That’s a wrap! The AEP 2015 season has come to a close, and health plans are now working to deliver the services promised to their new beneficiaries.
During our 6th AEP season, we conducted over 4,000 compliance audits between 10/01/2014 – 12/07/2014. Below are the trends we observed across a variety of plan types and regions.
DIFFICULTY LOCATING EVENTS
Secret shoppers encountered difficulty finding events, even when they arrived at the correct location and spoke to venue employees (e.g. manager of the restaurant, front desk of the hotel). Venue employees were frequently unaware of the event or provided inaccurate information. Poor signage, either because it was not prominent or not present, was also an issue.
MORE PLANS USED BOUND ENROLLMENT KITS
Compared to AEP 2014, more health plans used all-inclusive bound booklets that contained all of the necessary enrollment materials. These bound kits were used in place of loose materials to ensure that prospective members were provided the information required to make an informed decision.
We started auditing Member-Only events during this AEP season. While these events are not always publicly marketed to prospective members, prospective members do sometimes attend (with existing members or based on signage at the venue). Monitoring these events is a prudent step towards a robust compliance program.
LONG HOLD TIMES AT PROSPECTIVE MEMBER CALL CENTERS
High call volumes are inevitable during AEP, and the ability to manage increased volumes continues to be an area for improvement for many health plans. During this year’s AEP, our secret shoppers experienced long hold times, disconnections, and were sometimes told to call back at a later time, or that they would receive a call back later. Plans can expect the results of CMS monitoring, which started in November 2014, to show similar outcomes.
So what’s happening at TrendSource now that AEP is over?
DATA REVIEW
As we continue analyzing the results and year-over-year trends of the health plans we work with, we will release more information about the top violations during AEP 2015. Stay tuned for our Top Violations in AEP 2015 blog post.
CALL CENTER MONITORING
In light of the news that CMS will be adding Foreign Language Interpreter and TTY Availability measures into the 2016 Star Ratings, many plans are ramping up their call center monitoring programs with us to track compliance and identify areas for improvement.
