Medicare Advantage plans (MAPDs) spend a lot of money acquiring new members, so it is particularly harmful to their financial performance when new enrollees leave the plan within the first few months after their membership starts (a phenomenon known as rapid disenrollment). Health plans suffer many challenges to keeping their members happy. Foremost, access to care and pharmaceuticals can be restricted by health plans and, when this happens emotions run high and the motivation to desert the plan increases. Add to this the complexity of health networks and cost sharing and you have many opportunities for friction between consumers and their health plan.
Rapid disenrollment occurs when a new enrollee switches to a different plan within the first few months of enrollment. The range of rapid disenrollment rates runs from less than 5% to as much as 30%. It is often driven by communication of benefit designs and of the changes occurring from one year to the next. In years where benefits change dramatically, a health plan’s communication system is stressed, call centers, agents, and consumers may not get the message about all the changes made, and so negative surprises arise in the first encounters between consumer and the system. The degradation of consumer value is compounded when call centers and agents don’t have answers and can’t offer help.
While insufficient communication is a visible cause, understanding the consumer experience is never obvious. Clients that want to know more, have commissioned disenrollment studies focused on rapid-disenrollment. Below are some takeaways:
Rapid disenrollment is a creature of negative surprises. The distrust created is the enduring emotion fueling the motivation to switch as soon as possible.
Methods: Our rapid-disenrollment studies are usually conducted online or via telephone interviews using a list of disenrollees provided by the health plan. We pay careful attention to the sampling — often health plans want good representations of dual eligible and non-dual eligible members, health insurance products, geographies, and other considerations.
Client Benefits: Rapid disenrollment studies not only uncover areas where services need to be improved, they reveal which negative experiences are forgivable and which are not. Several of our clients have been happy to learn that most of their rapid disenrollers would consider re-joining the plan. Our research can also help identify the best messages for those consumers to hear.