Managing the annual enrollment welcome call surge

As millions of new members enroll in Medicare plans before Dec. 7, health insurance providers must manage the annual surge of welcome calls needed to connect with each person. These calls, made in the first 30 days of enrollment, help ensure members understand their benefits, available resources and support options. They serve as a critical touchpoint that can significantly affect a new member's experience, retention and overall satisfaction with their health plan.

To quickly reach new members, each insurance company must temporarily staff up and train a sizeable call center operation for just a few weeks, then pare back call volumes shortly after.

The Centers for Medicare and Medicaid Services mandates new member outreach: however, a high percentage of initial calls go unanswered. A well-trained, experienced welcome call team should be able to connect with at least 75% of new Medicare members and complete at least two-thirds of new member surveys, an important component of the onboarding process.

Typically, welcome calls cover the following aspects of care:

• Plan benefits and how to maximize them.
• Primary care providers and specialists needed for continuity of care.
• Premiums, supplemental benefits and other additional costs.
• Availability of community resources.
• Help setting up online access, portals and virtual education registration.

Welcome calls benefit Medicare providers and members alike 

• Enhanced plan performance. Welcome calls cultivate better plan performance by addressing each member's needs promptly and effectively. This proactive engagement can lead to higher member satisfaction and better health outcomes, which, in turn, elevates customer experience metrics and drives favorable CMS Star Ratings.

• Improved member retention. Medicare enrollees can switch plans annually, and they will do just that if their needs haven't been met. Plan providers must cultivate loyalty from the outset. Well-orchestrated welcome calls by an experienced, outsourced team can improve member retention by creating a positive first impression and establishing a trustworthy relationship.

Partnering to provide high-quality calls 

Strategic Medicare plan providers partner with highly trained teams that specialize in member outreach and can manage high volumes of welcome calls. Outsourcing resources as needed enables Medicare plans to handle the initial enrollment surge and establish high-touch, empathetic connections with new members. These member engagement partners play a crucial role in gathering and confirming pertinent new member information, explaining plan features, and addressing immediate needs.

By prioritizing member engagement from Day One, Medicare plan providers can increase satisfaction, reduce churn, and drive long-term retention. In a landscape where member experience is paramount, the importance of welcome calls cannot be overstated. As the saying goes, “You never get a second chance to make a first impression.”

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Gregory Deranian is vice president of business development and marketing at Focus Care. Contact him at [email protected].