Four ways a consultant can help health plans mitigate risk and exceed OEP performance goals

Posted on September 20, 2018

Open Enrollment Period (OEP) is a period of time each fall in which health plan members select their benefits for the coming year. This short window of time is a health plan’s peak season as they have mere weeks to run sales and marketing campaigns aimed at retaining current membership and attracting new customers. This year Affordable Care Act (ACA) open enrollment period runs from November 1 to December 15, 2018; while the Medicare annual election period is from October 15 to December 1, 2018; and group open enrollment is dependent on plan-specific timing.

Health plan sales and marketing teams prepare for open enrollment all year and their performance during this season has a lasting impact on their plan’s overall performance, ability to drive member benefits, and deliver on plan profitability goals. When preparing for this high-stakes season, it is crucial to develop the best plan or solution. According to Ray Dalio, a financial industry leader and author on peak performance, “You should look for the best answer, not simply the best answer you can come up with…” The sentiment behind this thought underscores the importance of shielding against insulated thinking and the benefit of integrating external perspectives into a planning process.

Health plans looking to win during the this year’s OEP season and into the next fiscal year are turning to healthcare sales and marketing consultants, not just leading up to peak season, but throughout the enrollment period and beyond.

Below are four reasons why health plan leaders are partnering with consultants to drive performance to exceed OEP performance goals

1. An objective third party perspective 

One or two basis points in either direction can impact whether a health plan’s open enrollment member acquisition and retention campaigns are considered a success or miss the mark. Health plan sales and marketing teams craft compelling messaging highlighting benefits and features for specific audience groups and then amplify that messaging across multiple channels including web, face-to-face, digital and other proven and emerging platforms. Successful campaigns rely on hundreds of data points and levers to effectively reach members. This complexity increases the chance for disconnects and potential errors. Familiarity can create blind spots if campaigns are being set up, checked and implemented by the same team of internal resources. Pressure testing concepts, messaging and channel selection using a fresh set of eyes – either through a third party or different in-house team members – can catch tactical issues, or identify more massive strategic misses that if left unidentified could prove extremely detrimental to a plan’s go-to-market efforts.

2. Supplement internal talent burdened with executing the plan

The road to OEP is the health insurers’ peak season. Internal teams are entirely focused on finalizing implementation and go-to-market strategies while balancing other day-to-day requirements. A health plan consultant is an effective way to supplement the bandwidth and amplify the talent and overall impact of internal resources. An active consultant can blend strategy and practice; providing immediate benefit of strategic counsel with actionable insights to apply and refine programs in flight.

3. Channel expertise

Successful consulting engagements should result in tangible takeaways, not just strategic briefs and reams of presentations. Partnering with a consultant leading up to and during OEP can provide a health plan insight and channel expertise needed to ensure that go-to-market plans include tactics and channels that are adequately mixed and matched. Real-time analysis of channel performance metrics can also provide insight into where incremental updates and improvements are needed to drive better outcomes. An example of data analysis driving updated execution strategy includes analyzing inbound and outbound telephonic results, identifying performance gaps, and then shifting scripts, voicemails, cadence, and other levers to improve campaign performance.

4. Long-term post-OEP benefits

The longer-term benefit of engaging a consultant prior and during open enrollment is how the engagement builds familiarity with the plans’ goals and go-to-market programming, which in turn translates into the ability to maximize the ROI of the newly acquired or retained members secured during OEP.

  • Welcoming and Onboarding: Customer experience experts agree that a customer’s onboarding experience permanently impacts their view of the service provider. Consultants engaged during OEP can concurrently assist plans to build out a robust and strategic onboarding program to welcome the new or returning member and secure critically important information early in the relationship including communication preferences and high-level health assessments.
  • Extended Medicare Open Enrollment Period (OEP)Specific to the Medicare market this year, welcome and onboarding will be more critical than ever before due to the extended OEP period that runs between January 1 and March 31, 2019. During the extended OEP window, members with a Medicare Advantage plan can drop the advantage plan going back to Original Medicare or switch to another Advantage plan. To prevent a member from changing plans and increase stickiness, health insurance providers should actively be preparing now. Working with a consulting during OEP to ensure attraction and acquisition campaigns are quickly followed up by proven welcome and onboarding tactics will reduce member fallout and improve Medicare plan performance in 2019.
  • Proven market best practices and emerging channel expertise: Engaging consultants with a proven track record with health plans throughout the year provided plans access to:
    • Deep market intelligence as best laid plans are still subject to stress from market forces such as competition, changing consumer trends and more
    • Assist in helping refine traditional channel activations while being able to integrate emerging channels into their go-to-market mix with less risk

Consultants deliver value to a health plan year around through serving as a trusted provider and providing a different perspective when creating go-to-market strategies, marketing campaigns and channel mix recommendations.

Connect with a GuideWell Connect consultant!

GuideWell Connect (GWC) provides health plans technology-based solutions to engage consumers throughout the member journey. The team at GWC has extensive experience in turning ideas into reality, with specific expertise as practitioners in the sales, marketing and engagement space for health plans and providers.

Health plans looking for a competitive advantage and unmatched market insights are turning to GWC for practical, results-oriented consulting services. GWC Consulting leverages the experience and insights gained through managing the strategic development and tactical execution of engagement efforts for 15+ health plans and providers.

GWC Consulting Practice can help your plan:

  • Open new markets and lines of business
  • Reimagine existing businesses
  • Drive engagement that delivers results
  • Create robust analytical capabilities
  • Deliver go-to-market and channel expertise
  • Assess technology and operational processes through a third party perspective

To get started, contact GWC Consulting practice lead, Charlie Kirksey, to discuss how to take your plan’s go-to-market strategies and engagement initiatives to the next level.