6 Reasons Keeping Member Enrollment Up Will be a Challenge

May 1, 2014 Marijah Adams Cleek

While President Obama might have done a full-on victory dance on the White House lawn in celebration of enrolling 8 million people for healthcare, health insurance executives are experiencing some mixed emotions.

On one hand, more Americans purchased insurance plans from them this year (win). On the other hand, they’re now taxed with figuring out how to keep them for the long hall in this new age of healthcare consumerism.

6 reasons keeping member enrollment stable might require a whole new game plan:

  1. Policyholders don’t really understand what they’re holding. Roughly two-thirds of adult have holes in their comprehension of basic insurance lingo, and understandably so. Insurance is a tricky subject to grasp. Unfortunately, if those gaps aren’t bridged, it may result in a slew of dropped policies.
  2. They can’t find their doctors… Going back to the lack of basic insurance lingo, “in network” is a term that many don’t fully get. It would stand to reason that when one signed up for insurance, that insurance would cover any type of doctor that the plan covers. Unfortunately for some, that is not the case.
  3. Or their prescriptions. In a report released last week from Avalere Health that examined 85 health plans, it was difficult or impossible for nearly half of the buyers to figure out which drugs were covered by their plans.
  4. Plan options keep changing. Companies plan to expand their presence in the 2015 open enrollment exchange, giving shoppers more shopping options next year than they received in 2014. And several of the plans that had been extended through 2014 will expire, no longer being offered on the market.
  5. Money. Currently, plans have a built in 90-day grace period for late premium payments. But there’s a lot of speculation about some not-so-awesome policy price hikes that have insurance customer a little freaked out. Many people were already taken aback by the monthly premiums they received this year, and we’re not exactly living in the most stable of economies these days. Plus, when it’s taken into account that ¼ of premium subsidy qualified citizens don’t have bank accounts, I’d say financial education and cash payment locations are going to be pretty important.
  6. Word-of-mouth reviews will change the game. Both online and in person, word-of-mouth reviews of a company are powerful and should not be taken lightly. Where previously, insured Americans were attached to an employer’s plan, they now have quasi-free reign to go where they please. So, customer service is more important than ever. Many companies are offering health-management plans and digital platforms in hopes of increasing health profiles into brand loyalty. A growing number are acquiring plan education tools to ensure their customer base is fully informed of the purchases they’re making.

Zappos testimonials

Exponential changes like the healthcare industry is experiencing don’t come with quick fixes, but conveniently it’s not the first industry to undergo massive structural changes. Take into consideration what Amazon or Zappos have done to become leaders of the retail industry. Or take a page from Oscars book on customer-centric health insurance coverage.

In healthcare, some crucial lessons include:

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