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Tips to Keep the Customer Journey Top of Mind During Medicare Open Enrollment

It’s no secret that healthcare is complicated, and Medicare is no exception.

With open enrollment currently happening from October 15 thru December 7, Medicare leaders face the enormous challenge of educating both eligible and existing beneficiaries on the many different coverage plans and benefit options that are available to them. Medicare aids a huge swath of the American population (63 million and counting!) of the primarily 65 and older crowd.

And yet, a 2021 Kaiser Family Foundation study found that over 70% of Medicare beneficiaries don’t explore coverage options during open enrollment.

That means there’s friction in the customer journey.

With a large majority of Medicare beneficiaries not leveraging the open enrollment period to review their medical coverage year over year, there’s a perceived knowledge gap in the customer experience journey where consumers are getting lost.

The Center for Medicare and Medicaid Services (CMS) is not unaware of this misalignment and has placed more emphasis on assessing customer experience. One method, the Medicare stars program, was introduced to grade the quality of the plan coverage from private providers participating in Medicare Advantage with particular emphasis placed on customer experience. Since Medicare Advantage programs rely on private insurance carriers, the 5-star rating framework offers a direct revenue incentive to score well.

Medicare leaders face the challenge of proactively engaging with consumers to help them feel informed and confident in program offerings. This includes new enrollments as well as ensure existing beneficiaries are retained. This comes down to listening directly to the feedback your beneficiaries are sharing. Investing in customer experience analytics is becoming critical as CMS places heavier weight on it for 2023 program ratings. To prepare for future retainment and enrollment goals, program leaders need to be taking steps now to audit their current programs for service improvements.

In short, with a rapidly aging population and growing concentration around customer experience in evaluating star values, Medicare leaders need to be strategically considering how they can leverage conversational analytics during open enrollment.

Keep the Customer Journey Top of Mind

Healthcare is not immune from this big data dilemma and there’s ongoing discussion on the use of data in healthcare. Health-focused organizations have many avenues for data cListening to customer interactions offers the most direct feedback for program leaders to assess customer frictions, praises, and knowledge gaps existing in their Medicare coverage. These tips highlight how focusing on the customer journey can have a large impact during open enrollment.

Understand what is being communicated

Auditing customer interactions during open enrollment is a critical way to identify wins and misses with your program. A better strategy cannot be built and implemented until leaders understand the voice of their customers and how their agents are communicating with them. Customer experience tools can assist in listening for key insights and pain points of a program expressed directly by the program’s beneficiaries. This is particularly relevant for Medicare Advantage providers as they navigate rapid expansion of the program with increased enrollment and competition.

Identify where additional support is needed

Mapping your customer journey can identify current channels of communication available to consumers and help pinpoint key indicators of friction. Different options and coverage plans from multiple providers can be difficult for customer to compare. Additionally, how customers can enroll can be complicated from the open enrollment time now, to initial enrollment windows, or special circumstances. By identifying where confusion arises leaders can better enhance and support their customers’ journey.

Solicit quality feedback from customer conversations

As we’ve established, observations without context can’t facilitate action. However, all action can’t be taken at once, so it’s important to prioritize next steps. That could mean To understand why friction exists, organizations need to establish ways to gather and assess unsolicited feedback. There are many different Medicare and Medicare Advantage coverage options available at a wide range of costs. By focusing on the customer and listening to what is being said, organizations have an opportunity to leverage this feedback to make changes and directly apply customer insights to business growth strategies.

Invest in personalization

By proactively assessing current customer conversations and sentiment, Medicare leaders have an opportunity to understand their customers on a personal level. There are opportunities to hear the context around frustrations, needs, and questions being asked. Healthcare is inherently personal, so targeted analysis towards customer conversations can have a large impact on the overall experience of meeting customer needs at an intentional, individual level.

Prepare for Next Year’s Open Enrollment Now

By keeping the customer top-of-mind, Medicare leaders can in turn, lessen their own operational expenses. A consumer-focused mindset can help provide tools that prepare them for costs and clear options, increase self-service options, and better deploy contact center resources.

A critical piece of communication is listening. Leveraging an AI platform that listens for Medicare conversations can be critical to identify trends that are affecting Stars ratings and member retention. In turn, this equips leaders to best assess, and change programs as needed for strategic growth.


About Authenticx

Authenticx was founded to analyze and activate customer interaction data at scale. Why? We wanted to reveal transformational opportunities in healthcare. We are on a mission to help humans understand humans. With a combined 100+ years of leadership experience in pharma, payer, and healthcare organizations, we know first-hand the challenges and opportunities that our clients face because we’ve been in your shoes.

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