Achieving Member Retention Excellence: Strategies for Healthcare Payers

In today’s competitive healthcare landscape, member retention is paramount for all health plan types. Retaining existing members is significantly more cost-effective than acquiring new ones. However, achieving high retention rates requires a delicate balancing act between member satisfaction, operational efficiency, and cost control.

This blog delves into the key factors healthcare payers need to consider when prioritizing member satisfaction. We’ll explore how identifying operational gaps can illuminate areas for improvement, ultimately leading to a more engaged and loyal membership base.

The Member Experience Matters

Member satisfaction remains a fundamental element in the realm of member retention. While specific statistics may vary, the consensus across the healthcare industry is clear: the experience a member has with their health plan plays a significant role in their decision to continue their coverage. Ensuring a positive member experience across various touchpoints is essential for health plans aiming to retain their members.

Here are some key areas to consider:

• Customer Service: Is access to customer service representatives smooth and efficient? Are inquiries handled promptly and professionally?
• Care Management: Do members feel supported in navigating their healthcare needs? Is communication clear and concise regarding plan benefits and utilization?
• Claims Processing: Is the claims processing experience transparent and efficient? Are members informed and supported in case of any issues?

Retention Rates: A Key Performance Indicator

Tracking member retention rates is essential to understand the success of your member engagement strategies. Here are some helpful steps:

• Analyze Your Retention Trends: Track and evaluate your health plan’s member retention rates over time to pinpoint patterns and fluctuations. Investigate if there are specific times when turnover peaks, and assess the impact of various strategies and external factors on these trends. This analysis will help identify opportunities for enhancing member loyalty and reducing churn.
• Compare with Industry Benchmarks: Evaluate your retention rates against industry benchmarks to gauge performance. For Medicare health plans, the average retention rate for Medicare Advantage enrollees hovers around 90%, as reported by Convoso.¹ On the Medicaid front, Healthmine has found that the average disenrollment rate is about 18%, which indirectly suggests the retention rate.² Additionally, a 2023 AHIP report indicates that commercial health plans typically achieve an average member retention rate of about 86%.³ These benchmarks offer valuable insights, enabling you to pinpoint areas for strategic enhancement in your retention efforts.
• Gauge Competitor Performance: Analyze how your retention rates stack up against competitors. Distinguishing your performance from peers provides insight into competitive advantages or areas needing improvement, guiding targeted strategies for better retention outcomes. According to a 2023 report by AHIP, the average member retention rate for commercial health plans sits around 86%.

Identifying Operational Gaps: The Missing Puzzle Pieces

Operational efficiency plays a crucial role in member satisfaction. Gaps in your organization’s structure can lead to frustrating experiences for members and ultimately contribute to churn. Here’s how to identify these gaps:

• Staffing and Resource Assessment: Evaluate current staff levels and expertise. Are there specific areas where additional support could improve member service delivery? Consider the impact of burnout.
• Workflow Analysis: Examine internal workflows related to member interactions. Are there bottlenecks or delays hindering timely communication or service delivery?
• Automation Analysis: Assess the current level of automation within your processes and identify opportunities where technology can enhance efficiency, reduce errors, and improve member experience.

By proactively identifying operational gaps, healthcare payers can implement strategic solutions to enhance member experience, such as targeted Staff Augmentation

Filling critical gaps with qualified professionals like member outreach coordinators or patient advocates can significantly improve member engagement and satisfaction. HealthAxis offers comprehensive staff augmentation services specifically tailored to the needs of all health plan types. Our team of experienced recruiters can identify and place highly skilled professionals to address your specific needs, ensuring a seamless integration into your existing workforce.

Additionally, HealthAxis provides consulting services focused on core system optimization and automation strategies. These services are designed to streamline your operations, enhance efficiency, and further improve the member experience by leveraging the latest technological advancements.

Investing in Retention: A Long-Term Strategy

Addressing operational gaps and prioritizing member satisfaction through strategic solutions like staff augmentation from HealthAxis can significantly improve member retention rates. This translates to long-term benefits for healthcare payers such as:

• Reduced Acquisition Costs: Retaining existing members is significantly cheaper than acquiring new ones.
• Increased Premium Revenue: Loyal members are more likely to maintain coverage and potentially even upgrade plans, leading to increased revenue streams.
• Improved Brand Reputation: Positive member experiences translate into positive word-of-mouth marketing, attracting new members organically.

By focusing on operational optimization and prioritizing member experience, healthcare payers can achieve a sustainable competitive advantage.

Seamless Staffing Solutions: Empowering Member Loyalty

Creating a comprehensive member retention strategy demands both precision and adaptability. With HealthAxis, you gain a strategic ally adept at swiftly and effectively filling operational gaps, regardless of scale or scope. Our specialized staff augmentation services are designed to seamlessly integrate with your operations, providing the precise expertise needed to enhance your member experience and solidify your retention objectives

Let HealthAxis be your partner in building a loyal and thriving membership base. Learn more about how our staff augmentation solutions can empower your organization to deliver exceptional member service.

Sources:
1. How to Boost Medicare Retention with the Right Strategies and Tools and Protect Your Growth Potential, Convoso
2. Why All Health Plans Should Prioritize Member Retention, Healthmine
3. New State-by-State Data: How Health Insurance Providers Contribute to Health and Financial Well-Being, AHIP