The HSM Group Ltd.

Member retention is an increasingly important issue for health plans to address. It costs health plans $75 to $200 to acquire a commercial member and $400 to $800 to acquire a Medicare member. If members leave the plan within the first year or so, up to half of this investment is lost. Health plans should implement several strategies, therefore, to improve member retention. They should communicate the value of retention throughout the organization, use a cross-functional team approach to retention, analyze who is disenrolling and why, improve access to referral providers, and extend the retention effort until a relationship exists, evaluate and strengthen member orientation efforts. Other ways to enhance member retention are to improve access to health and service information, improve provider-staff interaction and communication skills, implement relationship-enhancing communication campaigns, manage expectations about treatment, and create personal relationships at the plan-purchaser level.

Medicare/Medicaid risk marketing is a vital business challenge, one that countless managed care organizations are facing right now. Early entry into new markets and aggressive participation in existing markets are essential to meet competitive pressures. Health plans intent on success in government risk programs should conduct research to learn the medical needs, wants, and desires of older persons in the geographic area they serve. Original, market-specific research yields critical marketing and clinical data that can be used to improve care and member satisfaction along with customer loyalty and retention.