Resource
Center:
Strategies for Improving Health Plan Member Retention and Loyalty
Member retention is becoming an issue of increasing concern and focus among HMOs and other health plans. There was a natural tendency to grow through aggressive new member acquisition in the early growth stages of the managed care industry. As market penetration has increased and the marketplace has become very competitive, new members are increasingly lost members from other plans. Attention is therefore being given to member retention.
There are a number of steps you can take now to increase member retention and build customer loyalty. This page will offer a series of tips to help you achieve these goals.
Step #2: Analyze Who is Disenrolling and Why
Generalizations acquired from journal articles, seminars, and conversations about why members leave health plans are useful to understand the relevant set of defection causes, but dangerous if implemented without thoughtful consideration of appropriateness and customization to fit the market and membership.
- Focus
on loyalty market research before implementing any disenrollment initiatives.
The reasons for member defection will differ from one plan to another
and, at times, within a plan from product to product. Loyalty-focused
market research will require ongoing tracking of certain variables (various
behavioral intentions related to disenrollment; real reasons why members,
or groups of members from an employer/payer defect, voluntarily disenroll)
and episodic focus groups on specific issues (e.g., problems identified
in other ongoing research, and/or a competitor's product or plan design
changes).
- Use
telephone or personal interviews for best results. Research
of this nature is best done in a personal manner. Telephone or personal
interviews employing valid "root cause" or "critical
incident" techniques work best with disenrollees and disenrolling
employers.
- Conduct
research on satisfaction and loyalty attributes with continuing and
disenrolled members. This will accurately identify which factors
are truly associated with disloyal behavior — regardless of the
level of satisfaction.
- Combine
and compare disenrollment reasons from this form of research with the
reasons indicated by the plan's sales force. This can help
you assess the extent to which the sales staff focuses on retention
as well as acquisition of members.
- Conduct
staff and provider interviews and focus groups. These methodologies
have proven extremely enlightening about potential and actual causes
of disenrollment.
- Conduct
mystery shopping and observation studies of customer service areas,
such as the reception area where patients first interact with reception
staff members. Such studies are useful in evaluating service
process and attribute issues.
- Merge
member research with data about the members' medical and administrative
utilization behavior, health status, and other externally obtained data
when developing intelligence for retention strategies. A member
who has asked more than once to switch primary care providers is probably
more likely to defect.
- Identify
members considered "low utilizers" (e.g., few visits to a
plan physician in the previous nine to 12 months). These members
may be more probable candidates for voluntary disenrollment.
- Obtain geodemographic data to overlay onto member files to obtain more highly segmented profiles of members and disenrollees.
Sign HSM's Keep Me Posted page to receive e-mail notification of when updates are added to this ongoing series designed to help you leverage member loyalty and improve your bottom line.
Step #1 | Step #2 | Step #3 | Step #4 | Step #5 | Step #6 | Step #7