also have them strategizing. Though some of these rules don’t take effect until next year or even later, plans must act now to accommodate the extra costs they will bring. For many plans, that will mean shrinking the list of benefits. When this year’s Annual Notice of Change (ANOC) drops and members are faced with what may be significant changes to their coverage, they may be tempted to shop around for a better option. How can plans convince them to stay put? By implementing our three-part retention strategy. 

Step 1: Mitigate

At least a few weeks before your ANOC drops, start reconnecting with members with thoughtfully crafted, confidence-boosting messaging. This journey needs to focus on engagement content that gently reminds them of all the reasons they chose your plan in the first place. The goal is to create a feeling of calm reassurance — you’re here to help them take the next step toward better health.

Timing is key though. Don’t wait until the ANOC is delivered and questioning calls have already started coming in. Instead, start sharing this messaging in September or sooner. You can gently prime members for what’s coming with a smattering of well-timed postcards, emails, and SMS text messages.

Equally important: Keep the conversation going after the notice arrives and the Annual Election Period begins. In the post-ANOC period, focus on fostering a sense of trust and encouraging members’ loyalty through transparency. Let members know that Medicare Advantage is changing for the better by helping to ensure consumers understand, access, and use the health-improving benefits available to them.

As ever, segmenting your audience can make a big difference. A longtime member who’s highly satisfied with their plan may just need to be reassured that they are appreciated. You remind them that no action is needed just now, and that you’ve still got their back. Meanwhile, you may want to engage plan hoppers — those who are less engaged and/or satisfied — by intensely focusing on your unique plan value and encouraging them to make the most of their benefits this year. You’ll instantly communicate that you’re a true partner in their care. 

Step 2: Activate

Dedicate January through March, the Open Enrollment Period (OEP), to delivering on your partnership-building promise. Members who engage early and often with their benefits are more likely to feel satisfied with their plan — but they need to know what the benefits are to begin with. And many don’t: In fact, one survey by The Commonwealth Fund found that 24% of people who hadn’t used their supplemental benefits in the last year simply didn’t know what their plan offered.

The solution: Kick off your communications in January with an easy-to-follow journey that introduces members to the priority benefits and services that matter to them (and to you). It may start off by encouraging members to create their online member account, and then move on to choosing a primary care provider and scheduling their annual wellness visit. Focus on the highest value actions first and use impossible-to-resist engagement content that grabs members’ attention and moves them one step closer to activation.

As OEP continues, personalize your journeys so that members are learning about the additional benefits that will be most helpful to them. There’s no better retention strategy than being worth retaining. For example, if someone has a rising risk of prediabetes, help them level up their activity with a fun article that shows them how to turn their walk into a workout. A few strategically placed calls to action can then highlight the perks of signing up for the plan’s fitness benefit.

Members may not convert on first touch. But by giving them information that can truly help their health, they will soon come to expect (and rely on) hearing from you. The happy result: They’ll be much more willing to click those CTAs and fall in love with their plan.

Step 3: Stay connected

Steps 1 and 2 are all about catching members at an opportune time. Lasting retention isn’t only captured in moments though; it builds over time with an always-on approach to engagement. These email and/or SMS journeys should be timely and highly useful — the targeted, accessible, cut-through-the-noise health information that members crave.

There’s no content for content’s sake here though: The goal, always, is propel members to act, whether by scheduling their preventive screenings, improving their general health habits, or getting serious about addressing chronic conditions. Those activations don’t only fuel retention rates. They also target key quality measures and clinical outcomes in preparation of Star Ratings. When you educate members about depression and drive activation into your virtual behavioral health platform, you’re also helping to support better outcomes. With the new triple-weighted mental health measure going into effect next year, it’s hard to find a downside in that.

Bottom line? This is a tumultuous time. Things are changing at breakneck speed. There are challenges ahead. But redoubling your plan’s commitment to pitch-perfect activations delivered at high-impact moments and year-round can help you come through with your membership intact, and hopefully, even bigger than before.

Our three-part, year-round retention playbook zeroes in on what members desire from their MA plan and speaks to those desires via well-timed interventions and activations. Drawing on the power of behavioral science and AI-driven predictive analytics, this holistic strategy cements a plan’s value in the minds of its members, then delivers on that value again and again. To learn more about the value that Linkwell can unlock in your engagement strategy, contact us today.