top of page
Blue Surface

Predictive Churn Risk Assessment: A Roadmap to Reduce Short-Term Disenrollment

Is this a familiar scenario?

You’ve added 5,000 new enrollees to your Medicare Advantage plan during AEP.

  • Despite being onboarded by your call center, short-term disenrollment typically averages 30% for your plan.

    • One thousand five hundred new enrollees will likely churn in the next 90 days.

  • Who are they?

  • What issues are driving their dissatisfaction?

  • Who should you call? What should you do?

Technology to the Rescue:

State-of-the-art technology acts as a “virtual assistant” for call center agents. Cognizant of plan benefits and campaign goals, technology monitors conversations, searching for health plan features and benefits that match the new enrollee’s lifestyle and aspirations. Conversational scripts are curated for the agent in real-time, resulting in a highly personalized introduction that leaves the enrollee feeling, “This health plan was created just for me.”

While increasing plan literacy and utilization, technology constantly monitors disparate comments and emotions expressed by the new enrollee as it searches for churn risk. When churn drivers are often recognized, the agent is prompted to unpack and diffuse the issues in real time.

A Roadmap to Reduce Churn:

Predictive Churn Risk Assessment Member
Above names are fictional.

Following each conversation, technology provides an evidence-based roadmap that identifies churn risk.

Automated outputs include a predictive churn risk analysis and a social profile for each enrollee.

Churn risk is forecasted at multiple levels:

  • At the 10,000-foot level, the PBP is split into four levels of churn risk: very low, low, moderate, and high

    • The percentage of new enrollees in each level is quantified

  • A more specific by-member analysis categorizes each enrollee in one of the four forecasted churn risk categories

  • Even more precise, the topics that either mitigate or encourage short-term disenrollment are detailed for each member

Predictive churn risk assessments enable your health plan to proactively engage high-risk enrollees, discussing and diffusing the topics that go unnoticed today.


Mike was trending toward high churn risk. He had a bad experience with the plan’s help desk and had to call three times to resolve the issue.

The call center agent had previously discussed Mike’s former career as an I.T. manager. Technology prompts the agent to introduce the plan’s portal and then demonstrate how to navigate and research topics important to Mike, including plan benefits and FAQs.

Finally, the agent invites Mike to join the plan’s “Member Insight Group”, where plan members can offer suggestions and participate in research polling.

Mike was a problem.

Now he’s a partner.

Jan is categorized as a high churn risk, and “costs” are listed as a churn risk driver. Her social profile includes her quote, “My friend has a zero-dollar copay plan. I’m not going to pay $30 for in-network visits”.

A senior call center agent follows up with Jan, acknowledging her frustration and reinforcing that the plan cares about value. The agent explains that the zero-dollar copay plan Jan referenced has a $135/month premium, whereas Jan’s plan has no monthly fees. All totaled, Jan’s plan is much less expensive.

Churn defused.

With scripted call center onboarding, Jan and Mike are under the radar, destined to churn. Acknowledging and diffusing their concerns isn’t difficult; you just need to know the risk factors.

Scalable and affordable:

Lowering short-term disenrollment from 30% to 28.3% yields a 2:1 ROI for the typical Medicare Advantage plan. (Decreasing from 30% to 25% is an 8:1 ROI.)

See for yourself:

With OEP behind us, now is the time to plan for success in 2024. Click the link below to learn how PlanAllies™ leads call center agents through conversational engagement. While improved literacy, utilization and satisfaction are a big win, having a road map of forecasted churn risk is a game changer for your health plan.

Now is the time to test:

Test these new technologies with members who age into your health plan, onboard half with your current approach and the other half with PlanAllies™. Moving forward, you’ll identify a scalable opportunity to increase satisfaction and retention meaningfully. And in 2024, you won’t fear short-term disenrollment; you will proactively diffuse it.

It’s time to ditch the scripts!


Rated 0 out of 5 stars.
No ratings yet

Add a rating
bottom of page