Four Best Practices to Prevent Rapid Disenrollment

November 13, 2019 Anne Davis

Medicare Advantage Annual Enrollment Period (AEP) is in full swing. With less than a month to complete enrollment for 2020, savvy plans already have their disenrollment strategies in place.

The disenrollment period — known as the Open Enrollment Period (confusing!) allows Medicare Advantage (MA) beneficiaries to make a one-time change from the plan they selected during AEP (October 15 – December 7). Enrollees can move from one MA plan to another, or return to Original Medicare. The Open Enrollment Period lasts from January 1 – March 31.

This means that first impressions matter.

Generally, the first impression your members may have with the health plan is with the pharmacy benefit, prior authorization process, or transition of coverage process.

More than ever, Medicare Advantage plans must identify issues quickly, and make rapid adjustments. With the flurry of activity, a bolus of members, and organizing details of campaigns and key performance indicators, there is no end to improvement opportunities.

As Medicare Enrollment Numbers Soar, Don’t Overlook Disenrollment

Remember these four proven best practices as you build a process to hit the year strong and responsive to the needs of your members:

  1. Review Your First Touch. For many, the welcome call (or kit) is not the first contact with the plan. Review pharmacy, care management, and authorization processes and procedures.  Listen to calls, track time to resolution, and coach member services’ on de-escalation techniques and solid service skills.
  2. Be an Extension of the Care Team. We know that members with a primary care provider have better clinical outcomes. Are you receiving calls about changing providers? Be proactive with your members to ensure they are getting the care they need now, and identify any issues with your provider network.
  3. Ask for Feedback. Use every interaction with your members as an opportunity for feedback. Ask “How can we make your experience easier/faster/better?” Sponsor disenrollment surveys to best understand why enrollees are making the switch, if they are. Use those surveys to inform what’s next for your plan.
  4. Plan for Next Year. When you begin your 2021 bid process, conduct population analyses to see which members will be most impacted. Which member cohorts are at the highest risk for leaving the plan? Which cohorts will be most impacted by plan changes? Once you have identified these members, reach out and be transparent. It’s never too early to start planning your strategic member outreaches and targeted communications plans!

We have an opportunity to be part of better healthcare for our members. Ask and then respond.


Are you interested in learning more about how your health plan can support your member onboarding and prevent rapid disenrollment of Medicare members?

Schedule a conversation with one of our solution consultants for a walkthrough of HMS’ portfolio of engagement programs, including Welcome & Onboarding, Disenrollment Surveys and more.

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