Why Many Organizations Are Replacing Their Outsourced Medicare & ACA Enrollment Contact Centers

For healthcare providers, insurers, and brokers in the United States, Medicare enrollment services and ACA enrollment services are essential for connecting people to the care they need. Many organizations choose outsourced contact centers to handle these critical processes—expecting efficiency, compliance, and improved member experiences.

However, the reality often falls short. Over recent enrollment seasons, more organizations have reported serious issues with their outsourced partners—issues that hurt operations, jeopardize compliance, and erode trust with members.

If your organization is facing these problems with its current outsourced contact center for Medicare or ACA enrollment, you’re not alone.

The Real Challenges Organizations Are Facing

1. Compliance Missteps that Risk Penalties

Medicare and ACA enrollment are governed by strict CMS and HIPAA regulations. Even one error—such as incorrect scripting, improper consent capture, or insecure data handling—can trigger fines, sanctions, or even loss of authorization to enroll members.

Many outsourced contact centers operate with generic sales or service scripts, failing to meet healthcare’s unique compliance demands. This exposes organizations to significant legal and financial risk.

2. Volume Spikes Overwhelm Service Levels

During the Annual Enrollment Period (AEP) and Open Enrollment Period (OEP), call volumes can skyrocket overnight. While most outsourcing partners claim they can scale, reality tells a different story.

Some rush to hire seasonal agents without proper training, leading to long hold times, dropped calls, and rushed conversations. Others simply don’t have the capacity—causing missed enrollments and frustrated members.

3. High Error Rates in Applications

Errors in eligibility verification, subsidy calculations, or application completion can create a chain reaction of problems: processing delays, rework, member dissatisfaction, and dropped enrollments.

For the organization, these mistakes waste valuable time and resources while directly impacting revenue.

4. Poor Lead Handling and Follow-Up

In healthcare enrollment, speed matters. Delays in reaching qualified leads—or failing to filter out unqualified ones—means lost opportunities.

Some outsourced contact centers have outdated workflows that allow leads to sit idle for days, long enough for competitors to enroll them first.

5. Limited Visibility and Reporting Gaps

Healthcare leaders need real-time insight into enrollment performance. Yet many outsourcing partners provide minimal, generic reports that lack actionable detail.

Without clear visibility, organizations can’t pinpoint bottlenecks, adjust staffing, or fine-tune their strategy during the enrollment period.

6. Customer Experience Takes a Backseat

Choosing a Medicare or ACA plan can be confusing and emotional. If agents are rushed, lack empathy, or struggle with language barriers, members feel undervalued.

This leads to lower satisfaction scores, more complaints, and reduced trust—problems that can follow the organization well beyond enrollment season.

7. Data Security Concerns in Remote or Offshore Models

Medicare and ACA enrollment involve handling sensitive personal and health information. Weak security protocols—especially in remote or offshore teams—can put organizations at risk for data breaches or HIPAA violations.

Even a single security incident can cause lasting damage to both compliance status and public reputation.

8. Outdated Technology That Slows the Process

Manual data entry, disconnected systems, and slow CRM tools can cripple an enrollment operation. When systems can’t keep up with real-time demands, it not only frustrates agents but also delays member onboarding and increases abandonment rates.

The Cost of Sticking with the Wrong Partner

When these problems persist, organizations face:

• Revenue loss from missed or incomplete enrollments.
• Increased costs from rework, compliance penalties, and inefficient operations.
• Reputation damage from poor member experiences.
• Greater compliance risk from regulatory violations or poor documentation.

The longer an organization stays with a partner that can’t meet the demands of Medicare and ACA enrollment, the more difficult it becomes to recover lost ground.

Why Organizations Are Turning to Boomsourcing

Many of Boomsourcing’s current healthcare clients came to us after frustrating experiences with other outsourcing partners. We’ve built our Medicare and ACA enrollment solutions to directly address the challenges they faced—combining industry-trained teams, scalable staffing models, and AI-driven technology to deliver compliant, high-performing enrollment operations.

Here’s how we solve these pain points:

• Healthcare-Specific Expertise: Our agents are trained in CMS guidelines, HIPAA requirements, and the nuances of Medicare and ACA enrollment. This ensures accuracy, compliance, and member satisfaction at every step.
• Scalable Staffing for Enrollment Peaks: We can rapidly scale your enrollment team during AEP and OEP without sacrificing quality or compliance—thanks to a global talent pool and proven onboarding processes.
• AI-Powered Accuracy & Speed: Intelligent lead qualification, real-time eligibility checks, and automated quality monitoring reduce human error and accelerate processing.
• Rapid Lead Response: Intelligent call routing and automation ensure that every qualified lead is contacted quickly—before they move on to a competitor.
• Full Transparency: Real-time dashboards provide clear visibility into performance metrics, so you can make informed decisions during enrollment season.
• HIPAA-Compliant Security: From end-to-end encryption to strict access controls, our systems protect sensitive member data at all times.
• Member-Centric Service: Multilingual, culturally aware agents create positive, empathetic interactions that strengthen trust and encourage enrollment completion.

Moving Forward with Confidence

If your organization has struggled with compliance risks, missed enrollments, or dissatisfied members because of your current outsourced contact center, you don’t have to face another enrollment season with the same problems.

Boomsourcing offers the people, processes, and technology to make your next Medicare and ACA enrollment period your most successful yet—while keeping you compliant, efficient, and trusted by your members.

Let’s Talk About Your Enrollment Goals

Your enrollment strategy is too important to be hindered by an underperforming partner. Whether you’re ready to replace your current provider or need additional capacity for peak enrollment, Boomsourcing is ready to deliver.

Contact Boomsourcing today to start building your high-performance, compliant enrollment operation.