Integra Insights


Open Enrollment: The Ultimate Checkpoint

Are you ready?

Medicare Advantage open enrollment starts October 15 and ends December 7. ACA starts November 1, 2017 and ends December 15. This will test your application system and call centers, but it is the ultimate test for your benefit design team.

As you look ahead, the next step is onboarding these members to ensure a smooth transition and a well mapped out care plan for their first quarter, and possibly their first experience with your health plan.

Questions to ask:

  • What are we mailing to them?
  • Are we creating an excellent member experience?
  • How many telephonic HRA and welcome calls we will complete?
  • What is the medical cost for those not engaged by March?
  • What is the cost of a non-retained member?

We find that in the same population, a well-onboarded member who understands the benefits, formulas, networks, and completes a HRA costs 12% – 23% less than those who don’t have a high-touch onboarding and HRA. We find the cost differential affords our team the opportunity to conduct the HRA in the home. We find that after our screening, onboarding, and resources network sharing with the member, the cost is 23% less for inpatient utilization and 16% less in outpatient expenses. Also, we improve retention rates.