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Payers May Be Neglecting a Growing Medicare Advantage Market

Healthcare payers may be able to capture Medicare Advantage market share by improving their consumer outreach and education efforts.

Healthcare payers can tap into a growing Medicare Advantage market by improving outreach and education

Source: Thinkstock

By Thomas Beaton

- Payers may be able to secure more of the growing Medicare Advantage (MA) marketplace by expanding their member messaging efforts and improving consumer education about what the supplementary plan has to offer, according to a new J.D. Power survey.

The poll indicated that the growing geriatric population in the US (65 and over) is projected to increase from 14 percent to 21 percent in the next two decades, which presents payers a significant opportunity to provide Medicare Advantage plans to newly eligible beneficiaries.

Currently, a just third of all Medicare beneficiaries are Medicare Advantage users.  

“Medicare Advantage plans represent a significant growth opportunity, but many health plans are not maximizing that potential,” said Valerie Monet, Senior Director of the Insurance Practice at J.D. Power.

Only 11 percent of members 60 or older indicated that they received any communications from their health plan regarding a potential switch from current coverage to an MA plan, the poll revealed.

Among those who have received premarketing contact from their health plan, overall satisfaction scores were higher than among those who received no marketing contact.

And just 54 percent of MA plan members say they “completely” understand how their plan works. When it comes to the cost for prescription drugs under MA coverage, fewer people understand how this works compared than last year, the survey found.

If payers want to excel in the MA market, then they must improve education and improve MA key performance indicators (KPIs) of customer satisfaction. These KPIs include coverage and benefits, customer service, claims processing, cost, provider choice, and information and communication.

Ensuring members see their doctor as a trusted partner in their medical care was the most important satisfaction driver for Medicare Advantage beneficiaries. Also extremely important to beneficiaries was the ability to gain assistance with finding available healthcare providers and managing associated costs.

Yet most MA members said their plan isn’t able to effectively help them with coordinating their care.  Just 34 percent of members said their plans aided them with ensuring that they have access to necessary providers and understand their path of care across the continuum.

Kaiser Permanente ranked the highest in MA member satisfaction for a third consecutive year, the survey said. Kaiser outperformed all other plans across five of the six consumer satisfaction KPIs. Highmark ranked second and Humana ranked third.

Payers that address consumer satisfaction indicators in MA plans have a head start in succeeding in an MA market, J.D. Power said.

“Our data shows that the ability to deliver consistently strong customer satisfaction in the Medicare Advantage market is becoming a key differentiator for the leaders in this space and that satisfaction is achieved through a series of highly choreographed best practices,” Monet said. 


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