The True Path to Improving the Medicare Member Experience

I’ve been struck lately by two new research reports that demonstrate improving the member experience is the top challenge facing Medicare Advantage plans. First, JD Power is out with its 2017 Medicare Advantage Satisfaction Rankings. Among the results:

  • Unsurprisingly, Kaiser wins handily for the third consecutive year, followed by Highmark Blues and Humana.
  • There are significant opportunities to improve pre-eligibility marketing to Baby Boomers. Only 11% of members aged 60+ received any communications from their health plan regarding moving from current coverage to a Medicare Advantage plan. Among the 11% who have received pre-marketing contact from their health plan, overall satisfaction scores were significantly higher.
  • Only 54% of MA plan members say they “completely” understand how their plan works, with far fewer understanding drug benefits and cost-sharing. Assistance navigating providers and managing copayments and deductibles matters most to customer satisfaction, by far.
  • JD Power also turned up a new key driver of satisfaction: coordination of care among doctors and other healthcare providers. Most members say their plan isn’t able to effectively help them with this; on average, just 34% of Medicare Advantage plan members indicate their plans met this criterion.
The findings echoed those from Deft Research’s recent studies on drivers of member retention for Medicare Advantage plans. In its most recent Medicare Member Experience Study, Deft found:
  • The most significant loyalty driver is satisfaction with help understanding coverage.
  • Understanding of which pharmacies offer the best costs for their specific drugs was second-most impactful to the member experience, followed by comprehension of which services are under a deductible.
  • The biggest drag on member loyalty: needing a referral to see a specialist.

LeversofloyaltyA clear conclusion from both studies: actively helping members act like smart consumers of healthcare and drug benefits is the true path to improving the member experience. In doing so, Medicare Advantage plans can expect rapid improvement in Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and Health Outcomes Survey (HOS) beneficiary survey results, higher Star Ratings, improved revenue, and reduced costs of membership growth.



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John Gorman
John Gorman

Under John's leadership, Gorman Health Group has become the leading professional services and solutions firm for government-sponsored health care, providing thought leadership and expert strategic, operational, and technology-based solutions. Read more

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