A number of economic factors are driving unprecedented membership losses at most health insurance plans, according to a recent study.
The study showed that member retention is increasingly difficult for health plans to achieve, and most plans are doing it poorly.
The research, conducted on behalf of ConnextionsHealth, also had some good news for health plans. The study revealed that properly managing member disenrollment delivers a significant, positive impact on net enrollment and revenue generation for health plans.
Results of a proprietary study conducted by a management consulting firm show:
Two-thirds of members in individual health insurance plans have multiple reasons for leaving; these include six broad categories, 32 subcategories and nearly 300 distinct root causes for dropping coverage.
Root causes of member disenrollment vary widely, based on factors such as plan type, geographic region, sales channel and, most notably, a member's tenure with the health plan – which can be identified and addressed by specific stages in the member lifecycle.
Traditional phone-based campaigns to capture and analyze disenrollment reasons are ineffective. Exit interviews that lack clear focus and tenacious questioning regarding root causes do not provide health plans with meaningful insight into disenrollement.
The majority of disenrollment drivers are controllable. But success in member retention involves sophisticated research into disenrollment drivers, careful design of proactive and reactive retention initiatives and, most importantly, a sustained commitment to member retention from senior management.
The most successful disenrollment initiatives by health plans do not approach member retention as an isolated strategy, but also integrate the discipline into their member acquisition and member service programs.