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A Global Health Services Company Used Predictive Analytics to Reduce Medicare Disenrollment Rates by 30% 


Challenge 

A global health service company serving Medicare Advantage and Dual Eligible populations aimed to reduce voluntary disenrollment by:

  • improving targeting of retention outreach activities

  • tailoring outreach approach and materials for individuals based on likely reason for disenrollment

Solution

The company partnered with Welltok’s analytics team to analyze their population and deliver targeted solutions. Welltok leveraged its proprietary consumer database to supplement the client’s data and create a longitudinal view of each Medicare recipient with individual preferences.

The population was stratified based on likelihood to disenroll and likely cause of disenrollment. The analysis identified key predictors, including copay, healthcare services utilization, available competitive plan options, and demographic factors, such as number of adults in household, voting status, and affluence.

Upon the analysis, Welltok provided the client with a prioritized list of individuals for retention outreach.

Results 

Due to Welltok’s advanced analytic capabilities, the client was able to deliver effective interventions to their target population and achieved a 30% reduction in their disenrollment rate.

Nearly half of the key predictors for disenrollment came from Welltok’s proprietary datasets. This drove 22% improvement in model strength, which identified the top 10% of the population that were over 3X more likely to disenroll than the average. The team revealed that individuals identified as high risk had a 10.2% disenrollment rate, which is a 2X higher than those in the low risk group. 

Highlights:

  • 30% reduction in disenrollment rate

  • 60% - 65% accuracy in identifying at-risk individuals

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