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

Medicare Retention Solution Pairs Social Determinants of Health and Machine Learning to Keep Members Coming Back

DENVER, July 9, 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 satisfactionWhether 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.

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Welltok is an award-winning consumer activation solutions company that improves people’s total wellbeing. Only Welltok leverages proprietary data and advanced analytics to engage consumers in personalized and rewarding ways to drive action. Our solutions integrate data-driven SaaS software, curated resources and professional services to help health plans, self-funded employers and health systems support healthier, happier populations.

Welltok is an equal opportunity employer.