Opportunity Lost: The Cycle of Open Enrollment

We recently asked more than 1,000 health care consumers about how they interact with open enrollment – and what their plans are this year – so that health plans can improve their member engagement and education efforts.

We found that three-in-five people are planning to participate in open enrollment this year. And those who will be participating have a variety of intended actions and reasons behind their planned behaviors. Just check out the results below:

With more than half of consumers planning to participate in open enrollment this year, this short time period represents a prime opportunity for health plans to drive engagement, particularly with those individuals who are considering switching plans.

I’d like to share some insights on three opportunities health plans can seize to engage with and delight their members during open enrollment: education and guidance, staying specific to help members take action, and planning the right sequence of communications to maximize impact.

Seize the opportunity to educate and guide

Educating members as they navigate their health care journey is a perfect opportunity to instill confidence and build trust that can later be expanded to a greater degree of engagement.

In addition to the 60% of our survey respondents who plan to participate in open enrollment this year, 70% indicated that they find health benefits and medical bills confusing. Health plans can take these two facts together and consider open enrollment a pivotal moment in which members will absorb educational information while they are looking for guidance to make better health care choices. Seize this member engagement opportunity to educate members and increase their health care literacy by providing education on terms such as co-pay, deductible, co-insurance and equate them to potential clinical interactions. According to a recent Accenture study, 52% of health care consumers have low health care system literacy. Further, “People with low health care system literacy struggle to make informed decisions about everything from the health plan types they choose and the premiums they pay to the doctors they see and the procedures they have done.”

For example, in your email announcement to notify members of the upcoming open enrollment period (which 48% of our own survey respondents find helpful), create collateral explaining to members, in simple terms, what ‘In-network’ means to them and how it can impact their health care journey. Then give them a direct way to access their account and verify their in-network providers. Get them thinking about their health care expectations for the coming year, prior to open enrollment, and encourage them to plan effectively.

Be specific, be very specific

From HealthSparq’s own internal UX research, we know that when members are faced with accomplishing explicit tasks (ex. find a hospital), they form the majority of their expectations for engaging with transparency search tools (such as HealthSparq One) at two main touchpoints:

• Through a call to action (CTA) on the health plan portal for accessing ‘Find a doctor’ tools
• And, through the landing page of the provider search tool

The results from our internal research are dramatic:

• 30% abandoned the search tool site and returned to the plan portal when the primary CTA did not specify the task the member was looking to accomplish (ex. Find a doctor versus find a doctor or hospital) and the secondary touchpoint did not provide any additional context or expectation setting about what the user could search for on the tool.
• 9% abandoned the site when the primary touchpoint label did not specifically mention the task (Find a hospital) and instead said something similar to just ‘Find a Doctor,’ but the secondary touchpoint, the landing page, was able to set expectations for finding a hospital.
• 0% abandoned the site when the primary touchpoint label on the plan portal said “Find a Doctor or Hospital,” and the secondary touchpoint on the landing page provided users with additional context and expectation setting around what they could search for on the tool.

The key takeaway for your ongoing member engagement efforts is this: members need clear direction on task support along with appropriate expectation setting when engaging with digital tools. The primary touchpoint appeared to form the majority of users’ expectations and further influenced what expectations the secondary touchpoint was able to convey once the user was on the landing page. Simply providing a universal link to search and cost tools is not enough. The need is to guide and direct. For example, leverage educational material to define ‘In-network’ providers and create a link or button to ‘Find In-network providers’ that lands the member on a results page they can understand and trust instead of simply directing them to use a ‘Find a doctor’ tool.

Find the right sequence to drive action

Our survey also found that 52% of consumers find reminders the most helpful resource during open enrollment, with additional resources (listed below) following:

Taking a look at all these useful sources of information your members review during open enrollment and finding a meaningful cadence to target members across these resources is an important step in helping your members take action when needed.

The timing or sequence in which you attempt to interact and engage with your members is critical to the success of your efforts. Establishing a communications calendar that includes open enrollment as just one piece of the “member education” puzzle is a particularly useful way to think about finding the right sequence. Taking the time to educate your members on the language of health care throughout the year and expanding that education to include how it personally impacts them leading into open enrollment, and then moving to guidance throughout the open enrollment and health care utilization processes can help round out your approach to helping your members make informed decisions.

For example, let members know what preventative services means, where and how to get these services and how that translates to taking steps sooner or finding problems faster to avoid negative impacts to their lives and those around them. Take the perspective up a level and support your members in planning for these events and thinking through which product supports them best, or what their needs are, prior to open enrollment. For some other great examples of how to progressively educate and expose your members to deeper understanding of their benefits selection, look at this interesting article on the Fortnite Effect. Help your members link these concepts together into a cohesive program as they embark on their open enrollment adventure, and you have developed a recipe for success and planted a seed for deeper engagement and trust.

To all the health plans out there, this is your opportunity to drive deeper engagement with your clients and, more importantly, your members. Best of luck this open enrollment season and if you would like to discuss in more detail, feel free to reach out to us. We are here for you.