Acquisition, Retention Strategies Member engagement, communication is even more important during these turbulent times
nยบ3 - Summer 2020
The impact of COVID-19 on Age-In campaigns
Medicare Advantage in 2020: KFF looks at the latest trends in enrollment, premiums, and out-of-pocket limits
5 findings on the state of Medicare Advantage in 2020: Trends in enrollment growth, health care quality, and consumer attitudes"
Study reveals 5 trends in Medicare Advantage member clinical characteristics, health care use, and spending
AEP planning: 4 tactics to align compliance, sales, and marketing
CMS: Special enrollment period available to those affected by COVID-19 pandemic in a FEMA declared disaster area
How one health plan developed a rapid response for member communications during COVID-19
Telehealth study: Technology disparities correlate with health disparities
3 strategies for AEP planning in a COVID world
Empower your agents and brokers with virtual tools Engagent Health
Poll: Seniors give two thumbs up to telehealth, Medicare Advantage amid COVID-19 pandemic
Embracing the new member experience Engagys
Age-in outreach strategies: A video interview with Inter Valley Health Plan’s Larry Baca
See our entire collection of Insights & Articles
2
Member A&E Newsletter
Note from the Director:
Creative solutions to connect with current and prospective members during COVID-19 COVID-19 has wrecked a lot of things and taken so many lives. There is no debate on that. However, along with that we have also witnessed amazing things arising from the crisis in terms of human responses to one another’s needs and creative ways to adapt to the ways this public health emergency has imposed changes to our lives, our jobs, and our sense of possibilities. As I write this letter to you all, I am midway through a fantastic RISE virtual seminar on Converting During COVID: Winning Strategies for Medicare Member Acquisition and Experience. All the speakers have presented impressive ideas and techniques they have devised through brainstorming with their colleagues and physicians to keep connected with both current and prospective members of the plan. We heard about what they learned to quickly pivot to digital tools to outreach and connect. They also talked to us about how they tested for customer acceptance and user friendliness to allow for technology adoption on the part of seniors. Simple user experience research led to certain decisions. Other decisions came through direct experimentation. And these ideas are working. Creativity is being described in terms of developing safe experiences that establish bonds between customers and their physicians using Zoom and Facebook Live platforms, such as Doc Talks and Cafecitos (coffee and chats in San Antonio). Other ideas emerged around drive-through doctor clinic tours once the time is right again for nearly in person events. Our marketing and sales user groups have both concentrated on how to prepare for the AEP, making assumptions that nearly everything will need to substitute for traditional face-to-face selling. This requires everyone on the sales rep and broker sides, as well as the client side, to e have the necessary technical set ups. Telephonic enrollment will be a fallback mode for those buyers who are not comfortable with Zoom or Teams. Self-service online enrollment will also get the job done for others. It turns out that we have a lot more tools available than we might have thought, now that we are forced to really deal with it. And the consensus is that these modalities will not just disappear once the public health emergency subsides‌these are modalities that will continue as part of our tool kits. The rapid pace of innovation and experimentation, along with customer acceptance, means that we all must keep keenly tuned to the stream of ideas and success stories constantly unfolding across our community of local and regional Medicare Advantage plans. RISE is pleased to be a channel for news, webinars, user group meetings, and information sharing to help you navigate these tricky waters. Be sure you have your logon credentials for the Medicare member acquisition & experience (MMA&E) portal. We have seen hundreds of RISE association members claim their passwords and logon to tap into the rich resources available inside. Keep on top of developments, trends, and strategic options, and many other changes in the landscape with this vibrant community that has found successful ways to compete and thrive. Check out our user groups inside the portal: https://www. risehealth.org/event-center/rise-events/rise-user-groups/
Join the conversation. Take a seat at the table with colleagues Kevin Mowll Executive Director kmowll@risehealth.org
and peers as we figure out all of this together.
5 WAYS TO TAKE ADVANTAGE OF YOUR RISE ASSOCIATION MEMBERSHIP The Medicare Member Acquisition & Experience Community (MMA&E) offers a multitude of member benefits including conference discounts, live webinars, user group meetings, and more. Here are some recommended tips to make the most of your online community. Earlier this year, The RISE Association launched the MMA&E Community to help local and regional Medicare Advantage health plans differentiate themselves from national carriers as well as grow and retain membership base. The free virtual community connects professionals involved in marketing, business development, member engagement, member experience, product development, and product management. MMA&E community members can also join RISE’s other communities, including quality and revenue and social determinants of health. The MMA&E virtual community provides a space for professionals and thought leaders to share best practices, continue their education, and interact on a 24/7/365 basis. MMA&E members can experience frequent networking, education, and industry collaboration through a variety of features in the member portal, all of which are included in the free membership. 4
Member A&E Newsletter
Here are five tips to take full advantage of your membership benefits
1. Attend a Conference Attend a RISE conference with your exclusive discounted member rate. A RISE Association membership includes a discounted member rate for all live RISE conferences, including both in-person and virtual events. Community members also enjoy exclusive onsite member benefits at RISE conferences.
2. Join Live Webinars Join live webinars to hear thought leaders discuss the hottest topics in the industry to stay up to date and ahead of the game. Webinars are free to RISE Association members. Within the webinar dashboard, members also have access to the complete webinar archive library for on-demand playback at any time.
3. Participate in User Groups Participate in user group meetings alongside like-minded professionals to network and discuss timely topics for your job function. The MMA&E Community features two user groups: Medicare sales and Medicare marketing. The intimate, interactive meetings are held telephonically on a scheduled basis and facilitated by subject matter experts. The user groups are a safe space for peers to discuss challenges, insights, and lessons learned from firsthand experiences.
SEE OUR UPCOMING USER GROUPS
2
4 4. Utilize Discussion Boards Connect with other members through the discussion board and solution partner directory. The online discussion board allows members to learn from and benchmark with one another through open conversation, questions, and recommendations. Members can also access the solution partners directory to explore ways to collaborate with fellow community members. The interactive report showcases the services offered by community partners and can be filtered by a range of categories for personalization.
5
5. Find Career Opporunities Learn about career opportunities within your profession. The Talent Hub dashboard within the member portal enables members to search for career opportunities within your profession or recruit for open positions in your organization.
Click to see other articles
5
4 STRATEGIES FOR MEDICARE MEMBER ACQUISITION LEADING UP TO THE AEP Although the COVID-19 pandemic, combined with the upcoming presidential election, may limit health plans’ reach, there are still opportunities to connect with prospective members and engage with your current members. As cases of COVID-19 continue to spread across the United States, Medicare Advantage health plans have had to overhaul their strategies to enroll new members and retain existing ones. Since seniors are among the most vulnerable to serious illness from COVID-19, it is unlikely that plans will be able to conduct inperson meetings as they have in the past. Although the pandemic, combined with the upcoming presidential election, may limit health plans’ reach, there are still opportunities to connect with prospective members and engage with your current members. Here are four takeaways we’ve gathered from the July RISE virtual seminar, Converting During COVID: Winning Strategies for 6
Member A&E Newsletter
Medicare Member Experience.
Acquisition
&
Conduct virtual meetings in place of in-person meetings For BlueCross Blue Shield of Western New York, the Microsoft Teams communication platform has allowed the health plan to create an in-person type experience and engage clients. Thomas Sass, director, consumer markets, told attendees that the platform has been easy to use and allows the sales team to book appointments and record sessions, which is critical in the lead up to the annual enrollment period (AEP). The app sends out reminders about the meetings and instructions in advance so seniors receive information ahead of time and can feel comfortable with the technology. The health plan does have five Medicare retail centers and may open them for inperson appointments when it is safe to do so, but Sass believes the virtual meetings are a good substitute to build relationships because seniors can see the faces of sales reps rather than rely on a voice on the phone.
“Virtual meetings are here to stay…I definitely see this as an area of focus for us,” he said.
Follow best practices for virtual meetings Judie Victor, sales manager, SCAN Health Plan, suggests that health plans be open to using different apps, such as FaceTime, WhatsApp, Skype, Zoom, as well as Microsoft Teams, and let the prospective member decide on which one to use. Make sure clients have the plan information in advance of the meeting (some reps drop off hard copy information at the client’s doorstep) and take advantage of the ability to share your screen so you can walk them through the information. Victor also suggests brokers and sales representatives have PDFs of all plans, and information on formularies, and the list of doctors in the networks for reference on their desktops. She also recommends that they have any collateral they use for in-person meetings next to their computer or phone.
Her other tips: Be on time for the meeting and dress for success (some of her sales reps wear business jackets with their name tags on the lapel). She also suggests conducting mock presentations with field representatives because some may be great at in-person face-to-face meetings but not necessarily at the virtual ones. For example, during a mock presentation, one of the reps went straight into information about the plan, instead of easing into the conversation. Victor says it’s important to make the client feel comfortable, ask how they are doing, before going into the presentation. She also suggests that sales reps keep the presentations concise and meetings to under an hour.
Create other opportunities to connect with potential members In addition to one-on-one virtual meetings, HealthTexas Medical Group has developed relationships with prospective members by scheduling events, such as produce giveaways and a 30-minute live exercise group on Facebook Live that it calls Fitness Fridays, said Tricia Lopez, executive marketing director. Both have been successful. The medical group also has interacted with agents and brokers during the pandemic by conducting a CEO doc talk where they could ask questions via a Zoom meeting and also conducts community virtual meetings on topics like depression and COVID-19 information. Some agents still want to meet with clients in-person but in a safe manner. So, they bring lunch to the client and they “picnic on the porch” while social distancing. Some have weekly coffee chats. The important thing, she said, is to be visible.
Victor said SCAN has also created virtual flower arrangement classes, yoga classes, and even a “Scattergories” game with scratch paper. During the seminar, other plans said they had arranged for a virtual Bingo, a virtual cooking class, and even a virtual painting class.
Don’t forget to engage existing members Louis Yacovoni, senior director, Medicare sales, Geisinger Gold, said it is important that Medicare Advantage plans also spend time on activities to retain members. Plans spend so much time and money to acquire members, it’s vital that they take the time to retain them. “Every time we lose a member, we need two to make up for the one,” he said. COVID-19 has provided an opportunity to talk to members in a different way than the plan normally would and let them know about their existing benefits. Their message to members: You don’t have to leave your house, we will take care of you. If you want a televisit, there is a $0 copay. The health plan also reinforced mail-order pharmacy and refill discount benefits. Since sales and field reps couldn’t go out and sell, the plan had them call Geisinger Gold’s newest members (one year or less) to review their benefits. They also contacted the plan’s most critical patients to explain the Geisinger At Home benefit for people with Geisinger Gold insurance. The Medical management team (doctors, nurses, dieticians) will visit the patients at home to treat them. Steve Selinsky, vice president, Health Alliance Plan, agreed that health plans must focus on retention as part of their sales strategy. As a result of COVID-19, the health plan beefed
up its social media presence and posted daily messages that educated members and held virtual town halls on Facebook Live to address any questions they had. Health Alliance Plan also repurposed its community outreach team and had them make outbound calls to at-risk members to check on them. This allowed the plan to connect members to community resources if they had food and housing issues in addition to medical concerns. For example, one Medicare member was isolated at home and couldn’t get her medications, so the community resources rep arranged for her to get the prescriptions delivered. The member appreciated the outreach. “They were so impressed their insurer took time to reach out to them…The member couldn’t believe an insurance company was checking in on them,” he said. As a result, the plan pleases to weave these strategies into the member journey going forward. One health plan also went the extra mile for its existing members. When Inter Valley Health Plan realized that COVID-19 wasn’t going away any time soon and saw news coverage about people searching for masks, the plan purchased 20,000 masks and sent one to all its members. “It was a challenge and it was an expensive thing to pull off, but it was a great thing. We got a ton of emails, phone calls, and pictures on social media with posts saying thank you… It was a big win for us,” said Larry Baca, VP sales & marketing, Inter Valley Health Plan.
Click to see other articles
7
MEMBER ENGAGE
NO LONGER B Kevin Mowll
Executive Director, The RISE Association
Member engagement is not a choice: to do or not to do. Even if your health plan just sends paper mail to members at home, you are still engaging them. I’ve worked at several health plans and at all of them, , we dumped a lot of USPS mail on our members: claims, health services, pharmacy, member communications, and so on. Many of these mailings were intended as one-way communications, but they still count as member engagement touches. These activities on behalf of all our functional departments colored and determined the way the members thought of our health plans by default. Unaware of the activities of other departments, everyone had a hand in contributing to the resulting confusion. Of course, customer service always took pains to be member friendly. They were the only employees who really thought of member engagement as an essential part of their job. Unbeknownst to the customer service folks, they were operating at a disadvantage because all the other interactions the members had with the plan had set the tone of the relationship. So, customer service was starting out in a relationship “hole” before they took their first inbound complaint call. One of the health plans I worked at hired a consulting firm to help us get grounded in the reality of our members’ experience with the plan We conducted a member journey mapping exercise by gathering all the touchpoints for our members over the entire annual cycle of their membership. It looked something like this: • As prospective buyers reacting to our marketing activities • As newly sold enrollees talking with sales and submitting their applications • As new enrollees receiving their new member welcome materials, their ID cards, and so on • As new members receiving outreaches to get their regular prescriptions filled in time for their first month of eligibility
8
Member A&E Newsletter
EMENT:
BUSINESS AS USUAL • As members receiving health assessments with health services to stratify them info population health programs, potentially into case management, medication therapy management programs, etc. • As members receiving a regular barrage of claims statements and explanations of benefit forms s from claims • As members receiving health reminders for HEDIS related care gaps • As members receiving renewal member communications during AEP When you gather all the mail pieces, phone calls, emails, and other touches from all the departments, it becomes clear very quickly that the whole experience from the member perspective is an uncoordinated mess. At certain points, members would receive multiple outreach requests from multiple departments at the same time. Sometimes it overwhelmed our members and caused paralysis of inaction. When asked in the CAHPS survey, members tell us what they think about their experiences with their plans, and it is not always the news we want to hear, but it gets dialed directly into our Star Ratings and impacts our related bonus payments. Obviously, doing member engagement by bumbling along on “default mode” is not a good idea, but that is not uncommon. When it comes time in AEP for members to choose their coverage for next year, do we want to roll the dice with whether they chose to renew or to switch companies? If we lose members because of poor customer engagement, we must spend a lot of money to attract new members to replace each one we lost in AEP or in OEP.
HOW DO WE MAKE IT BETTER? The RISE Association has been conducting annual member health plan surveys for four years in a row, providing a mirror back to our association members on how they compare to industry peers. But truly, we need to take a hard look at best practices and compare ourselves to those. There are a lot of terrific case examples out there. That is the next mission for RISE to tackle around member engagement: helping health plans get a handle on what practices should look like instead of what they currently do look like. First, let’s look at some of the key challenges that keep us from moving the needle toward best practices:
Click to see other articles
9
Poor enterprise competence • Fragmented governance across all involved departments and function–no coordination • Lack of a shared and unified view of customer • Immature engagement capabilities–each department is only doing what it can separately and without leveraging their collective resources • Lack of metrics for management–score cards for monitoring, tracking, evaluating
Losses of revenue without attribution to root cause • Member turnover without understanding causes and contributing causes • Lower risk scores and lower Star scores that sap the health plan of funding due to inability to effectively activate members to close care gaps • Noncompetitive products due to lower funding levels resulting in less competitive products to sell, hampering growth of membership and revenues
Higher costs of care and administrative expenses • High health care costs from inability to active members to benefit from care coordination and population health • Missed opportunities to provide high-quality care • High cost locations of care due to inability to impact member decisions through engagement, particularly around social determinants of health issues • Need new members to replace those lost
NEXT STEPS FROM RISE RISE intends to launch a new initiative to pull together the audiences at health plans and provider organizations who own their own roles in member engagement. We aim to take member engagement to the next level by bringing together the whole spectrum of players who have the opportunity to link across the organizational boundaries and move toward a best practices model of their own. The future calendar of relevant conferences provides a series of events where will showcase ideas, tools, models, and exemplars for a new paradigm of coordinated (if not integrated) cross-departmental best practices: • RISE West – September 9-11 • The 10th Annual HEDIS® and Quality Improvement Summit – October 25-27 • The RISE Population Health Summit – November 9-10 • The RISE Star Ratings Master Class – December 9-10 • Medicare Marketing & Sales Summit – February 21-23, 2021 • RISE National 2021 - March 28-20, 2021 • National Summit on Social Determinants of Health – March 2021 • Qualipalooza 2021 – June 2021 Keep an eye out for upcoming news articles, webinars, and user groups from the RISE Association that will help tell the stories you need to hear and which will bring you into a closer community connection with peers and colleagues across the industry and from all over the country. Coming soon.
10
Member A&E Newsletter
COVID-19 MEMBER COMMUNICATION STRATEGIES:
YOUR FEEDBACK IS NEEDED How is your organization handling member communications now that we are in month five of the COVID-19 pandemic? We know this is a difficult time to determine the right member communication strategies and tactics to deploy in response to COVID-19. RISE is here to help. We have once again teamed up with Engagys to get a pulse on how our member organizations are responding to this dynamically changing environment caused by COVID-19. Please take five minutes to click on the link below and complete this short survey. We will report survey results back to you as quickly as we can.
TAKE OUR FIVE MINUTE SURVEY
Questions? Reach Out to Our Team
Kevin Mowll
Ilene MacDonald
Tricia Rosetti
Tracy Anderson
Debbie Weidrick
Executive Director
Editorial Director
Content Marketer
Marketing Coordinator
Graphic Designer
kmowll@risehealth.org
imacdonald@risehealth.org
trosetti@risehealth.org
tanderson@risehealth.org
dweidrick@risehealth.org
UPCOMING EVENTS
MEDICARE PRODUCT DESIGN MASTER CLASS
SEPTEMBER 21-22, 2020
FEBRUARY 21-23, 2021
Learn more at risehealth.org/product-design
Learn more at medicaremarketingsalessummit.com
The 5th Annual
SEPTEMBER 9-11, 2020
Learn more at risewestsummit.com
Learn more at risehealth.org/accounting-recon 12
Member A&E Newsletter
LEARN MORE AT RISEHEALTH.ORG/AEP
Learn more at risehealth.org/aep