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Improving Health Plan Member Retention with AI

Article Summary: 

  • Health plan member retention is critically important, and AI can help solve problems members face. 
  • The most important data lives in member conversations, so unlock them by using AI to listen at scale and glean crucial insights. 
  • AI turns contact centers into insight centers that surface the biggest member, brand, and employee issues. 
  • AI can help improve member retention by: 
    1. Providing real-time feedback from member conversations 
    2. Identifying drivers of attrition and negative sentiment 
    3. Enabling proactive adjustments to improve retention rates 

Member retention is critically important for any insurance organization. Not only is it cost-effective to retain existing members, but it also helps to build a loyal and dedicated community. Leading insurance plans are using AI to transform health plan member retention with industry-specific AI models and healthcare conversational data analytics. 

Retaining Members by Listening to Root Causes and Needs

Insurance organizations are using AI-powered solutions to improve member retention and provide better customer service. And they’re changing the way healthcare approaches member care. With this approach, the information needed to solve problems and improve member satisfaction can be found in the actual conversations that members have with contact center agents. Equipped with AI, large volumes of actual member conversations can be quickly analyzed to identify patterns, trends, and insights that can help make informed, data-driven decisions. These include: 

  • Analyzing pre-enrollment calls 
  • Training agents to locate areas for improvement 
  • Adjusting call guides and communication  
  • Preparing with post-enrollment calls 
  • Track special event enrollment calls 

With healthcare-specific AI models, identifying high-risk members who may need extra attention or personalizing member interactions based on their experiences is possible.  

The largest benefit of using AI in insurance organizations for health plan member retention is that it can help address the root causes of member issues. By analyzing member conversations, you can identify emerging trends and issues before they become major problems. This allows you to proactively address member needs and prevent issues from escalating, in turn, improving member satisfaction and loyalty – key components of member retention. 

Customer Voices Report - Listening at Scale with Artificial Intelligence

Member Retention and AI Create Action

When it comes to member retention, there are a variety of factors to consider. One of the most important is ensuring that members feel valued and appreciated. This can be achieved through personalized communication, helpful resources, and opportunities for engagement – members are talking, so start finding value in your recorded conversations by listening for context. AI can analyze data found in contact center conversations to surface trends and problems members are actively – in real-time – facing in the member experience.

In addition, it is important to provide members with ongoing value. Contact center leaders can use AI to locate training and coaching opportunities for agents to better serve members in need, which helps health plan member retention. This could include access to relevant resources, and educational opportunities or events. By providing ongoing value, members are more likely to remain engaged and committed to the organization.

By focusing on making members feel valued, providing value, and improving the member experience, organizations can build a loyal and dedicated community that will support their goals while meeting member outcomes.

3 Ways AI Helps Improve Member Retention

AI is transforming the way healthcare approaches member care. Three ways AI innovation can help improve health plan member retention rates are: 

  1. AI aggregates real-time feedback from members to surface trends. Rather than struggling with feedback being an annual burden or facing difficulties in setting actionable metrics, AI provides proactive insights. By listening at scale in real-time, agents and leaders alike can gather member feedback quickly and efficiently. Insurance organizations can identify their members’ needs and wants and make the necessary adjustments to keep them satisfied and engaged. 
  2. AI helps identify the leading drivers of member attrition and negative sentiment. With proprietary, healthcare-specific machine learning and AI algorithms, organizations can analyze vast amounts of conversational data and pinpoint the root causes of member dissatisfaction. Insights found with AI automation enable proactive measures to address these concerns before they lead to member churn. 
  3. AI proactively monitors adjustments to improve retention. With predictive analytics, you can forecast member behavior and anticipate their needs and friction points. This way, you can make targeted changes to your programs, services, and communications to keep your members engaged and loyal. 

AI is a powerful tool to improve health plan member retention rates. With Authenticx AI, member retention is possible by providing real-time feedback by listening at scale, identifying drivers of attrition by strategically investing in areas of the plan based on need, making proactive adjustments with predictive analytics. Explore the potential impact that AI brings to insurance organizations by helping solve health plan member retention. 


About Authenticx

Authenticx is the new standard for humanizing conversational intelligence in healthcare by analyzing millions of customer interactions (like voice, chat, or emails) to surface immersive and intelligent insights at scale. Authenticx was founded to aggregate, analyze and activate customer interaction data to surface transformational opportunities in healthcare. Using existing data that’s likely being stored and ignored in your organization, Authenticx reveals hidden barriers, motivators, and strategies so healthcare organizations can make confident, data-backed decisions. In 2023, Authenticx was ranked No. 349 on the Inc. 5000 recognized as one of America and Indiana’s fastest-growing private companies. 

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