GoHealth Encompass Solution
Radically transforming and simplifying the Medicare experience.
The Medicare market landscape is an abrasive, disjointed process.
The number of eligible Medicare enrollees choosing Medicare Advantage (MA) plans has increased 130% since 2009*. MA’s rapid growth has led to issues for beneficiaries and health plan partners:
Beneficiary experience:
- Overwhelmed with information
- Increase in plan options available
- Lack of trust in the process
Health plan partner experience:
- High CTMs
- Low effectuation
- Underutilized benefits
*Kaiser Family Foundation https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2022-enrollment-update-and-key-trends/
Enrollment
Limited awareness of coverage options.
Plan Selection
Lack of in-depth plan comparison.
Post Enrollment
Fragmented onboarding progess.
The Market
Market drives plan switching.
Preventative Care
Appointments are delayed or foregone.
Engagement Drop
Underutilized Medicare benefits.
Encompass is a member-centric experience designed to address gaps in the market.
Identification
Agents assist interested beneficiary in navigating plans.
Selection
Agents choose best plan benefit based on beneficiary’s needs.
Verification
Agents connect the beneficiary to health plan resources to confirm best plan fit.
Enrollment
Agents facilitate the process to enroll the beneficiary.
Activation
Dedicated agents begin onboarding initiatives and provide benefits education.
Renewal
Dedicated agents continue outreach to assist beneficiary and aid the renewal.
GoHealth’s end-to-end Encompass Solution simplifies the Medicare journey and drives member satisfaction.
Since 2020, the Encompass Solution has improved member satisfaction.
- Creates a single, trusted source for beneficiaries to learn more about their Medicare Advantage options with a knowledgeable guide to help identify plan fit.
- Unbiased, carrier-agnostic approach helps build trust between the beneficiary and their advisor, providing a seamless experience from initial call through subsequent plan renewals.
- Using knowledge of each beneficiaries personal needs, GoHealth verifies plan fit and engages members to utilize their benefits – alleviating confusion and reducing likelihood of member churn.
- Of every 100 Medicare Advantage enrollees, the Encompass solution retains more members past 90 days than other approaches.
When beneficiaries enroll through Encompass, health plans see meaningful impact to retention metrics.
