Here’s how health plans are adapting to the ever-changing Medicare marketplace to drive high-quality enrollment, new member engagement, and long-term retention.

Each year, Medicare’s Annual Enrollment Period (AEP) comes with its own set of unique challenges. The 2023 AEP is shaping up to be no exception. As the Medicare marketplace continues to evolve, health plans are building a better member experience through increased focus on early engagement between enrollees and agents or brokers; value-based onboarding; and other midseason changes aimed at improving net-new business sales metrics and long-term member retention. Here are six trends we’re seeing:

  1. Volume is down. Marketing is delayed.
    Across the industry, health plans are experiencing marketing delays and diminished lead gen response and sell-through. This is likely a result of midterm election communications crowding out mailboxes and occupying television screens in early November. Health plans hope to see an increase in response throughout the remainder of AEP but should continue to plan for delivery delays at post offices and expensive media buys resulting from pent-up demand and the holiday shopping season.
  2. Extra benefits continue to drive shopping curiosity and confusion.
    While the industry is noticing a reduction in celebrity marketers with fewer callers wanting to “check their ZIP code” than this time last year, the messaging and response rates around value-added benefits remain a driving force for response and shopping behavior. Educated frontline representatives will be key to ensuring health plans make the most of these caller interactions, offering case-by-case clarification and further explanation where needed.
  3. Plans are making midseason changes to foster enrollment and new-member engagement.
    Smart plans are leaning into the opportunity to provide ways for agents and brokers to further support quality enrollments and earn additional fees by helping to initiate new member onboarding activities. “This AEP we noticed a rise in agent administrative fees for DSNP enrollments, with some plans offering up to 80 percent more than previous years,” said Jamee Sunga, director of value-based onboarding at Bloom Insurance. In addition, health plans are shifting to paying out administrative fees to agents who complete the Health Risk Assessment (HRA) versus in previous years, when simply launching the HRA triggered a payout. By completing pre-effective data collection immediately (or soon after) application submission, brokers are aiding the plan in reducing onboarding costs. Health plans that closely engage with their broker/agent sales teams also tend to drive higher HRA completion rates. According to Sunga, “Bloom clients who provide daily HRA status to their sales teams complete HRAs for enrollees three times as often as clients who do not actively monitor performance.” Encouraging agents and brokers to participate in value-based onboarding activities correlates directly to better Stars quality outcomes and HRA completion rates, as well.
  4. Value-based onboarding activities continue to drive member retention.
    The opportunity to leverage inherent engagement at point-of-sale remains the best retention weapon in a health plan’s arsenal. Building on Bloom’s Value-Based Enrollment (VBE) program, which began in 2017 and included HRA collection; benefit confirmations, annual wellness scheduling, and other new member activation options are making tangible differences in early engagement and retention. In a case study Bloom conducted in partnership with a national plan, results showed a 49 percent reduction in cancellations when onboarding activities such as the HRA are completed as part of the pre-enrollment process (i.e., prior to the effective date) instead of months later as part of a post-enrollment welcome process. If an annual wellness visit is scheduled during plan-represented onboarding calls, that number climbs to 60 percent. When members are engaged within 48 hours of completing an application, Bloom clients have tracked HRA completion rates as high as 90 percent and an average of 82 percent during the 2023 AEP, so far.
  5. Within onboarding, HRA questionnaires and social determinants of health (SDoH) questions are here to stay.
    In early 2022, the Centers for Medicare & Medicaid Services (CMS) released the Framework for Health Equity 2022-2032 to encourage the gathering of SDoH with the ultimate goal of advancing health equity and improving health outcomes. As a result, SDoH questions are more commonplace within HRA questionnaires than in years past. “Two-thirds of new Bloom clients have included questions related to housing, food security, and access to transportation to assist with capturing this valuable information,” Sunga said.
  6. Brokers are responding to the CMS requirement for enrollment recordings.
    The CMS Final Rule released earlier this year indicated that all calls with Medicare beneficiaries must be recorded in their entirety. This change caused many health plans to reassess their current technology to remain compliant while still providing the best experience for new members. The change also had a direct impact on field agents, who were previously not subject to telephonic recordings, and were now in search of a compliant solution. Bloom’s Ascend technology, which includes a Remote Agent Telephonic Enrollment (RATE) feature, allows health plans to meet the new requirement. Not surprisingly, this feature saw a substantial uptick in usage following the new CMS guidance.


About Bloom
Bloom helps health plans grow through innovative technology and industry-leading telesales services. Driven by our deep insurance sales expertise, we enable health plans to improve the enrollee experience and increase membership while promoting efficiency and long-term retention. We do this through advanced sales automation software that supports value-based enrollment (VBE) powered by our Ascend technology platform; and call center services focused on supporting health insurance plans specializing in Medicare sales.