Article

Five Priorities for Optimizing Health Plan Annual Enrollment

1 month ago

Becky Watkins, Senior Vice President, Client Solutions, ResultsCX

Annual enrollment is upon us—Medicare’s has just started, and enrollment for the Healthcare Marketplace starts November 1. This is a vitally important time of the year for every health insurance plan. The success or failure of an organization at maintaining enrollment and attracting new members can have a significant impact on its bottom line. Many plans commit a tremendous deal of effort and marketing resources as they work to grow membership as well as retain members from the current year. At the same time, the extra support needed to assist members investigating or changing plans creates a steep spike in human resources needs. Plans and the customer care providers serving them commonly work very hard to hire and train the qualified teams necessary to handle large volumes of member inquiries. Moreover, just answering the call isn’t enough; every existing or potential member contact needs to be approached with professionalism, commitment, and compassion.


Five Priorities for Optimizing Health Plan Annual Enrollment

With annual enrollment happening now, here are five strategies that health plans should implement to maximize member experience and operational success during this crucial time.

1. Prioritize members facing disruptive plan changes and be ready with comparable plans. Be prepared for heightened emotions among members faced with big changes in their health plans. Being proactive about helping members identify and choose solutions to a difficult problem can be a big winner when it comes to the quality of their enrollment experiences.

2. Emphasize plan value rather than just price. Cost is only one of the important data points relevant to choosing a health plan. Develop support language and messaging around the benefits of a plan that encourage members to consider more than just what they will be paying for it.

3. Encourage members to use all of their benefits (gym memberships, mail order pharmacy, etc.) to stay healthy. Health plan benefits work together to promote members’ wellness, which is good for everyone involved. Members who use a broader range of benefits are typically healthier, which is advantageous to the plan’s bottom line and operational performance.

4. Communicate marketing plans to maximize return on that spend. Ensure that everyone involved in support is in the loop and using key messages developed to explain plan details. A best practice that pays off is for enrollment assistance to echo and reinforce the vetted, specialized language used to promote a health plan’s value.

5. Consider a triage approach to reduce licensed agent demand and maximize their output. By necessity, highly skilled licensed agents earn a higher rate and are becoming harder to hire. Structure annual enrollment support so that these staff members are brought in for the highest possible value functions, not just to answer general member questions. When it makes sense, incorporate support hand-offs to use expertise most effectively.


Ultimately, annual enrollment requires the same kind of empathy-based support that health plan members deserve and receive throughout the year. Support needs to be delivered by advocates, rather than agents, who look beyond the transaction to provide ongoing healthcare advocacy that centers around the member or patient and is laser-focused on helping them throughout their health journey. Annual enrollment needs to be another opportunity to put the member at the center of an interaction that is grounded in competency, confidence, and compassion. This is how to begin making a difference in someone’s life from the moment they enroll.

About the Author

Becky Watkins, Senior Vice President, leads Client Solutions at ResultsCX and serves as the senior point of contact for all clients. She has extensive experience with meeting the member engagement needs of health plans during annual enrollment and is adept at leading teams that foster empathetic human connections with clients’ health plan members.

Her effectiveness as a leader is exemplified in the change she has overseen in our healthcare plan support. She led the reorientation of our support to ensure that every member contact is an experience grounded in empathy that includes an awareness of possible suffering and the motivation to help. Becky has overseen the alignment of our services across client engagements to the external standards of the CMS Star ratings, helping our clients improve health outcomes, enhance their reputations, and strengthen their ability to qualify for survey outcome-based incentive payments.

Becky is currently a finalist for a 2022 Stevie Award for Women in Business in the category of Female Executive of the Year – Business Products – More Than 2,500 Employees. She has more than 30 years’ experience in the BPO industry, including 10 years dedicated to healthcare solutioning and outsourcing. Becky joined ResultsCX in 2017 following leadership roles at other outsourcers. She has earned a reputation for fostering organizations’ ability to deliver personal and empathetic human connections between their high performing agent teams and clients’ customers and members. Becky is especially skilled at ensuring that any technology leveraged to enhance service, effectiveness, and efficiency also achieves excellent member and customer experiences.