MEDICARE MARKETING COMPLIANCE New RISE workgroup to address Joe Namath’s controversial Medicare TV ads
STATE OF MEDICARE ADVANTAGE 7 findings from BMA’s 2021 report
4 FINDINGS ON MEDICARE AGE-INS Deft Research offers insight into the health plan preferences of seniors new to Medicare
nº6 - Sumer 201
THE LATEST NEWS
Study: Despite overall customer satisfaction, MA plans continue to struggle with member communication, engagement
Medicare marketing alert: Google will now require certification for health insurance advertisers
The latest trends in Medicare Advantage: What enrollment, Star ratings, and plan benefits look like in 2021
RISE Radio Episode 8: Dr. Abdullah Albeyatti on the acceleration of telemedicine during COVID
Former HHS chief of staff to take over as president and CEO of the Better Medicare Alliance
Research roundup: AEP switchers take advantage of OEP; MA beats Medicare in quality, outcomes, and costs; and more
Regulatory update: OIG says CMS unable to ensure hospitals are ready for future pandemics; 3 big name California health insurers sued over ‘ghost networks’; and more
RISE Radio Episode 7: Colleen Gianatasio & Dean Ratzlaff on managing a remote workforce
Supreme Court dismisses GOP-led challenge to Affordable Care Act, leaves law intact
Study: 5-Star ratings don’t necessarily mean all MA members receive top-level care
Senate confirms Chiquita Brooks-LaSure as CMS administrator
How to tackle the complexity of preparing for the Annual Enrollment Period Messagepoint
READ OUR ENTIRE COLLECTION OF INSIGHTS AND ARTICLES 2
MA&E COMMUNITY NEWSLETTER
Letter From the Chair
TAKE ADVANTAGE OF RISE MEMBERSHIP TO PREPARE FOR THE UPCOMING ANNUAL ELECTION PERIOD We find ourselves in the swing of summer and the gearing up process for the Annual Election Period (AEP). The plans for AEP must take into consideration all the learnings from the oddball year last year and making an educated guess about how the next season will unfold. How much will the virtual dimensions dominate the shopping and buying process? Clearly, we’re not going to return to the patterns from two years ago. The mix will almost certainly be a blend. But how much of what and which things in particular? Whatever the new normal will be, it’s going to deliver success to nimble and adaptive Medicare Advantage plans. Whoever can be flexible and innovative will be the winners. We all learned a lot, but more than anything, we learned about ourselves and our ability to adapt. Ultimately, the key will be staying close to the customers and giving them the experiences that matter the most to them. Rigidity and bureaucratic will be the kiss of death. RISE exists to support you in learning how to do this from the community of peers in community plans across the country. Do yourself a favor and make sure that you are plugged in along with your friends. It’s really taking all the collegiality we can summon. It turns out, we’re really all in this together.
Kevin Mowll, Medicare Member Acquisition & Experience Community Chair The RISE Association
CLICK TO SEE OTHER ARTICLES
3
The 2021 ‘State of Medicare Advantage’ 7 findings from BMA’s annual report
4
MA&E COMMUNITY NEWSLETTER
The annual report compiles the latest data to provide a full picture of the Medicare Advantage (MA) landscape from beneficiary demographics and enrollment trends to consumer savings and improved outcomes, as well as MA’s response to COVID-19 and the continued drive to health equity. The Better Medicare Alliance (BMA), a research and advocacy group that supports MA, recently released its 2021 State of Medicare Advantage report, which reveals near-universal satisfaction, greater consumer savings, and better health outcomes in MA compared to traditional fee-for-service (FFS) Medicare. The 24-page annual report also provides a snapshot of the MA community’s response to the COVID-19 pandemic. Here are seven of the key findings:
ENROLLMENT IS UP MA enrollment has nearly doubled over the last decade with enrollment at 26 million individuals in early 2021, or 42 percent of all Medicare beneficiaries. Furthermore, enrollment is projected to increase to more than 50 percent of total Medicare enrollment by 2030. The report said the spike in enrollment is driven by increased access to MA plans. In 2021, Medicare beneficiaries have access to more than 4,800 plans offered across the country, an increase of 2,100 from 2017. Of the 4,800 plans offered, 2,900 are in rural counties.
MEMBERS ARE HAPPY Recent polling shows that 98 percent of MA beneficiaries are satisfied with their coverage, while 97 percent are specifically satisfied with their network of physicians, hospitals, and specialists. The overall satisfaction rate was 99 percent among minority beneficiaries.
SUPPLEMENTAL BENEFITS ARE MORE POPULAR THAN EVER About 90 percent of MA plans offer benefits such as wellness, dental, vision, or hearing coverage and over two-thirds of plans cover all four benefits. Vision
“Recent polling shows that 98 percent of MA beneficiaries are satisfied with their coverage, while 97 percent are specifically satisfied with their network...”
benefits are the most common supplemental benefit. Furthermore, in 2021, more than 94 percent of MA plans also offered additional telehealth benefits, reaching 20.7 million beneficiaries.
HEALTH OUTCOMES ARE BETTER MA beneficiaries had 41 percent and 18 percent fewer avoidable acute and chronic hospitalizations, respectively, than traditional FFS Medicare beneficiaries. Indeed, 21 percent more MA beneficiaries received a physician visit within 14 days of discharge compared to traditional FFS Medicare beneficiaries. MA beneficiaries were also more likely to receive an annual flu vaccine.
MEMBERS REPORT MORE COST SAVINGS MA beneficiaries report lower average annual individual spending, with cost savings of $1,640 resulting in a 40 percent lower rate of cost burden than traditional FFS Medicare. The report finds that the MA average monthly premium is $21 in 2021, which is $2.63 less than 2020 and the lowest average premium since 2007.
MEMBERS ARE MORE DIVERSE WITH HIGHER RATES OF SOCIAL RISK FACTORS Minorities comprise 33.7 percent of MA beneficiaries compared to 16 percent of traditional FFS Medicare beneficiaries. MA beneficiaries are also more likely than those in traditional Medicare to be dual-eligible for both Medicare and Medicaid, and more than half of MA beneficiaries live on annual incomes of less than $24,500.
MA PROVIDERS AND PLANS QUICKLY RESPONDED TO COVID In addition to offering telehealth visits, some providers went above and beyond by providing tablets to their patients who lacked the necessary technology to complete a virtual visit. Many health plans waived beneficiary cost sharing for telemedicine visits, and all waived consumer out-of-pocket costs for COVID-19 testing and COVID-19 treatment. Some plans sent their beneficiaries care packages that included hand sanitizer, masks, thermometers, and over-the-counter health items to protect their members from COVID-19 and the flu. Others offered additional support services, including meal delivery, patient contact to address social isolation.
CLICK TO SEE OTHER ARTICLES
5
MEDI CA RE AGE -INS : 4 FINDINGS FROM DEFT RESEARCH’S 2021 STUDY For the second year in a row, Deft Research has found a higher proportion of age-ins lean toward selecting a Medicare Advantage (MA) plan when they enter Medicare. Although the balance of interest between MA and MedSupp may have changed during the COVID-19 pandemic, it doesn’t appear to be reversing, according to an executive summary of the 2021 Age-In Study. The annual study gives insight into the health plan preferences of seniors who are considering Medicare health insurance for the first time. This population, who are “aging in” into Medicare, are typically between the ages of 60 and 65 and are a key source of new customers for MA and supplemental Medicare insurers. The Deft Research study findings help health insurers understand the likely coverage choices of Age-Ins upon their initial Medicare enrollment as well as the channels which they tend to shop and enroll. The research is the fourth study in Deft’s 2021 six-part Senior Market Insights Service. The survey looks at AgeIns’ retirement plans just over one-year removed from the start of the COVID19 pandemic; expected plan selections and reasons for those preferences; the appeal of supplemental benefits; shopping activities and the timing of those activities, including agent utilization and online shopping; and Medicare enrollees’ 6
MA&E COMMUNITY NEWSLETTER
experiences with the process of transitioning to Medicare. The 2021 Medicare Age-In Study includes the responses of two sample groups. The first is a quantitative sample that included 1,731 respondents with the following breakdown: 644 Age‐Ins who are in their initial enrollment period (IEP); 243 full Social Security Age‐Ins; 307 late‐to‐Medicare seniors; and 537 recently enrolled Medicare members. The survey was administered May 24 to June 3. The second sample involved respondents who kept a monthly diary to provide their thoughts on the transition to Medicare in their own words. That qualitative sample included 187 respondents not yet enrolled in Medicare who completed at least the first month of the survey and 51 diary respondents who completed all five months of the survey. Here are four findings from the executive summary of the report: • For the second year in a row, a higher proportion of Age-Ins report they are leaning toward selecting an MA plan when they enter Medicare. The top reasons for their interest: Extra benefits, affordability, and the combination of medical and drug coverage. For those who preferred MedSupp, they said they preferred to have the ability to use any doctor/ hospital and to have all their medical bills covered by insurance.
• Age‐Ins leaning toward a private Medicare plan are often more aware of the supplemental benefits available with MA plans. When looking just at traditional supplemental benefits (excluding dental coverage), the three most popular benefits were eyewear allowances, over-the-counter allowances, and rewards for healthy behaviors. • Nearly two‐thirds of 65‐year‐olds who are still in their IEP but not yet enrolled in Medicare have begun shopping for a plan. Motivators to begin shopping: for younger AgeIns, a birthday; for older Age-Ins, retirement; and late-to-Medicare seniors cited a change in health needs. • Overall, one‐third of recent Medicare enrollees who were previously insured converted to Medicare with that insurer. Maintaining positive member experiences among under‐65 members not only positively impacts loyalty, but it can also pay dividends as those members age into Medicare, Deft noted. FOR MORE INFORMATION ABOUT THE FULL RESULTS OF THE SURVEY, CONTACT DEFT RESEARCH.
New RISE Association workgroups tackle Medicare marketing compliance issues, KPIs for marketing and sales The new workgroups will address issues of most concern to members of RISE’s Medicare Member Acquisition & Experience (MAE) community. Up first, the fallout from Joe Namath’s Medicare television commercials and key performance indicators (KPIs) around marketing and sales. One of the biggest surprises from the Annual Enrollment Period (AEP) last fall was the widespread problems that local and regional Medicare Advantage
(MA) plans experienced when seniors responded to television commercials featuring celebrities who promoted rich health benefits for MA plans. Individual plans thought they were the only ones with the problem–that is until the community got together at recent RISE conferences, including the Medicare Marketing & Sales Summit in February and the AEP Medicare Readiness Summit in June.
RISE MAE community members learned that other MA plans had also experienced issues after the television spots ran and seniors called a 1-800 number for more information. The result? Thousands of seniors unknowingly switched plans, only finding out weeks later when their new identification cards arrived in the mail.
Controversial Joe Namath Medicare television commercials Here’s an example of one of the commercials featuring Joe Namath that ran during the AEP. The advertisement for the “Medicare Coverage Helpline” tells viewers that they are entitled to eliminate premiums and copays and get dental care, dentures, eyeglasses, in-home health services prescriptions, unlimited transportation, and home delivered meals at no additional cost. It also touts a give-back benefit for those who live in certain ZIP codes that adds money back to their monthly Social Security check. Viewers often think they are calling the federal agency for information.
CLICK TO SEE OTHER ARTICLES
7
But in tiny print, the commercial states that they aren’t affiliated with a government agency or program and that callers will be directed to a licensed insurance agent or to a third-party partner of TogetherHealth PAP, which owns the registered trademark “Medicare Coverage Helpline.” The advertisement has been flagged as misleading by the watchdog website truthinadvertising.org, which is run by a nonprofit organization based in Madison, Conn. that is dedicated to helping consumers protect themselves against false advertising and deceptive marketing. MAE advisers noted that the commercial violates Centers for Medicare & Medicaid Services’ (CMS) marketing guidelines on how MA products may be marketed, including specific “can say/can’t say” words in the regulations. CMS can only regulate MA plans using these regulations. The agency has no jurisdiction over the electronic marketing organization (EMO) putting out the advertisements because they are not contracted with CMS. However, the agency can sanction MA plans for using these leads if they buy them from the EMO. The commercial pushes benefit descriptions and promotion of benefits that are only found in counties where there is intense MA competition and has
forced plans to offer rich benefits. But the commercials also aired in geographic markets where these types of benefits are not available. It appears that this led competing lead generation companies to step up activities and aggressively promote their lead sales to e-brokers who were not always vetting vendors for how they obtained the leads. As a result, the ads drove rapid disenrollments at some MA plans with members not understanding the implications of plan switching or what they might be giving up. One RISE member said his plan identified close to 550 members who switched to a national carrier unknowingly.
RISE workgroup to review compliance issues In response, the MAE advisory board has created a workgroup under the leadership of MAE Community Chair Kevin Mowll, to address Medicare marketing compliance for the RISE association and our community of member health plans. Workgroup members include representatives from DMW, Experience Health, Guided Medicare Solutions, and HealthCompare.
The workgroup is taking steps to: • Advise RISE on best practices around health plan contracting and vetting processes with their distribution channel partners • Create a compliance pledge for vendors in the marketing and sales space • Outreach to CMS around changes and revisions to marketing guidelines and standards for compliance • Second workgroup to focus on KPIs on marketing and sales
Second workgroup to focus on KPIs on marketing and sales In addition, Mowll is overseeing another workgroup to create surveys on KPIs around marketing and sales. The workgroup, which includes representatives from DMW and Engagys, is working on metrics plans to launch a survey to community member MA plans every year so RISE can provide benchmarks for the community, against which members can gauge their own performance. As we currently do with the annual member engagement survey conducted by Engagys on behalf of RISE, we will publish the results and present our findings at our annual conferences, including the Medicare Marketing & Sales Summit. Look for updates and announcements here regarding the launch of these surveys. Mowll said the workgroup aims to get one representative from each MA plan to complete the surveys (one for marketing and another for sales) so the participation creates useful and valuable benchmark insights. In response to the survey findings, as we determine where the community needs a boost, Mowll said RISE can design and develop programs (conference topics, seminars, webinars, articles, etc.) to help with performance improvement.
Medicare commercial featuring Joe Namath 8
MA&E COMMUNITY NEWSLETTER
UPCOMING EVENTS Enhancing Medicare and Medicaid Member Engagement with Behavioral Science
LEARN ABOUT THIS WEBINAR
August 19th, 2021 - 1:30 pm EST
Medicare Product Design Master Class 2021 September 21 - 22, 2021 InterContinental Magnificent Mile, Chicago
Women in Health Care Leadership Summit December 14 - 15, 2021 Manchester Grand Hyatt Hotel, San Diego, CA
The 6th Annual CMS Bid Boot Camp January 2022 Location Pending
Medicare Marketing & Sales Summit 2022 February 16 - 18, 2022 Caesars Palace, Las Vegas
VISIT THE EVENT WEBSITE
VISIT THE EVENT WEBSITE
VISIT THE EVENT WEBSITE
VISIT THE EVENT WEBSITE
CLICK TO SEE OTHER ARTICLES
9
QUESTIONS? REACH OUT TO OUR TEAM
Ilene MacDonald Editorial Director imacdonald@risehealth.org
10
MA&E COMMUNITY NEWSLETTER
Tricia Rosetti Content Marketer trosetti@risehealth.org
Tracy Anderson Marketing Coordinator tanderson@risehealth.org
Deborah Antoszyk Graphic Designer dantoszyk@risehealth.org