MA Plans Brace for More Switching During 2020 OEP

The following is an article from AIS Health’s RADAR on Medicare Advantage, a publication dedicated to strategies and analysis for Medicare Advantage, Medicare Part D and Managed Medicaid.

Only 4.5% of Medicare Advantage members switched during the Open Enrollment Period (OEP) that was reinstated for 2019, according to Deft Research. But as member awareness of this opportunity is likely to grow with future cycles, MA organizations should be paying extra attention to members’ early experiences with the plan as well as investing in year-long engagement strategies that reach members who are most likely to leave the plan, industry experts tell AIS Health.

In its 2019 OEP Supplemental study published in May, Deft observed that among those members who switched during the Medicare Annual Election Period (AEP) that runs from mid-October through early December, 25% later changed their coverage selection during the three-month period from Jan. 1 through March 31. And 15% of those who made a change switched between insurers, according to a webinar hosted by RISE that highlighted the data.

“Based on our clients’ experience, and what was relayed at various webinars and conferences, it seems switching did not happen uniformly across the country,” observes Renee Mezzanotte, executive vice president of client engagement with Chesterbrook, Pa.-based DMW Direct. “While a considerable number of plans did not see a large fluctuation in members, for those that did, the impact was significant. For all plans, losing even a small number of members is not a direction anyone wants to go.”

“One of the things that we found looking at some of the data is that those plans who were not doing well during the AEP tended not to do well in OEP” either, says Diane Hollie, vice president of sales, marketing & strategy with Gorman Health Group. “So if they were losing members in AEP…they were losing members during OEP,” although not at the level that they were losing members in AEP, she points out.

Welltok, a technology firm that delivers a data-driven “consumer activation” platform, estimates that retaining just 1% of members results in approximately $11 million in revenue. And plans that didn’t “fully execute on a year-long strategy as it relates to retention” will find themselves behind the curve in 2020, says April Gill, senior vice president of solutions management for Welltok. After facing unexpected losses during the OEP this year, many organizations across the country approached the firm about ways to adopt a “more holistic, year-round approach and being able to build the relationships” that will lead to long-term member retention, Gill tells AIS Health.

“From our perspective, that retention really starts on Day 1 with creating a really positive experience for the member and then having the ability to maintain that relationship over the course of a given year,” says Gill.

Hollie agrees that MA plans must have a year-long multichannel education strategy for new members that is “heavily weighted” to the first three months of the year. “You don’t want to wait until the AEP.”

The strategy should start with looking at the previous year’s data to determine who left during the AEP and why. “What do their claims look like? Do they have a lack of claims or were their claims denied? Were they with a provider group that is no longer with the plan?” asks Hollie. “Collect and understand that data and then profile that with the rest of your membership. And do an analysis. If you haven’t engaged the member and they’re not utilizing their benefits, they could most likely be a switcher.”

Likewise, Gill recommends “leveraging the information that you have about a population to understand what’s really going on with them and then creating a plan that runs the full year so that you really are interacting with individuals on a regular basis, not just about, ‘Go close your care gaps,’ or ‘Participate in this program,’ but also just to say, ‘Thank you for being a member; here are some benefits you might want to know about.’” This could include educating existing members about “differentiators” such as coverage of over-the-counter items and reminding them how to use supplemental offerings such as a fitness or transportation benefit that may involve an outside vendor.

Additionally, as plans think about their annual notice of change documents, establishing campaigns to educate members about any change that might “create a level of concern or anxiety” will help drive retention, suggests Gill.

Awareness May Lead to More Switching

Deft in its Medicare Member Experience study, which surveyed seniors in August 2018, found that only one in every four seniors knew that the OEP existed. But by April 2019, when it surveyed seniors again for the supplement to its annual Medicare Shopping and Switching Study, “awareness ballooned” to about two-thirds of MA Prescription Drug plan members, observed George Dippel, Deft’s senior vice president of client services, during the RISE webinar. And the top three ways they found out were TV ads that may not have explicitly referenced
the OEP but suggested, “‘There’s still time,’” a letter or pamphlet from CMS, and talking to a health insurance agent, he said.

Mezzanotte suggests that OEP awareness is likely to increase as more websites and Medicare informational guides highlight it. After all, CMS in its updated Medicare Communications and Marketing Guidelines explicitly stated that plans can include general information about the OEP on their website, she points out. “If plans were reluctant to add it last year, there should be no hesitation now,” Mezzanotte asserts. “This information should be on all websites now for individuals that are looking for the rules around OEP.”

Impeachment Coverage May Limit Ad Time

Another factor that may alter the 2020 landscape for switching is the likelihood of televised coverage of the Senate impeachment process in January, which means limited airtime for direct response television (DRTV) spots. “DRTV has always been an important part of the media mix during AEP, but we have found over the past few years that DRTV can be a powerful lead-generation and brand-awareness channel year-round,” explains Mezzanotte. “For instance, even though during the 2019 OEP there was a 28% increase of Medicare advertising activity (based on Kantar media reports), our clients saw a 37% decrease in their DRTV cost per lead.

We believe that consumer awareness of the OEP and the increased activity aided in driving consumers to take an action.”

As a result, MAOs may want to run DRTV ads outside the times of the live Senate coverage if they are able to expand their call center hours (i.e., earlier in the morning or later in the evening) or “lengthen their flight schedules” (i.e., remove planned hiatus weeks to increase available airtime to reach consumers), she suggests.

According to the experts, here are some additional tactics that can be employed throughout the year to maximize member retention:

  • During the AEP, make sure sales agents help prospective clients understand their benefits (including new supplemental benefits), check to make sure their primary care physician and other key providers are in the network and that their prescription drugs are on formulary, and list the expectations as to when they will receive their welcome kit, ID cards, etc., recommends Hollie.
  • “Don’t go dark after December 7,” when the AEP ends, says Mezzanotte. “Plans need to keep their brand presence out in the marketplace beginning immediately after the AEP, as competitor messaging will continue through the OEP. Particularly online — the No. 1 shopping resource for consumers.”
  • Educate providers (especially if operating provider-led plans) and provider personnel on the OEP. “Doctors and front desk staff are often the first to hear that a patient is unhappy with their plan,” points out Mezzanotte.
  • Implement a “robust onboarding program” that includes welcome calls during the OEP to help “members understand what their coverage offers them in terms of the benefits, [and] some of the things that they can do in order to maximize their coverage — in some cases that could mean that they have things that are rewardable as part of their program,” says Gill.
  • Do not overwhelm members with a mass of communications from different departments. Instead, “look at the communication stream that’s coming from your health plan from a holistic standpoint…so that you can give the new or the existing member a really strong experience from Day 1,” adds Hollie.

For more information about the Deft study, go to https://bit.ly/2CZsJ20.

To subscribe to AIS Health’s RADAR on Medicare Advantage, visit their website.

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