Direct Member Acquisition Challenges
Payers face unique challenges acquiring new members. Constraints of the Patient Protection and Affordable Care Act (PPACA) dictate that health plans are subject to a Mandatory Loss Ratio (MLR) of 80 percent, limiting the resources available for administrative expenses. These limited margins require a careful analysis of how payers allocate revenue.
Statistically member acquisition is the single largest payer expense outside of the mandatory 80 percent MLR.
Common Problems Facing Payers
- Medicare and Qualified Health Plans (QHP) have very limited seasonal enrollment periods creating temporary staffing challenges
- Acquiring new membership is cost prohibitive and payers often neglect to capitalize on prospective new member inquiries
- Payer’s generally lack a unified member acquisition strategy
- Educating prospective members regarding subsidy eligibility is often complex, cumbersome and cost prohibitive
- Developing an effective multi channel engagement platform is typically impractical
- Payers are continuously challenged to educate their prospective members regarding the complexities of how to best utilize their plans and benefits
Benefits of a Unified Member Acquisition Strategy
- Overall reduction in cost per member acquisition
- Better educated and a more engaged membership
- Harness member analytics to gain insight and identify additional member acquisition opportunities
Solutions for Direct Member Acquisition
VistaBPO has developed a comprehensive, personalized and cost effective approach to member acquisition.
We deliver support tools and strategies designed exclusively for the payer market.
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