Healthcare SDL

5 Best Practices for Healthcare Open Enrollment

Let’s face it, for managed care providers, Open Enrollment is the most important yet stressful time of the year. There are deadlines to meet, ever evolving regulations, new documents to create, and culturally appropriateness considerations for your increasingly diverse member base. With the diversity and dynamic nature of today’s members, readiness for the October deadline could be adversely impacted.
According a recent survey, 80% of plan decision makers think it’s important for members to understand their benefits, but they feel only 60% really have a good level of understanding about their plan. And about half of members wish that plan benefits could be communicated in a way that is easier for them to understand. So how can managed healthcare providers attract, engage and retain members while meeting government mandates? Here Janis Shea, Manager of Regulated Industries at SDL, offers five best practices to prepare managed care providers for a smooth Open Enrollment season that supports business goals and uses plan content in a way that truly engages members.

1. Timely communications are critical

Today, managed care providers must consider beyond the timely delivery of communications to meet open enrollment deadlines, and understand how to best serve an aging, diverse and connected population. With more than 16% of the demographic over 65 and that number increasing (Population Reference 2019), we must examine how and what we are communicating to our members. The same report cites the share of the older population that is non-Hispanic will drop by 22%, from 77 % to 55% by 2060, challenging providers to adopt more representative methods of communication. As experts in the business of providing information to the industry, we need to examine our outreach methodology to ensure we can satisfy the needs of a diverse population with communication across different formats and languages for an ever-changing Open Enrollment proposition.

2. Open Enrollment doesn’t have to hurt

Every year annual enrollment presses down upon the industry, and every year there are more plans, more languages, and more numbers to comply with, yet our teams remain the same or even shrink. Resources are constrained, budgets are tight, and the global pandemic has created a new unanticipated range of cliff-edges and existential challenges. Meanwhile, the population’s needs grow along with the expectation that it shouldn’t be this hard to provide care coverage.

And it doesn’t.

Releasing your materials to members with Limited English Proficiency (LEP), as well as 504/508 compliance, shouldn’t drain your resources or your budget. The answer lies in maximizing your resources while minimizing exertion for your growing needs.

Managed care companies have faced similar challenges in preparing for their deadlines while alleviating work for internal teams to focus on the business of member services. SDL has provided trusted advisor services and demonstrated how to deliver content, compliance, and language solutions to our clients with a 99.9% on-time delivery performance during peak enrollment season in over 120+ languages. For many of our clients, seamless 508 remediation into all languages follows, along with on-demand 504 services like large print and braille.

3. WCAG 2.x compliance counts, too!

Compliance doesn’t end with 508 remediation, though. Web Content Accessibility Guidelines (WCAG) 2.x covers a wide range of recommendations for making Web content more accessible.

Following these guidelines helps to ensure accessible content is available to a wider range of people with specific needs or abilities as well as making your digital content more user friendly. Through the process of managing regulatory and administrative changes, payer, providers and their members can benefit from a better user experience, improved compliance, and a more productive marketing outreach. Notarized Attestation and Accessibility Reports provided with each delivery enables instantaneous and demonstrable compliance metrics.

4. Certificate of accurate translation

Attestation is also important as The Centers for Medicare & Medicaid Services (CMS) require the provision of accurate, consistent, and high quality written translations of member informing materials. 

This is essential to ensuring effective communication between Health Plans and the patients and enrollees. To maintain the focus on improving members’ access to health information, this key and critical component must be attested to being committed to providing translated Vital Documents to enrollees in threshold languages, as required by state and federal requirements. By focusing on such bespoke patient engagement to reduce the time and cost required of providers to comply with programs’ requirements, CMS is offering a much needed enhancement in quality to the industry.

However, Health Plans must establish quality standards and processes by which departments can request written translations from preferred vendors, with confidence that the documents will be translated accurately and carry consistent terminology and phrasing. As such, Health Plans can only use qualified translation professionals to translate, edit and proofread member informing documents. This requires an organization to manage language and content needs across a diverse population, enhanced with artificial intelligence to reduce resource burdens.

5. Don’t worry, SDL has you covered for Open Enrollment

SDL can help managed care providers to protect your STAR ratings by delivering flexible and timely content to fulfil the delivery of mandated communications for open enrollment. We understand the challenges you face in mastering the growing volume and velocity of content required for positive member experiences, and SDL has been helping companies like yours for over 25 years. We can streamline and simplify your translation and compliance requirements, to deliver a seamless process that makes your operations run better, and your members happier.

So, take a deep breath, let’s get ready for this season together and ask yourself if you’d like this year to go better than last year?

If you’d like to discuss how to increase your enrollment efficiency, please click here.