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Blue Surface

Predictive Churn Risk Assessment – The AEP Gamechanger

As FMOs and health plan call centers gear up for the 2024 AEP battle, everyone’s sights are set on our old nemesis:

Short-term disenrollment.


Top FMOs and payers struggle with 15% - 30%+ short-term disenrollment. (You’re not alone.) As stated by a top 10 Medicare Advantage payer:


“I know that over 25% of our new enrollees won’t make it past 90 days.

But I don’t know who is at risk.

And I don’t know what they’re thinking.”


While the above is common, there are also large FMOs and carriers whose rapid disenrollment rates are consistently less than 10%. Observing this, it’s clear that they approach the challenge with a different mindset.


Success is intentional with low-churn FMOs and payers. Organizational structure, corporate culture, recruiting, and messaging are all mission-specific. But with only weeks before AEP, this formula for success isn’t of much value for high-churn call centers. It’s time for an out-of-the-box, turnkey solution.


SUCCESS BEGINS BY RETHINKING ENGAGEMENT


It’s time for a “sit down, use this tool, and deliver lower churn” solution.


One proven approach synthesizes technology and human engagement. This disruptive solution begins by “ditching the scripts.” Scripted onboarding and retention campaigns typically yield about 20% member comprehension and retention. Scripted communication is one way, yielding minimal client feedback. Expensive sentiment analysis programs have little to digest.


This stuff isn’t a secret. Leading FMOs and health plans successfully mitigate onboarding churn by proactively addressing known churn drivers. These topics are easy to bring up in discussions.

It all requires the fusion of technology and human-to-human conversations. Campaign-specific algorithms are cognizant conversational inputs and deliver active prompts that keep call center reps on topic. Yes, clients will wander, but real-time prompts refocus reps back on campaign goals.


While two-way conversational engagement can take longer than a scripted approach, technology offsets this by supplementing the rep’s subject matter expertise. Having digested all HContract_PBP-specific data, call center reps are provided thorough, satisfying answers to client questions. Technology lowers “time to answer” by more than 50%, and overall rep efficiency increases by 17%. All are delivered in the context of an enjoyable conversation.


NONE OF THIS CAN HAPPEN WITHOUT YOUR

TALENTED CALL CENTER REPS

happy male enrollee speaking to call center rep

While interactive technology increases campaign focus and subject matter expertise, your call center reps provide another vital element that computers just aren’t good at:


Empathy.


Technology’s job is to maintain total situational awareness. The call center reps’ job is to lead enjoyable conversations. Even when speaking with a stranger, the rep begins by reviewing the client’s social profile and chatting about those things most important in their life, maybe a grandchild, their garden, or their favorite sports team. There is nothing better than beginning each engagement with a smile.


THE TECHNOLOGY IS COMPLEX, BUT THE WORKFLOW ISN’T


Proprietary algorithms deliver answers to each client’s questions. The beneficiary is relaxed, knowing they’re dealing with a health plan pro. Cognizant of conversational inputs, PlanAllies recommends plan benefits that uniquely support the client’s lifestyle and aspirations. Natural and relaxed, these calls are a pleasant surprise for the health plan member. Client satisfaction and benefit utilization are a breeding ground for persistence and high LTV.


Agreed, this all sounds different than how your onboarding calls work.

And that’s why the results are different.


THE SAFETY NET: REAL-TIME CHURN RISK ASSESSMENT


Every millisecond, technology is assessing churn risk. Informed by conversational inputs, system prompts proactively guide the rep into conversational topics known to aggravate disenrollment. The interactive system scours disparate data points, creating an overview for each member. These composites are filtered through a nationwide predictive churn database, and the client’s forecasted persistence is calculated.


A predictive churn risk assessment is provided with every engagement. Your FMO or health plan is notified of high-risk enrollees. Each analysis includes a breakdown of both mitigating and aggravating factors. Higher-skilled call center staff then make a second call, and after a quick social chat, the identified churn drivers are diffused.


The busy FMO or health plan call center didn’t add new managers or reorganize. They didn’t spend weeks in training (more like 3 hours). They simply used the right tool for the job. Technology solves the problem, and everyone has fun during the process. What a concept!


AFFORDABLE – DELIVERING A YEAR ONE R.O.I.

  • As tech-supported conversational engagement increases clients’ plan literacy and benefit utilization, rapid disenrollment naturally decreases.

  • When your call center rep prevents two members from churning out, you’ve more than paid their annual PlanAllies expense. (This usually happens in the first month.)

SIMPLE TO TEST

  • Pick two or four call center reps

  • PlanAllies will train and coach them so you won’t be distracted

  • For less than the cost of a pizza night, you’ll discover how to increase plan literacy, benefit utilization, and member retention


It’s time to ditch the scripts.





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