Data Universes - Friend not Foe
Data universes are not new in the Medicare Advantage and Part D space. The Centers for Medicare & Medicaid Services (CMS) requires data universes for a variety of purposes, including program audits and timeliness monitoring. Gorman Health Group has communicated time and time again the importance of pulling accurate universes as well as continuous review of that data. Universes tell a story often not heard via other monitoring efforts.
Whether you are from a health plan or a first tier, downstream, and related entity (FDR), universes are critical to your organization’s success. During a CMS program audit or timeliness monitoring effort is not the time to realize your organization cannot pull the data or the data is inaccurate. CMS imposes strict penalties and fines when health plans cannot produce data – $25,000 for an invalid data submission (IDS) per violation/contract. IDS issues, if identified, can also have a negative impact to a health plan’s Star Ratings. Conversely, health plans can impose corrective action plans and monetary penalties on their FDRs for the same problem.
Ask yourself the following:
- Can our organization produce all applicable data universes?
- Is the data pulling from the correct source?
- Has the data been tested for accuracy?
- If a health plan, can our FDRs produce accurate universes? Have they been validated?
These activities can be time consuming for any organization and compete with other monitoring and auditing activities. Gorman Health Group offers customizable universe review services for both health plans and FDRs, including:
- Automated review utilizing Gorman Health Group’s proprietary analytics/algorithms
- Subject matter expert review in order to identify any risks and/or compliance concerns
- Timeliness testing of CDAG and ODAG universes
- Validation testing of the data conducted via webinar
Clients can tailor these services to fit their specific needs, e.g., monthly, quarterly, annually. Contact us today to learn more!
Resources:
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Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
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CMS Timeliness Monitoring Underway
The Centers for Medicare & Medicaid Services (CMS) timeliness monitoring is currently underway at organizations with active contracts in 2017 and 2018, with a few exclusions, such as Medicare-Medicaid Plans and organizations that underwent a program audit in 2017 and did not have any invalid data submissions in key audit areas. Is your organization excluded? See the Health Plan Management System memo dated December 12, 2017. If I had a nickel for every time someone referred to this activity as a timeliness audit, I’d have quite a pile of nickels. While it is not an audit, it sure feels like one as the validation activity is the same.
The first of three waves of letters is being issued this month. After upload, a data review will be conducted and a validation webinar scheduled. Once complete, timeliness rates will be calculated. To make sure this is an efficient process, here are some ways we have recently assisted clients:
- Coach and guide delegates in the timeliness monitoring requirements
- Evaluate universes for adherence to instructions
- Review both timely and untimely case samples for data accuracy
- Review systems to validate accurate population of fields
Data integrity continues to be a priority not only for informing Star Ratings and Independent Review Entity data accuracy but also for required Part C and Part D reporting and for the compliant operations of plan administration. Universe preparation steps are not one size fits all, as the methodologies for a small plan delegating very few activities and the steps a larger, more delegated model plan takes will vary. Not surprisingly, during the course of our review, our team often finds potential issues or concerns unrelated to timeliness. This gives our client partners the opportunity to conduct a deeper review to address and mitigate.
We currently provide guidance, suggestions, and best practices for universe development to address quality and identify potential risks. If your organization is not getting these data universes correct, you should ask yourself, what other reports might be flawed? Dashboard metrics? Board reporting? Identify and correct these issues before CMS and their contractors find them for you.
Resources:
Registration is now open for the Gorman Health Group 2018 Forum, April 25-26, 2018, at the Red Rock Resort ideally located near the Red Rock Canyon in Las Vegas.
Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
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Second NOIA Deadline Approaching
Applicants looking to enter Medicare Advantage, Part D, or the Medicare-Medicaid Plan space have two deadlines to submit a Notice of Intent to Apply, commonly referred to as a “NOIA,” for contract year 2019: November 13, 2017, and January 26, 2018. The first submission allows the Centers for Medicare & Medicaid Services (CMS) team to gauge what resources might be needed during this critical time of year. The second date is provided to allow potential suitors to review the final 2019 application requirements, which should be released here, here, and here around January 9, and then make a decision.
CMS initiated the NOIA process in 2007 for the 2009 application season and have always noted the NOIA submissions should be completed by the due dates, stating those that miss the date might experience delays in being assigned a contract number. Six years ago, CMS implemented a second NOIA submission date into their application activity timeline, noting they would continue to process NOIAs through the second date.
Remember, the NOIA is non-binding. Based on Gorman Health Group experience, CMS would prefer you make any decisions not to pursue the application as early as possible. The deeper you get into the process, the more taxing it is on the agency, on actuaries, and on your resources.
NOIA Links
- New/Initial Medicare Advantage or Part D Plans, click here
- Medicare Advantage or Part D Service Area Expansions, including adding a Special Needs Plan, click here
- New/Initial Medicare-Medicaid Plans, click here
- Medicare-Medicaid Plan Service Area Expansions, click here
Resources:
Registration is now open for the Gorman Health Group 2018 Forum, April 25-26, 2018, at the Red Rock Resort ideally located near the Red Rock Canyon in Las Vegas.
Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
Stay connected to industry news and gain perspective on how to navigate the latest issues through GHG’s weekly newsletter. Subscribe >>
Three Considerations For Those Entering Medicare Advantage
Every few months the industry hears news of new players getting into the Medicare Advantage (MA) game. And why not? According to the Kaiser Family Foundation, more than 19 million Medicare beneficiaries are enrolled in MA plans this year. Either someone is building from the ground up or purchasing an existing structure, such as CVS Health Corporation’s recent agreement to acquire Aetna. I don’t expect this will be the last pharmacy benefit manager to look for an insurer partner with the promise of being able to lower healthcare costs. While analysts argue over the benefits and concerns, one thing is for certain: you need experienced administrators at the helm. I borrow from the late Mitch Hedberg who summarized just because you can do something really well in one field doesn’t make you an expert in everything:
Whether you are building from scratch or partnering with an established entity, you might be adept at one thing but not necessarily everything related to it, nor should you be. In Hedbergian spirit, I’ve outlined three pieces of advice for those entering this arena.
- If preparing for the Part C and Part D Application process, the clock is ticking. Make sure the right people are in place to implement this product. If the application submission is the wedding day, the implementation and execution are the marriage. What vendors are being considered vs. what will be built in-house?
- For those undergoing mergers, I speak from experience about its arduous process. Integration activities do not happen overnight, nor should they, but it is possible the drivers of success may get derailed during integration. Thoughtful engagement of the right people with the experience and skillset in the delivery of this product is imperative to make sure successful practices are not lost.
- Focus on what needs to be done in order to be successful, but first, make sure everyone agrees on the definition of success. Is it fiscal success for long-term viability? Is it the establishment of a sustainable product set with steady membership growth? Are Star Ratings and other quality measures part of the equation? We always hear about top-down communication strategy, but for those responsible for implementation, lateral communication is essential. Ensure everyone understands the organization’s priorities, and remove silos that impede progress.
- Know your members well. What does the market look like? What are their health and cultural needs? What are the product, benefit, and premium trends in the area? If you are submitting an application, you have likely already gone through these studies as outlined recently by my colleague Diane Hollie in a recent article on expansion strategy.
You do not want to set up your organization or team to fail – no one sets out that way. Before you apply for the first time, expand, or acquire an existing plan, establish the right team, be on the same page, and understand your market. If you need assistance, please contact me directly at rpennypacker@ghgadvisors.com.
Resources:
Registration is now open for the Gorman Health Group 2018 Forum, April 25-26, 2018, at the Red Rock Resort ideally located near the Red Rock Canyon in Las Vegas.
Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
Stay connected to industry news and gain perspective on how to navigate the latest issues through GHG’s weekly newsletter. Subscribe >>
The 2019 Application - Key Dates
As a follow up to my last article on the Notice of Intent to Apply, I give you an enhanced chart of 2019 application activities outlining things you should have been doing or should be in the middle of now. Thanks to the Centers for Medicare & Medicaid Services (CMS) for creating a base, published recently via memo – my colorful additions peppered throughout for your perusal. If past activities have not been done yet, it is time to get a move on, or you risk missing the deadline.
| Calendar Year 2019 Application Activity | Date |
|---|---|
| Determine the feasibility of applying for a new plan or expanding an existing plan; identify vendor partners to contract with who will support administrative or health services, begin contracting process or review existing contracts to ensure application requirements will be met | Ongoing process |
| Review past finalized application guidance, determine licensure needs, contact pertinent state(s) to establish their needs and timeline | June 1, 2017 |
| Review the 60-day release outlining the proposed changes to the 2019 applications | August 1, 2017 |
| Tell Provider Contracting not to rest on their laurels | August 2, 2017 |
| Comments due on the 60-day release of the applications | October 2, 2017 |
| Read CMS’ Notice of Intent to Apply (NOIA) memo dated October 13, realize there are 36 calendar days between the release of the final application and submission, suppress panic | October 13, 2017 |
| Read this chart, and if anything is making you twitch, let me know | October 16. 2017 |
| Create a draft project plan, assigning specific tasks to your application project team; establish an earlier submission date; field angry emails from the team but hold firm; obtain the team’s vacation schedules now through submission date, establish back-ups | October 30, 2017 |
| Review the 30-day release of the draft 2019 applications (approximate time) | November 10, 2017 |
| NOIA deadline to ensure access to the CMS Health Plan Management System (HPMS) | November 13, 2017 |
| New applicants should download the CMS User ID connectivity form (aka CMS Access Request Form) and distribute to the application submission team and C-suite team members who will need to complete attestations. Provide specific instructions on filling out the application, or don’t, if you like a lot of re-work. Ensure back-ups. Send originals via traceable carrier to CMS. | November 15, 2017 |
| CMS sends NOIA confirmation e-mails to entities meeting the November 13 NOIA deadline to ensure timely HPMS access | November 30, 2017 |
| CMS User ID connectivity form submissions must be received by this date to ensure user access to HPMS by January 9, 2018 | December 1, 2017 |
| Try to enjoy the holidays, because that application work is coming | January 1, 2018 |
| Calendar Year 2019 Medicare Advantage (MA), Part D, and Medicare-Medicaid Plan (MMP) applications posted on CMS website | January 9, 2018 |
| Finalize project plan based on the final guidance, adding any new tasks and team members required; register for CMS user calls; re-communicate internally established submission date | January 9, 2018 |
| Final day to submit NOIA for 2019 | January 26, 2018 |
| If you believe stragglers will cause you to be working up to CMS’ deadline, order flowers for your significant other so Valentine’s Day isn’t completely ruined | February 12, 2018 |
| CY 2019 MA, Part D, and MMP applications submission deadline | February 14, 2018 |
Resources:
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Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
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CMS Notice of Intent to Apply
The Centers for Medicare & Medicaid Services (CMS) Annual Call Letter calendar marks November 13, 2017, as the first due date for the Notice of Intent to Apply. It is expected the Center for Medicare will release a reminder memo this month outlining the details. In general, the agency requires a Notice of Intent to Apply to be submitted when an organization plans on submitting a request for any of the following:
- Offering a new product type (such as a Medicare Advantage Prescription Drug plan or Prescription Drug Plan)
- Transitioning an existing non- or partial network Private Fee-for-Service (PFFS) to a full network PFFS
- Expanding the service area of an existing contract
- Expanding only an employer-only service area
- Adding prescription drug benefits to an existing contract for the first time
- Adding Employer Group Waiver Plan (EGWP) market to an existing individual-only service area for the first time
- Adding individual market to an existing EGWP-only service area for the first time
- Adding or expanding the service area of a Special Needs Plan
- Expanding the service area of an existing Medicare-Medicaid Plan
While organizations will have another opportunity once the final application guidance is released in January, for the most part, those who have properly planned are generally certain by November if they intend to pursue this initiative. Feasibility discussions have occurred to help leadership make that “go/no-go” decision. “Along with feasibility discussions, network analysis to determine adequacy and potential gaps is a critical component to consider as you decide on submitting your Notice of Intent to Apply,” states a colleague on the Operational Performance team. “Those steps will help set up the plan to move forward with their application filing.”
Turning to the application, interested parties have certainly already gone through the draft Part C and Part D applications with a fine-tooth comb to determine what’s new for the coming submission and what isn’t needed. If you haven’t reviewed the documents by now, what’s changed may surprise you.
The Notice of Intent to Apply is due in about a month. If you’ve conducted a feasibility study but are still unsure of what to do, don’t be alarmed. (Well, ok, be a little alarmed, but take a step in the right direction and contact us.) Then, once you have made the decision to pursue an application, ask us for assistance. Gorman Health Group has a proven track record of successful application assistance and support. Going in with a clear understanding of the process and expectations helps you put your organization’s best foot forward in the pursuit of this new endeavor.
Resources:
Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
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10 CMS Program Audit Risks
Program audits and oversight activities must be designed with many factors to balance: accuracy, consistency, efficiency, and in an effort to be least disruptive to a plan sponsor. Correspondingly, a plan should be tailoring its response to these audits with those same factors in mind. A colleague and I outline ten common risk areas we observe in plans large and small.
- Comprehensive Part D Benefit Administration Testing: Plans accept the standard Pharmacy Benefit Manager (PBM) testing scenarios and do not endeavor to do full benefit testing on the Part D formulary prior to the beginning of the plan year. This puts the plan at risk for transition issues and inappropriate rejected claims during the critical data universe window the Centers for Medicare & Medicaid Services (CMS) uses.
- Coverage Determinations and Redeterminations: Plans continue to experience issues with decision and notification timeliness as well as notice content that is unclear to the member and provider.
- Organization Determinations: Plans fail to do appropriate provider outreach and experience decision and notification timeliness issues.
- Claims Determinations: Claims are not fully developed, out-of-area emergency and plan-directed care denials continue to appear in universes, and appeals language is missing from notices.
- Delegated Function Audits: Plans do not complete annual delegation oversight audits (a CMS recommendation) for both the PBM and Part C delegates.
- Misclassification of Grievances/Appeals/Inquiries: Plans continue to struggle with multiple entry points of information into the plan, which increases the risk for misclassification and thus timeliness of outreach and decision notification.
- Special Needs Plan Model of Care (MOC): Oftentimes, it is found plans have misinterpreted the MOC requirements, leading to the realization a MOC was incorrectly written, regardless of high scoring from the National Committee for Quality Assurance.
- Failure to Connect the Compliance Dots: Plan staff struggle to articulate their roles and responsibilities when it comes to program oversight, whether it pertains to internal or delegated operations. With only six tracer samples to evaluate, each sample matters a great deal in the evaluation of the three Compliance Program audit areas.
- Data Integrity in Universe Preparation: Incomplete or inaccurate universes continue to plague Operations and Compliance teams, an indication of readiness and a possible indicator on the state of delegation oversight.
- Commitment: Plans operate in full-on reactive mode, which may be palpable to CMS. They agency has noted in the past they can tell within five minutes whether or not a plan has a culture of compliance. Demonstrated organizational commitment changes the “have to do it” mindset to a “we are glad to do it” attitude.
If any of the 10 items listed resonate with you, contact us. Do you already have a dedicated audit team, comprised of the specialists in your plan, who can speak to your operations and samples? Practice with and exposure to the CMS program audit process gives you and your colleagues a leg up on expectations. Secondly, are the program audit areas on your auditing and monitoring plan for this year? These are areas of particular concern for Medicare Parts C and D. We are more than halfway through 2017 – are you on track to meet your audit plan goals? Contact us for information on how Gorman Health Group can help with your 2017 internal audit activities and your CMS audit preparedness.
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Addressing Key Questions on the 2018 Medicare Marketing Guidelines
We had a fantastic turnout for our webinar last week on the 2018 Medicare Marketing Guidelines (MMG). Something I’ll reiterate is that the MMG are for everyone. Nilsa Rudisill and I had plenty of spirited discussions when working to narrow down the content to fit in a single hour. We know your time is valuable, and we appreciate everyone’s attendance.
Some great questions were received that Nilsa and I thought would be beneficial to share in case others in the industry are contemplating similar themes. Some of our clients even shared their responses from the Centers for Medicare & Medicaid Services (CMS). While we cannot share those specific responses, it does confirm to us there are ambiguities in certain sections, and the agency is responding in a timely manner. Therefore, if you are in doubt, reach out!
- Let’s address the sample Summary of Benefits (SB), a key document for beneficiaries. By no means is the sample a “model” document in the same vein as CMS releases model Evidence of Coverage documents. Most readers already have their SBs under development, which is great.
- A few questions came in pertinent to the submission of events to CMS in the Health Plan Management System (HPMS). When does the change take place? The guidance applies to 2018 activities. Unless CMS says otherwise, continue to submit events pertinent to the 2017 plan year.
- Does the change in HPMS submission of events signal a change in surveillance activities? From the outside looking in, the answer is yes. CMS used the information submitted by sponsors to select events for surveillance. A change in the agency’s direct monitoring activities should not change your own internal monitoring and auditing, unless, that is, you already know you need to step it up.
- How should Scopes of Appointment (SOAs) now be tracked? Nothing much has changed. The documentation may be in writing in the form of a signed agreement by the beneficiary or a recorded oral agreement. Any technology (e.g., conference calls, fax machines, designated recording line, pre-paid envelopes, and email) can be used to document the SOA. Remember, you must document the scope of the appointment prior to the appointment. Be prepared to demonstrate this in your documentation.
As we’ve stated before, you’ve got to wonder if each revised chapter CMS issues is a collection of lessons learned from the previous period of time. Regardless, the agency seems to be streamlining and refining guidance not only to ease burden on sponsors but to also provide necessary clarification as needed. What changes are impacting your organization and to what extent? Contact us on ways we can help your operations be successful in implementing the MMG.
Resources:
Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
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2018 Medicare Marketing Guidelines
It was a hot summer night when the Centers for Medicare & Medicaid Services (CMS) released the final version of the calendar year 2018 Medicare Marketing Guidelines (MMG), and a few hot summer days have passed while the industry digests the changes. Don’t make the mistake and only share the MMG with sales and marketing; those handling enrollment, customer service, mailings, printing, Star Ratings and quality, compliance and oversight, legal affairs, provider relations, and finance (including delegates handling these functions) all have a stake in this chapter.
My colleague Nilsa Lennig Rudisill and I will be hosting a free webinar to address some of the key changes in the guidelines on August 15. Register for the webinar here. In the meantime, highlights include the following:
- Some no-brainer language was added in Section 30.4, Anti-Discrimination. Plans/Part D Sponsors must comply with their obligations under other anti-discrimination rules and requirements, including Section 1557 of the Patient Protection and Affordable Care Act. This may sound simple, but unless you are a legal professional, you may be unsure of which rules and requirements apply to your organization. Partner with your legal team to ensure you not only have policies and procedures addressing your organization’s commitment to these rules, but make sure everyone is walking the talk, especially in member-facing operations. You may be discriminating and might not even know it.
- For those living in the material world, CMS has finalized Appendices 4 and 5 for Summary of Benefits Instructions and Disclaimers, respectively. This should be a welcome change for sponsors who have used the MMG and other CMS memos in the past as a reference and have created their own tools for use.
- CMS provides additional guidance regarding the mailing of materials to enrollees at the same address. The organization needs to either have reasonable assurance the individuals are related or have otherwise received consent from the recipients in case they are not related. We recognize CMS provided flexibility here, but we implore organizations not to take any shortcuts in documenting their criteria for “reasonable assurance.”
- Speaking of materials, CMS has provided sponsors the flexibility to either send enrollees a hard copy of the full or abridged formulary at the time of enrollment and annually, or send a hard copy notice describing where enrollees can find the online formulary and how to request the formulary in hard copy. Sponsors should note, however, the 2018 Evidence of Coverage template states the formulary is either attached or mailed separately, indicating a slight disconnect. This was not addressed in the July 27 corrections memo either, so perhaps more is to come.
- Sponsors no longer need to upload educational or formal or informal marketing and sales events into the Health Plan Management System. CMS still requires the sponsor to keep accurate records of events as they may request the information at any time, so we anticipate sponsors will still require reporting of events from agents and brokers. None of the secret shopping tools have been updated in the Surveillance Module for quite some time, and some sponsors have experienced a drop in surveillance activities conducted by the agency. This change could indicate a shift in focus for the agency and their resources.
- For those who were eagerly awaiting the final language pertaining to agent compensation, see my colleague's blog for the detail on that topic.
- CMS is now allowing sponsors to market via electronic communications, including email. “Although in the past, email has not typically garnered a large return of leads, it will be interesting for marketers to test this channel again to understand its effectiveness in the marketplace today,” notes Diane Hollie, Senior Director of Sales, Marketing & Strategy. Remember to review the disclaimers in Appendix 5 since there are disclaimers particular to email.
- There remains no mention of the 48-hour time frame for Scopes of Appointment (SOAs), only that the sponsor must document the SOA prior to the appointment. Given that this provides significant flexibility for agents, it stands to reason SOAs may be obtained minutes before an appointment takes place. CMS requires the SOA documentation to include the date of appointment, but if the SOA date and appointment date are the same, this leaves an organization open to scrutiny as to whether the SOA was obtained after the appointment. Capturing the time on SOA methods not currently capturing the time would fill this gap.
- In case you may have missed it, CMS released a sample Summary of Benefits document. Organizations are not required to use this document as long as they follow the requirements outlined in the MMG.
You’ve got to wonder if each revised chapter CMS issues is a collection of lessons learned from the previous period of time. Regardless, the agency seems to be streamlining and refining guidance not only to ease burden on sponsors but to also provide necessary clarification as needed. More to come during our webinar scheduled for August 15. If there are any questions you’d like us to review ahead of time, send them to us here. What changes are impacting your organization and to what extent? Contact us on ways we can help your operations be successful in implementing the MMG.
Resources:
Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
Stay connected to industry news and gain perspective on how to navigate the latest issues through GHG’s weekly newsletter. Subscribe >>
Digital Marketing in the Medicare Advantage World
“Internet shopping rates have surpassed the rates of all other shopping activities.” As marketers, we have heard for years now that omnichannel is the way to go and that baby boomers are online. But we still see a lack of focus on digital in many Medicare Advantage marketing strategies. Deft Research’s “2016 Age-in Study” shows for the first time that internet shopping is the highest utilized channel for researching products (the shopping part) among age-ins in 2016. Clearly, digital can no longer be considered an additional channel—it is the channel. And the best thing about digital marketing, it is data-driven. In nearly real time, you have the opportunity to understand what is working and what isn’t.
So, now that you are underway with pre-Annual Election Period (AEP) marketing and implementing your sales and marketing strategies, how does your digital marketing stack up? Consider the following…
- Be the local authority on Medicare Advantage: Not only ensure that you are the result in local website searches on Medicare Advantage but that your Medicare Advantage website includes educational information. Think easy-to-read visuals and 10-minute educational videos intended to provide common answers to Medicare Advantage questions and explain Medicare Advantage to those aging in. Consider making these videos searchable on video sharing sites like YouTube, then post your videos on social media sites like Facebook, Instagram, and Twitter. You want beneficiaries in your service area to go to you with their questions, not your competition.
- Internet shopping tool is a must! Internet shopping is the most widely used shopping channel by the Medicare Advantage age-in population. As more baby boomers age in to Medicare, this trend is expected to continue. If you don’t have an online shopping tool, make this a priority now. The shopping tool should support a potential member in clearly comparing plan options all the way through to completing an enrollment form.
- Current member email and cell phone communication programs (MA or other lines of business)Traditionally, email and cell phone communication programs have been rare in the Medicare Advantage world, but for the younger population, this method of communication is expected. It is what they are used to pre-Medicare Advantage. As we see more tech-savvy and internet-savvy beneficiaries, there is a huge opportunity to stay connected with your members, drive Star Ratings, and keep your members happy and healthy. You may want to consider care management text messages, reminding members of upcoming doctor appointments, seasonal at-home care tips (e.g., allergy season, flu season, etc.), and targeted medical tips and information for members with certain clinical conditions. And finally, when developing your mobile strategy, Gorman Health Group recommends considering a mobile application that allows members to access their personal, password-protected member portal. We recommend enhancing your member portal to include not only newsletters, member education videos (see #2) and plan information but also premium payment abilities, claims status checks, and doctor appointment tracking.
Interested in giving your marketing strategy a digital boost? We are here to help! Contact GHG today to see how we can partner with your Marketing team to develop a robust digital marketing strategy.
Resources:
Want to stay up to date on policy and regulation changes? The Insider is GHG’s exclusive intelligence briefing, providing in-depth analysis and expert summaries of the most critical legislative and political activities impacting and shaping your organization. Read our full press release >>
Stay connected to industry news and gain perspective on how to navigate the latest issues through GHG’s weekly newsletter. Subscribe >>