Three Reasons Why Pre-AEP Marketing Is Critical
One of the reasons healthcare marketing is so interesting is that it’s never static for long. Once you think you have it figured out, something changes in the mix. Pre-Annual Election Period (AEP) marketing is one of those phenomena that changes the mix in AEP marketing. If a pre-AEP marketing strategy is not in your marketing plan this year, here are three reasons why you may want to reconsider:
- In working with plans across the country, many are finding the pre-AEP mailing to be the most cost-effective mailing in the AEP mix and also generates the most leads. Typically, these are inexpensive mailings or postcards that arrive in the mailbox the latter part of September – right before AEP.
- Since the Centers for Medicare & Medicaid Services (CMS) states plans/Part D sponsors cannot market for an upcoming plan year prior to October 1, you must develop advertising that is very generic in your messaging, can be informational and educational, and utilizes direct response-oriented language with a very strong call to action to generate a response. This strategy seems to be paying off.
- When a plan is new to the market or introducing a new product to the market, multi-channel, pre-AEP marketing has been found to be very productive. Advertising the brand and/or hinting of something new helps build recognition, chatter, and leads before the full barrage of marketing begins in October, especially for new plans. Although this type of marketing may not have a strong return on investment by itself, it can be measured in the overall AEP marketing analytics.
Whatever your situation, we have seen pre-AEP marketing take many different approaches – with a few that appear to have crossed the line – so make sure you “stay within the lines” of CMS’ regulations with your pre-AEP marketing. We would be happy to assist you with developing a pre-AEP strategy to help you meet your goals.
Resources:
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2016 Annual Election Period (AEP) Medicare Advantage (MA) Enrollment Growth Slows Compared to 2015
The number and share of Medicare beneficiaries enrolling in MA plans continue to increase, but the pace of growth is beginning to decline. Currently, there are nearly 18 million Medicare beneficiaries enrolled in MA health plans across the country. This includes all individual and group plan enrollment.
Approximately 32% of Medicare beneficiaries are now in MA plans, but we are starting to see the MA penetration begin to flatten out (Figure 1).
Figure 1 — Total Medicare Private Health Plan Enrollment, 2012-Feb 2016
The following chart shows the dramatic growth of Medicare beneficiaries enrolled in MA plans as of February 2016 (Figure 2), but the percentage growth of enrollment is declining. Since 2012, MA enrollment has grown 32% to nearly 18 million.
Figure 2 Total Medicare Private Health Plan Enrollment, 2012-Feb 2016
Note: Includes Medicare Medical Savings Account (MSA) plans, Cost plans, demonstration plans, and Special Needs Plans (SNPs), as well as other MA plans (individual and group).
Gorman Health Group (GHG) analyzed the 2016 AEP and saw the following when analyzing national and state-level enrollment trends:
- MA enrollment has continued to grow and increase in virtually all states in the 2016 AEP.
- MA enrollment is highly concentrated among large organizations.
- Most enrollees continue to be in Health Maintenance Organizations (HMOs). (Enrollees in HMOs typically pay lower premiums and have lower limits on out-of-pocket expenses.)
But we also saw a real decrease in the MA percentage of growth from the 2015 AEP to the 2016 AEP. The following tables show the total enrollment from December to February of each year.*
2015 AEP VS. 2016 AEP
While the 2015 AEP saw an overall growth of nearly 650,000 beneficiaries enrolled in MA health plans, the 2016 AEP saw an overall growth of 445,245 beneficiaries enrolled in MA health plans — this is nearly a 31% decrease in enrollment from 2015 AEP to 2016 AEP. This is attributable to the lack of growth in the Medicare-Medicaid Plan (MMP) product, which had an almost 160,000 increase in growth last AEP but only increased approximately 15,000 in the 2016 AEP. In addition there were losses in enrollment in the HMO-SNP enrollment as well as in Preferred Provider Organization (PPO) plans. The enrollment in HMOs continues to see growth, although the growth was not enough to compensate for the other losses or decreased gains from last year.
*AEP is measured by looking at February MA enrollment since the total AEP enrollment is not captured in January enrollment numbers.
For more information on enrollment trends or other Sales, Marketing, and Strategy consulting services through GHG, email ghg@ghgadvisors.com or contact me directly at dhollie@ghgadvisors.com.
Also, read about "MA Plans' Must-Fix: The Member Experience" in a blog by John Gorman.
Resources
For actionable advice and best practices, join us at our annual Gorman Health Group 2016 Forum, April 19-20, at the Worthington Renaissance Fort Worth Hotel in Fort Worth, Texas. During this year's information-packed two days, our elite team of experts, operators, clients, and partners will help you figure out what matters and what doesn't. We will share proven tactics to cut costs, increase member satisfaction, and manage and drive sustainable growth. The hotel room block expires on March 28 so register now to reserve your seat!
The Medicare Advantage marketplace is evolving — are you prepared? Gorman Health Group's marketing experts have developed strategic plans for hundreds of Medicare Advantage Plans, Prescription Drug Plans, Special Needs Plans and Exchange participants. We will work with you to understand your market, mining demographic data for opportunity and finding the gaps in the competitive field into which your plan can fit. Visit our website to learn more >>
Stay connected to industry news and gain perspective on how to navigate the latest issues through GHG's weekly newsletter. Subscribe >>
How to Maintain the Accuracy & Consistency of Data through an Entire Life Cycle
It doesn't matter whether you call it the Annual Election Period (AEP), Open Enrollment Period or Fall Open Enrollment; it's that busy time of the year when beneficiaries are on the move. Now that the dust has settled, it's time to take a thorough look at your member data. Your members are your revenue. Accurate member data and continuous maintenance will yield the maximum, most accurate level of revenue to your organization.
While Plans strive to have correct data in their systems right from the start, it doesn't always work out that way. The result is inconsistencies in data and the need for an "AEP Reconciliation". That's the process of identifying a discrepancy, correcting it and not only making it right, but keeping it right. Reconciliation is about maintaining and assuring the accuracy and consistency of data from the start and over its entire life cycle.
Member data is the heart of an organization and the driver for many processes. It's critically important that this data is correct in all of your organization's systems. All systems need to be in sync, CMS to Plan, Plan system to Plan system, Plan system to PBM — it's a continuous circle of checks and balances.
Accurate data not only helps create that important first contact experience with your member but keeps you connected to your member. Correct member data reinforces your organizations credibility and promotes a feeling of value to your member.
Data Reconciliation Tips
- Member Demographic Information — Maintain and update any changes to names, DOB, addresses (permanent, billing, personal representatives, POA's), telephone numbers, email addresses.
- Enrollment Spans— Verify that the Plan/PBP/LIS is correct in all spans within the enrollment — not just the current span.
- Payment Method — Validate that the correct payment method is set up (SSA, Direct, RRB, EFT, etc.)
- Special Status — Update special status or status flags in the appropriate systems to ensure proper claims payment and plan payment. (i.e. ESRD, Hospice, MSP, Medicaid, Institutional etc.)
- Optional Supplemental Benefits — If your enrollee elects supplemental benefits, verify the Part C premium change was submitted to CMS.
- CMS Reports — Work monthly CMS reports promptly and completely. (List of CMS reports is available in PCUG v8.3, Table K-1 All Transmissions Overview)
- Plan Discrepancy Reports — Compare data within your own plan systems and with your PBM. Create discrepancy reports and work them daily or weekly.
Don't forget about Medicare Secondary Payer (MSP) Reconciliation!
Now is the best time to tackle all that MSP information you've received. Many plans get overwhelmed with MSP data, especially at this time of the year, and find it difficult to perform the time consuming outreach and research that's necessary to obtain validation results.
This simple process carries a powerful financial punch — efforts here can yield big results! GHG can assist with MSP Reconciliation. We have experienced analysts that can research, perform outreach and reconcile your MSP data.
Start the year off right - with clean, accurate data.
GHG's Consultants and Reconciliation Analysts have the expertise, knowledge and experience for all your reconciliation projects.
Resources
To hear more information on reconciliation, including detailed evaluations of the MMR & MOR reports, come hear GHG's expert, Jennifer Young explain the Fundamental of Membership Accounting & Reconciliation, January 26-27th at the Medicare Advantage Membership Accounting & Reconciliation Conference, Sanibel Harbour Marriott Resort & Spa, Ft. Myers, FL.
Let GHG check the box in each and every operational area of your organization. Our team of veteran experts can assist in AEP preparation, transmitting of timely and accurate membership information, recommending staff levels and utilization, and maintaining and improving all enrollment processes. Visit our website to learn more >>
Registration for the Gorman Health Group 2015 Forum is now open. Join us April 7-9, 2015 at the Gaylord National Resort and Convention Center in National Harbor. Register today >>
Selling Season is Nearly Here, Now what?
Most plans are in the process of onboarding their agents and preparing them to sell. Meanwhile, they've invested marketing dollars across various channels and different media. Now it's time to turn marketing dollars into members. With another AEP just around the corner, here are a few GHG best practice tips to keep in mind this season to help get the most bang for your buck out of those incoming leads.
- Cut down on lead distribution times as much as possible. This is one area that cannot be stressed enough; beneficiaries are not waiting for follow ups, if leads are not quickly & efficiently being converted into appointments another carrier could potentially get that all-important first meeting on the schedule faster. The industry is much too competitive, and the cost per lead is far too expensive to let any leads sit in today's marketplace. Statistics show that close ratios improve the faster the lead can be converted to an appointment and the quicker that meeting can be conducted by the agent. In an industry where the little details can matter, if this process is managed effectively there are additional members to be had.
- Once agent in-home appointments are in full swing, make sure to collect and document a disposition from the agent for EVERY meeting. A lot of good information can be collected about why a potential beneficiary chose to enroll or not enroll in a particular plan. That information doesn't only apply to the sales team. Share it with the benefit design team too, it will provide a real world perspective on why beneficiaries join, or more importantly, why they don't. Most plans are good at tracking dispositions for their employed sales force, but lack integrated systems to capture this for some independents. Consider adopting a mobile technology to capture the rest of the picture from the independent agents.
- Make every possible enrollment avenue available for potential beneficiaries. This means having a telesales unit, deploying a nimble sales force in the field, and finally in today's world, utilizing (hopefully creating one if not) the online enrollment process. The aging in Baby Boomer population requires us to provide a diverse number of channels for prospects to enroll. Missing one avenue could be detrimental to your sales numbers!
- Learn from your successes….and your mistakes! Improvement in years to come is only possible if there is an understanding of the effectiveness of current marketing campaigns, where enrollments are coming from, what return on investment various channels have yielded, and many more variables in play. Track…measure…assess….adjust…repeat!
As always, stay tuned to the GHG Blog and to the Point for more selling season tips later this month.