Preserving Your Investment Through the Member Experience

I was on a client call last week with a few of our Gorman Health Group Sales, Marketing & Strategy subject matter experts presenting a sales and marketing budget the team created to help illustrate pre-operational investments in sales distribution and marketing strategies to a potential “new market” entrant. These budgets are two pieces of a much larger “Go, No Go” analysis we performed for this client, however, the discussion around these budgets led to a question from our client’s CEO that could, in essence, define the future success of this health plan in Medicare Advantage: “Does this budget account for initiatives that will enhance the members’ experience?”

I paused for a few seconds to savor the thoughtfulness behind the question. The question was a simple question, a question that warranted a “yes” or “no” response, but it was the intent of the question that made me pause and think, “Is this really happening?”

For years, Gorman Health Group has promoted the idea that net growth happens with a balance between new sales and retention. As you consider the value of investing in the Medicare Advantage market, it is important to understand the financial impact of member experience. Medical expense, administrative cost, and risk adjustment are all impacts of attrition, which could mean millions of dollars in yearly revenue. It is a concept I have seen many executives nod their heads to in agreement but turn their backs on when it comes time to make the investment.

Our client’s CEO said a whole lot with that one simple question:

  1. I acknowledge that in order to provide beneficiaries with the healthcare coverage they deserve, we must invest in the overall member experience.
  2. I acknowledge that in order to thrive in a marketplace that continues to become more saturated with competition year over year, we must create an environment members do not want to leave.
  3. I acknowledge that investing in my members upfront will give us the greatest return on investment.

I’ve heard the industry refer to the term “member experience” in a variety of ways: as a catchphrase parroted in the form of industry buzzwords, as a way to measure Star Ratings and quality ratings, and as the core basis for which the governing body over Medicare and Medicaid defines its regulatory expectations. In the example above, member experience was referenced as a growth strategy necessity – a way in which to preserve a future investment while supporting a mission.

What is your organization’s answer to the question above?



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