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Blue Surface

Low Disenrollment & High Growth: How FMOs Deliver Both

High-touch FMOs’ importance to health plans is on the rise. Increasingly online brokers are struggling with high rates of short-term disenrollment with Medicare Advantage enrollees.

It’s common for health plans purchased online to experience 30%+ short-term disenrollment.

But, managed by a high-touch FMO, short-term disenrollment is under 10% for the same health plan.

The reason: The quality of member engagement.

Short-term disenrollment is becoming the key metric for health plans. High-touch FMOs are enjoying newfound opportunities as frustrated payers recognize the importance of human-to-human engagement.

FMOs understand that high-risk enrollees often signal their churn risk well in advance of changing plans. Sales agents are masters at deciphering these clues during conversational engagement.

But this introduces frustration: Many FMOs feel stuck, noting that ongoing check-in calls from sales agents limit their ability to continue selling. “How do we strengthen relationships (and retention) with existing plan members while also building our book of business and cross-selling, 12 months per year?”

Solving this problem requires a fundamental change in the approach to call center engagement.

Sales agents build relationships and retention with conversational engagement.

FMOs are increasingly leveraging technology that supplements call center reps’ subject matter expertise, allowing them to do the same.

male senior happily speaking on the phone

Acting as a virtual assistant for the call center rep, technology curates real-time scripts, based on each conversation’s unique flow. This leads to enjoyable conversations where the plan member does most of the talking. Known churn drivers are intentionally inserted into the back-and-forth discussion. A.I. then scrutinizes the sentiment, intent, and responses plan members provide. When churn risk is identified, the rep is prompted to discuss, unpack and attempt to diffuse the topic. Throughout the conversation, supplemental benefits are introduced to the enrollee in the context of how they support the member’s lifestyle and aspirations. Member satisfaction increases, along with plan literacy, utilization, and persistence.

The FMO receives automated reports that stratify churn risk by member. Aggravating factors are detailed for enrollees who are at high risk for disenrollment.

Imagine completing a Medicare Advantage onboarding campaign,

knowing which enrollees are at risk of short-term disenrollment and why.

The FMO focuses on the identified high-risk enrollees with a second wave of engagement, this time using the members’ sales agent.

The overall impact of this approach dramatically lowers the number of service calls made by sales agents, allowing them to cross-sell and increase revenue. The relatively few post-sale calls made by sales agents are super valuable, as each is an opportunity to save an enrollee who is about to disenroll.

Tech-enabled conversational engagement enables high-touch FMOs to achieve what fully automated brokers are failing to deliver: Rapid growth AND single-digit short-term disenrollment rates.

As new members age into Medicare Advantage, you can compare enrollee satisfaction and retention with call center rep/PlanAllies™ onboarding calls vs. your sales agents’ performance. You’ll find an excellent opportunity to increase growth while maintaining quality.


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