Eliza on Medicaid Retention

One of the biggest sources of angst for a Medicaid Managed Care Organization (MCO) is ensuring member retention. Easier said than done considering the majority of members don’t even know they are up for renewal, and if they are aware, many miss deadlines because they don’t know how to navigate the process or life circumstances get in the way. About half of all members who fall off of Medicaid, end up coming back on within 6 months. In the meantime, they may have gone without their medications, preventive care, or important treatment for chronic conditions. This translates into lost revenue for health plans, and higher administrative and medical costs as well.

Eliza’s Retention Solution is proven to keep members on your roster, reducing the headaches and costs of Medicaid churn. We recently worked with a large Medicaid plan to implement a proactive, personalized, and easy-to-understand outreach to members ahead of their redetermination date. Eliza drove compelling results, including over 6,000 members retained that otherwise would have lost coverage and $1 million in savings. We reached out to parents and guardians of over 194,000 children up for redetermination to inform members about their coverage and the renewal process, confirm receipt of the state Medicaid renewal letter, and direct them to update their information online. Those reached by Eliza completed the redetermination process 9.4% more than those who were not reached. Additionally, we saw a 10% increase in redetermination rates for those not reached via automated phone call, but opted in to receive text message reminders.

Whether deployed as a standalone product or as part of our multi-touch, multi-channel Medicaid solution, our best practices in program design yield strong completion rates for this notoriously hard to engage population. By sharing the important information they need to keep their coverage, you can help ensure they remain a loyal part of your membership year over year.

Eliza’s multi-channel redetermination outreach proactively engages members at critical points in their relationship with the plan to:

  • Remind the member that their redetermination date is coming up and confirm contact information to ensure the necessary paperwork gets to them
  • Highlight the steps the member needs to take to maintain their healthcare coverage
  • Determine barriers to completion, offer assistance as appropriate, and encourage the member not to let their benefits lapse
  • Connect members with helpful resources such as state websites, plan materials or health plan support

Join Eliza Tuesday, March 29th for the next World Congress sponsored webinar, “Reducing Churn: Strategies to improve member retention and loyalty for Medicaid MCOs and QHP.”  Eliza and Neighborhood Health Plan (NHP) will discuss how to effectively and efficiently improve member retention with strategies and results that overcome engagement obstacles while reducing Medicaid churn and build brand recognition and loyalty.

Updated 12/7/2016 -  This webinar is now available on-demand here.


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