Insights & Articles

Medicare Market

Regulatory update: MA penetration rate reaches all-time high; CMS’ Verma weighs in on the future of value-based care

RISE reviews the latest headlines that have an impact on Medicare and Medicare Advantage.

Revenue & Quality

2021 nominations now open for RISE quality award

RISE is now accepting nominations for its annual Martin L. Block Award that recognizes excellence and clinical leaders’ passion to improve patient care. For 2021, RISE has broadened the criteria beyond risk adjustment and Stars to ensure the spirit of excellence and innovation lives on.

Revenue & Quality

Regulatory roundup: CMS OKs Nebraska Medicaid expansion program; MA plans offer more supplemental benefits in 2021

RISE reviews the latest headlines that impact Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act marketplace.

Medicare Market

Video interview: Kevin Mowll reflects on his tenure at RISE and the future of the association

In this video interview recorded prior to his retirement as executive director of the RISE Association, Kevin Mowll, discusses his work with RISE over the past seven years and what the future holds for the association and its related communities.

Medicare Market

Back to Vegas baby! RISE’s Medicare Marketing & Sales Summit set to return to the ‘entertainment capital of the world’ in 2021

RISE will once again take over Las Vegas in February 2021 for the can’t-miss Medicare Marketing & Sales event of the year.

Medicare Market

Coming soon: RISE and Engagys to launch annual survey on state of consumer health engagement

Each year, Engagys and RISE partner to conduct the annual State of Consumer Health Engagement Survey. The survey is an examination of health care consumer engagement practices to further understand the rate at which health plans across the country are achieving engagement success and where they are investing in the future for better engagement and experience. Started in 2016, this survey now has four complete years of trend data.

Revenue & Quality

Regulatory roundup: CMS expands list of telehealth services for Medicare FFS; Health care policy implications under a newly configured Supreme Court;

RISE looks at recent headlines in the news that impact the health care industry.

Revenue & Quality

Have you checked out the RISE Talent Hub?

Learn more about one of the exciting benefits of joining the RISE Association.

Revenue & Quality

CMS releases 2021 Star ratings for MA, Part D Prescription Drug Plans

The Centers for Medicare & Medicaid Services (CMS) released the quality ratings so that beneficiaries can compare plans before Medicare Open Enrollment begins on Oct. 15.

Revenue & Quality

RISE’s Special Needs Plan Leadership Summit to explore integration requirements for D-SNPs

William Dede, MPP, health policy associate, Special Needs Plan Alliance, will lead a session on CY21 integration requirements for FIDE-, HIDE-, and D-SNPs during RISE’s upcoming live-streamed virtual event on Oct. 27-28.

RISE National

RISE National 2021 to feature new tracks on digital health care delivery, member experience, and compliance/regulatory updates

Mark your calendars! We are excited to return to Nashville, Tenn. in March for RISE National 2021. Get a first look at the new tracks we’ve already planned for you.

Revenue & Quality

CMS: Medicare Advantage premiums plunge as enrollment soars

The average 2021 premium for Medicare Advantage (MA) plans will be the lowest in 14 years, according to the Centers for Medicare & Medicaid Services (CMS).

Revenue & Quality

Regulatory roundup: Trump signs exec order on preexisting conditions; OIG officials weighs in on MA investigations; and more

RISE summarizes the latest headlines that impact Medicare, Medicare Advantage, and Medicaid.

Population Health & SDoH

Geriatric house calls can increase access to care in a COVID world

The innovative model of care saves money, improves patient satisfaction, and may boost Medicare Advantage plan enrollment.

Population Health & SDoH

Spotlight on RISE’s upcoming Special Needs Plan Leadership Summit

Learn best practices to improve outcomes for hard to reach and at-risk populations during a live-streamed virtual event on Oct. 27-28.

Medicare Market

RISE virtual seminar series to focus on member experience

The virtual seminar, Driving Change in Member Experience to Impact Your Bottom Line, will take place Sept. 29-30. The two-day interactive event is part of RISE’s ongoing response to COVID-19.

RISE West

RISE Association Executive Director Kevin Mowll to retire in mid-October

RISE Managing Director Ellen Wofford made the following announcement during RISE West on Friday:

RISE West

Video interview: Jefferson Health’s Dr. Stephen Klasko on the pandemic of the future and what the health care delivery landscape will look like

In this 10-minute video with RISE, Stephen Klasko, M.D., MBA, president and chief executive officer, Thomas Jefferson University and Jefferson Health, provides a glimpse into what a global pandemic would look like in 2030 based on what we’ve learned during the COVID-19 public health emergency of 2020.

Medicare Market

5 takeaways about member communications from the second RISE/Engagys COVID-19 response survey

RISE has once again teamed up with Engagys to find out how communications tactics have changed throughout the COVID-19 pandemic. Here are five findings from our most recent survey. Learn more when we discuss the complete results during a one-hour webinar at 1:30 p.m. EST, Wednesday, Sept. 16. The webinar is free to RISE Association members.

RISE West

RISE West 2020 to shine a spotlight on member engagement during new preconference workshop

COVID-19 has made member engagement more important than ever before. In this article, RISE talks to three of the facilitators of RISE West’s upcoming preconference workshop that tackles the need for Medicare Advantage (MA) plans to double down on member engagement in the second half of 2020.

RISE West

The long-term effects of COVID-19 on health care: Part 2 of a video interview with John McDonough of the Harvard T.H. Chan School of Public Health

Part 2 of our interview with John E. McDonough, DrPH, MPA, professor of public health practice, Harvard T.H. Chan School of Public Health, who will be a featured speaker at RISE’s upcoming virtual event, RISE West 2020, Sept. 9-11.

RISE West

The 2020 election’s impact on health care: Part 1 of a video interview with John McDonough of the Harvard T.H. Chan School of Public Health

John E. McDonough, DrPH, MPA, professor of public health practice, Harvard T.H. Chan School of Public Health, will be a featured speaker at RISE’s upcoming virtual event, RISE West 2020, Sept. 9-11.

Medicare Market

Medicare Product Design Master Class: Virtual summit will address new CMS guidelines, COVID-19, supplemental benefits, and the inclusion of ESRD members

The live-streamed virtual event, designed for those involved in Medicare Advantage product design, sales and marketing, and finance and revenue management, will take place Sept. 21-22.

RISE West

RISE West 2020 goes virtual: Sneak a peek at this year’s agenda and speakers

The live-streamed virtual event will take place Sept. 9-11 and features presentations from leading experts in risk adjustment, quality performance, documentation, HCC coding practices, member engagement, payer-provider collaboration, and social determinants of health. Take a look at the sessions we’ve planned.

Medicare Market

Medicare member acquisition: Tips to develop a dual enrollment approach amid the pandemic

The global pandemic has drastically limited in-person interactions and triggered the need for Medicare Advantage health plans to embrace a virtual world to connect with existing and prospective members. Here’s how one Florida health plan has maintained member connection, acquisition, and retention during this unsettling time.

Medicare Market

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.

Medicare Market

The impact of COVID-19 on Age-In campaigns

Deft Research’s new Age-in Study takes a deep dive into how the global pandemic recession has affected consumers as they move from commercial group or Affordable Care Act coverage into Medicare.

Medicare Market

Embracing the new member experience

Many variables can impact the member/patient experience—but some are more controllable than others.

Revenue & Quality

Regulatory Roundup: CDC no longer to collect COVID-19 data; CMS releases stats on telehealth use during outbreak

RISE reviews the latest headlines that have an impact on Medicare and Medicaid.

Revenue & Quality

5 findings on the state of Medicare Advantage in 2020: Trends in enrollment growth, health care quality, and consumer attitudes

The report, released by the Better Medicare Alliance (BMA), a research and advocacy organization that supports Medicare Advantage (MA), looks at beneficiary demographics, consumer satisfaction, health outcomes, and projections for the future.

Medicare Market

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.

Medicare Market

Empower your agents and brokers with virtual tools

Whether agents and brokers need to present Medicare Advantage (MA) insurance options to beneficiaries over the phone or online, health plans must now accommodate telephonic or telehealth videoconference presentations.

Population Health & SDoH

Telehealth study: Technology disparities correlate with health disparities

A new study by EmblemHealth, one of the largest nonprofit health insurers in the United States, reveals ownership of electronic devices, access to internet services, and overall lack of technology impinge on access to telehealth.

Medicare Market

Study: MA plans miss the mark when it comes to member communication

The analysis measures member satisfaction with Medicare Advantage (MA) plans based on coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. The result: Information and communication is a weakness for member satisfaction, which drives a general lack of engagement among consumers and increases the likelihood of health plan members switching plans.

Medicare Market

AEP planning: 4 tactics to align compliance, sales, and marketing

Learn about the strategies BlueCross BlueShield NC uses to build positive relationships, goal alignment, and a problem-solving approach among the three departments.

Medicare Market

How one health plan developed a rapid response for member communications during COVID-19

Here’s how Indiana University (IU) Health Plans elevated customer service and member communications when COVID-19 hit.

Medicare Market

3 strategies for AEP planning in a COVID world

Industry-leading experts in the AEP and Medicare Advantage space joined RISE for this week’s virtual AEP Medicare Readiness Summit 2020 to share best practices, strategies, and tips to navigate member needs amid a global pandemic. Here’s an inside-look at one Medicare sales manager’s recommended steps for annual election period (AEP) planning in such an uncertain time.

Medicare Market

Poll: Seniors give two thumbs up to telehealth, Medicare Advantage amid COVID-19 pandemic

The poll, conducted by Morning Consult and sponsored by the Better Medicare Alliance, surveyed 1,020 seniors in mid-May on Medicare Advantage. Here are the key findings.

Medicare Market

Age-in outreach strategies: A video interview with Inter Valley Health Plan’s Larry Baca

Larry Baca, vice president, sales & marketing, for Inter Valley Health Plan will be a featured speaker at RISE’s upcoming virtual event, AEP Medicare Readiness Summit 2020, June 2-3.

Medicare Market

OIG report: CMS must take more action to address opioid misuse among Medicare Part D beneficiaries

Thousands of Medicare beneficiaries are at extreme risk for opioid use disorder. A federal report urges the Centers for Medicare & Medicaid Services (CMS) to do more to ensure they receive treatment.

Medicare Market

RISE/Engagys webinar to examine member communication strategies during COVID-19

Join Kevin Mowll, executive director, RISE Association, and Kathleen Ellmore, managing director, Engagys, for a deep dive into the results of a RISE-Engagys survey that uncovers how health plans are communicating with members during the COVID-19 pandemic. The webinar, COVID-19 Communications Response Survey: Addressing Near and Long-Term Member Communication Strategies, will take place at 1:30 p.m. EST, Tuesday, May 5.

Medicare Market

3 takeaways from the first meeting of the MA&E Sales User Group

User group members discussed the impact of COVID-19 on Medicare sales strategies, the annual election period (AEP), and broker loyalty.

Medicare Market

Medicare Advantage in 2020: KFF looks at the latest trends in enrollment, premiums, and out-of-pocket limits

Here are five findings from the latest Kaiser Family Foundation (KFF) report.

Medicare Market

MA&E Marketing User Group brainstorms on COVID-19, age-ins, and marketing strategies for the AEP during a national election

RISE’s Medicare Member Acquisition Experience Community held its first user group meeting in March. Kathleen Ellmore, managing director of Engagys, and Renee Mezzanotte, EVP of client engagement at DMW, served as co-chairs. Here are highlights from the discussion.

Medicare Market

DMW execs offer key takeaways from RISE’s 2020 Medicare Marketing & Sales Summit

DMW staff offer their impressions from RISE’s 13th annual Medicare Marketing & Sales Summit in February.

Medicare Market

Expansion of telehealth services in response to coronavirus

The ability to offer telehealth services not only addresses a critical need at this time, it also signals to your members that you are their partner in health care and will provide support through a strenuous time.

Medicare Market

COVID-19: New-to-Medicare outreach to newly unemployed or uninsured

As the COVID-19 crisis unfolds, Medicare marketers across the country find themselves in a unique position to aid a group of individuals who they serve and who need their immediate help.

Medicare Market

RISE survey: How are you handling member communications during COVID-19?

Please take this short survey developed by RISE and Engagys that looks at member communication strategies in response to COVID-19.

Medicare Market

Hoping that insurance expansion will help tamp outbreak, 9 states reopen marketplaces

The states are allowing new enrollments this month to help ease consumers’ concerns about the cost of health care so that the sick will not be deterred from seeking medical attention and inadvertently spread the virus.

Medicare Market

Social determinants in the news: Social distancing may put those most vulnerable at risk; rural communities more likely to skip preventive care; and more (1)

RISE looks at recent headlines concerning social determinants of health (SDoH), including the impact social distancing has on those already most vulnerable.

Medicare Market

6 things Medicare Advantage health plans must do in response to the coronavirus

The coronavirus is spreading so quickly throughout the United States and the rest of the world that the response to the outbreak seems to change by the hour. Make sure your organization is in the best position to keep operations running smoothly and ensure that your members—who are among those at higher risk of becoming seriously ill from the virus—know they can rely on you for helpful, accurate, and the most up-to-date information.

Medicare Market

Deft Research report: Social determinants drive ‘convenience use’ of emergency rooms – but not for the reasons you may think (1)

A new blog post from Deft Research looks at the link between non-medical circumstances and the use of the emergency room for non-emergency and routine medical care.

Medicare Market

RISE Association launches new community, member portal for Medicare Advantage health plan professionals

The new Medicare Member Acquisition & Experience Community will help local and regional Medicare Advantage health plans grow and retain their membership base.

Medicare Market

5 lessons learned from the 2020 AEP

Unable to attend RISE’s January webinar that examined the 2020 Annual Enrollment Period (AEP) and emerging trends in the Medicare Advantage (MA) marketplace? We have you covered. Here’s a summary of what we learned.

Medicare Market

2020 Medicare shopping and switching: Deft Research brief examines the growth of $0 PPOs

Deft Research recently surveyed more than 3,200 seniors to better understand their shopping and switching behavior during the annual election period (AEP). An executive research brief about the survey focuses on one of the findings: how the growth of $0 Preferred Provider Organizations (PPO) have permanently changed the Medicare landscape.

Medicare Market

6 trends that will impact the Medicare market in 2020

What does the future hold for the Medicare market in the upcoming year? We asked Tim Brousseau, vice president client services, Deft Research, a member of the RISE Medicare Market Advisory Board, and Rachel Silva, vice president, strategy and Innovation for DMW, for their thoughts on emerging trends that will impact health plans in 2020.

Medicare Market

How your Medicare marketing can win in the 2020 elections

Here is a six-point checklist for 2020 election planning throughout the year.

Medicare Market

RISE webinar to explore factors that influenced the AEP for 2020

Members of RISE’s Medicare Member Acquisition & Experience Advisory Board will join Kevin Mowll, executive director of the RISE Association, during a January 30th webinar to discuss trends in the Medicare Advantage (MA) marketplace that emerged from the 2020 Annual Enrollment Period. In this article, RISE talks to Mowll about some of the factors that have changed the MA landscape in recent years.

Medicare Market

4 challenges that MA plans face when implementing new supplemental benefits

A new study from the Duke Margolis Center for Health Policy looks at early trends on Medicare Advantage (MA) offerings of supplemental benefits for patient populations with serious illnesses. Among the findings: Only a small number of plans have added new benefits in the first two years that the Centers for Medicare & Medicaid Services (CMS) has provided MA plans the flexibility to offer members new benefits outside of traditional medical services. The report looks at the barriers to implementation and strategies to promote greater adoption.

Medicare Market

A first look at the speakers and hot topics lined up for the 13th annual Medicare Marketing & Sales Summit

Find out what’s in store when marketing, sales, and product development professionals from local and regional Medicare Advantage health plans gather at The Venetian in Las Vegas for the annual Medicare Marketing & Sales Summit on Feb. 25-26, 2020.

Medicare Market

Website errors raise calls for Medicare to be flexible with seniors’ enrollment

Members of Congress and others complain Medicare’s revamped Plan Finder had problems. Federal officials say they can help consumers who got bad information change their plans next year. But details about how switching will work are yet to come.

Medicare Market

Star Ratings Master Class: Don’t forget about the impact of sales and marketing on member retention and star ratings

One of the mistakes that Medicare Advantage plans make when prioritizing efforts to improve their star ratings is focusing only on quality measures, says Malik Abdur-Razzaq, MPH, the chair of this year’s RISE’s Star Ratings Master Class in December.

Medicare Market

Study: More Medicare Advantage plans will offer adult day care services, in-home support as supplemental benefits for 2020

A new independent study finds that Medicare Advantage plans are incorporating new benefits in 2020 to care for the whole person and address social determinants of health.

Medicare Market

Coming soon to your inbox: The 2019 RISE/Engagys survey on health care consumer engagement

RISE and Engagys, a health care consumer engagement consultancy, are set to launch their fourth annual survey on the state of health care consumer engagement and need your input. Results will be revealed at 10th annual Star Ratings Master Class, December 12-13 in Carlsbad, Calif.

Medicare Market

7 lessons learned from the 2019 Medicare OEP

The return of the Medicare Open Enrollment Period (OEP) was fraught with uncertainty. No one knew how many Medicare Advantage (MA) members would use this year’s January 1-March 31 time period to switch plans or insurers, but now health plans can use the results of what happened to determine what to do during next year’s OEP as well as the traditional annual enrollment period (AEP). Here is what we’ve learned.

Medicare Market

New plan flexibility for Medicare Advantage brings opportunities for supplemental benefits and Part D drug coverage in 2020

The Centers of Medicare & Medicaid Services (CMS) recently issued its final Medicare Advantage (MA) and Part D plan payment policies and Final Call Letter for the 2020 plan year. This final notice continues the Trump administration’s efforts to introduce significant program changes with new plan option initiatives for the Medicare program.

Medicare Market

Award-winning author Meridith Elliott Powell named keynote speaker at RISE AEP Medicare Sales Readiness Summit

Powell, voted one of the Top 15 Business Growth Experts to watch by Currency Fair, will share strategies that attendees can use to turn uncertainty into a competitive advantage.

Medicare Market

Deft Research announces update of list scoring algorithms

Deft Research has announced the update of its 2019 Medicare Consumer List Scoring algorithms timed to coincide with marketing planning for Medicare’s fall Annual Election Period (AEP) and the rest of the year.

Medicare Market

Report: Medicare Advantage likely to reach 70 percent penetration within 20 years

Medicare Advantage (MA) enrollment has nearly doubled over the past decade, and it is showing no signs of slowing down. Indeed, a new report from L.E.K. Consulting finds that MA penetration will continue to rise as high as 70 percent between 2030 and 2040.

Medicare Market

3 proven strategies to prevent disenrollment

The average Medicare Advantage (MA) plan turns over about 10 percent of its members in voluntary disenrollment every year. For a plan with 100K members, this equates to approximately $110M in lost premium reimbursements.

Medicare Market

Attracting age-ins: A persistent issue

Most health plans are not satisfied with the proportion of their former commercial members who convert into Medicare members. This under-performance is called the age-in conversion problem. And it challenges Medicare plans trying to enroll their own individual and employer-sponsored health plan customers.

Medicare Market

Preheat marketing: The easy way to generate measurable results during Medicare’s AEP

Sixty-eight days. As Medicare marketers, we all know the timeframe challenge that comes with every Annual Election Period (AEP). And we all play by the same rules imposed by the Centers for Medicare & Medicaid Services (CMS). So, how can you gain a competitive edge given all the marketing restrictions? Simple: preheat the market.

Medicare Market

3 takeaways from Deft Research’s 2019 Age-In Study

Deft Research’s latest national market research report examines the age-in conversions of current commercial members, the factors that drive enrollment with consumers after the age of 65, and the key times that seniors shop for Medicare coverage. Here are three findings from the executive summary of the 2019 Age-In Study, which surveyed 2,400 seniors who are eligible for Medicare.

Medicare Market

HealthMine survey: Only 32% of Medicare Advantage members are familiar with star ratings

Only 32 percent of the 800 Medicare Advantage (MA) plan members with chronic conditions are familiar with the Centers for Medicare & Medicaid Services’ (CMS) star ratings systems, according to a HealthMine survey. Of those, nearly half said they used the grading system to help them choose a plan for 2019 enrollment.

Medicare Market

Medicare Marketing & Sales Summit: 3 health plan leaders offer insight into the Medicare Advantage market

LAS VEGAS — One of most anticipated sessions at RISE’s 12th Annual Medicare Marketing & Sales Summit in February was a town hall discussion about the Medicare Advantage (MA) market. The panel was moderated by Hank Osowski, managing partner, Strategic Health Group, LLC, and included executives from Blue Cross Blue Shield of North Carolina (Blue Cross NC), Scan Health Plan in California, and MediGold in Ohio, who discussed the inclusion of supplemental benefits into health plan offerings in 2019, how those offerings might change in 2020, and how they are able to stand out in an increasingly competitive market. Here is what we learned.

Medicare Market

A look back at the 2019 Medicare OEP: What happened and why

RISE will examine what happened during the 2019 Medicare Open Enrollment Period (OEP) and what actions health plans should take to prepare for next year’s OEP during a webinar on June 11 at 1:30 p.m. EST. The webinar will feature speakers from Deft Research, a Blue Cross plan, a field marketing organization, and an agency. In this article we talk to one of the webinar speakers, Renée Mezzanotte, EVP/client engagement, DMW, about the OEP and the current state of Medicare.

Medicare Market

4 mistakes that can destroy your digital marketing campaigns and how to avoid them

LAS VEGAS—One session at RISE’s Medicare Marketing & Sales Summit made us rethink our digital marketing campaign strategies. Justin Stauffer, vice president of integrated marketing at DMW, an agency that specializes in marketing for the health insurance industry, spelled out the six most common mistakes that organizations make and how to fix them. In this article, we examine four of the biggest blunders, and what marketing, sales, and product development professionals can do to avoid them in the future.

Medicare Market

Half of middle-income seniors won’t be able to afford housing and health care by 2029, new study finds

A new study in Health Affairs paints a bleak picture for the future of middle-income seniors. Fifty-two percent of U.S. seniors who will be 75-years-old and older in the next 10 years will be unlikely to qualify for Medicaid long-term care but won’t have the financial means to cover the costs for assisting living rent and out-of-pocked medical costs. Researchers refer to this growing population as “the forgotten middle.”

Medicare Market

Health insurance agency fined $50K for misleading elderly about their Medicare coverage

A California-based health insurance agency was fined $50,000 and ordered to cease and desist from mailing misleading marketing materials to elderly residents in Minnesota.

Medicare Market

Highmark-UPMC legal dispute likely reason Medicare Advantage members switched insurers during extended open enrollment period

Nearly 2,000 Highmark Medicare Advantage (MA) members in western Pennsylvania switched insurers during this year’s extended open enrollment period. Most members signed up with big-name national carriers to ensure they would have in-network access to University of Pittsburgh Medical Center (UPMC) hospitals and physicians.

Medicare Market

Medicare Trustees Report: Part A funds will deplete in 7 years

The Medicare Board of Trustees has been sounding the alarm about the future of the Hospital Insurance Trust Fund for years. Its latest report warns that the trust fund, which supports Medicare Part A, won’t be able to pay full benefits after 2026. It also projected that overall Medicare costs will continue to grow at a faster pace than the economy and put a strain on the federal budget unless lawmakers act now. Officials from the Trump administration have jumped on the findings, using the latest figures to push back against some Democratic lawmakers’ calls for a Medicare-for-All program.

Medicare Market

3 stages to successfully launch a whole new Medicare brand—or a new plan from an established brand

The number of provider-sponsored health insurance plans entering the market is growing exponentially. Why? Because it can be profitable for both health systems and physician groups. But this endeavor is vastly more difficult than launching a new plan from an established brand. There are essential elements for planning, designing, launching, and sustaining a totally new Medicare plan and brand. Plans new to the market need even more of an edge to compete against the incumbents. Therefore, it is imperative to follow these three mission-critical stages of a plan launch.

Medicare Market

Rewards and incentives: Best practices to help improve star ratings

The introduction of a Five-Star Quality Rating System from the Centers for Medicare & Medicaid Services (CMS) for Medicare Advantage (MA) Plans has resulted in opportunities for high-performing organizations to reap significant financial compensation and the ability to offer supplemental benefits while underperforming organizations risk fines, notices to their current members, potential removal of contract, and other punitive actions.

Medicare Market

4 insights into individual and family plan shopping and switching during the 2019 OEP

A new study that looks at how 4,700 consumers under the age of 65 bought insurance in 2019 provides insights into what prompted them to shop plans. The research, conducted and published by Deft Research, may help marketing, sales, and product development professionals better compete for members in 2020. Here are four findings from the market research firm’s Individual and Family Plan Shopping and Switching Study.

Medicare Market

Medicare Advantage plans can offer additional telehealth benefits in 2020 (1)

Medicare Advantage (MA) plans have another new benefit to offer their members in 2020: telehealth services. The Centers for Medicare & Medicaid Services (CMS) recently announced it has finalized changes that would allow MA beneficiaries to access health care services from places like their homes, rather than require them to go to a health care facility for treatment.

Medicare Market

A year of collaboration

Expect collaboration to reshape the Medicare Advantage landscape in 2019-20. Strategic alliances, partnerships, and affiliations are becoming a key component of successful MA programs as they coalesce around three key areas: Product, Care Delivery, & Distribution.

Medicare Market

Improve the member experience through value-based enrollment

When it comes to health insurance sales, the process doesn’t end once members sign their enrollment applications. Onboarding and care transition are key to member satisfaction and retention. When members have a positive experience with their new plan from the very beginning, it sets the stage for a successful, long-lasting relationship. In other words, the enrollment and onboarding process is an interaction, not just a transaction.

Medicare Market

National survey reveals greater risk of seniors switching Medicare Advantage plans in 2019

New research shows seniors want more health and well-being support from Medicare plans

Medicare Market

Converting commercial members to Medicare members: Barriers and opportunities

Health insurers that have a low conversion of commercial to Medicare members may have an awareness issue. Challenges on increasing awareness include siloism among commercial and Medicare departments within health insurer corporations. Opportunities include creating strategies to encourage collaboration and incentives to provide the motivation for these groups to work together and provide the right Medicare plan to their commercial members.

Medicare Market

Agent fraud alert: Beware of potential genetic test scams

Warning: Many insurance carriers have recently issued alerts about a genetic testing program enticing agents with a generous commission for each client who provides a swab for the cancer screening. The agents are told that the program is legal because the test has been approved by the Centers for Medicare & Medicaid Services (CMS). Jameson Keller, vice president of strategic development for AgencyRM, says the program is a potential scam to get agents to “pay to play and to gain beneficiary Medicare information.”

Medicare Market

Medicare marketing & sales: 6 trends in 2019 Medicare shopping and switching

LAS VEGAS—Senior citizens typically don’t want to shop for insurance products. But this year 1 out of 3 seniors either switched health plans or felt compelled to at least look at other options, according to George Dippel, senior vice president of client services, Deft Research, LLC. And about half of those who switched plans did so even though they were happy with the coverage they had in 2018.

Medicare Market

Medicare Marketing & Sales Summit: 7 business gems from marketing guru John Moore

Las Vegas—John Moore, the keynote speaker at RISE’s 12th Annual Medicare Marketing & Sales Summit, offered attendees a jolt of “espresso shots of business wisdom” that he has gleaned over his long career as a marketing strategist, including his role that turned Starbucks into a global icon.

Medicare Market

Countdown to the Medicare Marketing & Sales Summit: Everything you need to know to make the most of your two days of learning and networking in Las Vegas

RISE’s 12th Annual Medicare Marketing & Sales Summit is less than two weeks away. If you’ve already registered for the #1 ranked conference in the industry, we’ve compiled the highlights, so you can make the most out of sessions and networking opportunities. And for those who haven’t yet registered for this premiere event for senior executives in Medicare Advantage, prescription drug plans, and health plan startups, it’s not too late—there are a few delegate spots left. Read on to learn what’s in store when we gather at the Paris Las Vegas Hotel & Casino on Feb. 25-26.

Medicare Market

Boost AEP Campaigns with Targeted Lists

For many health insurance Marketers, a key problem is managing and improving the return on investment of their campaigns. A typical metric used is overall ROI: sales divided by marketing & sales dollars spent. Another metric capturing management’s attention is “cost-per-conversion” or marketing & sales dollars spent divided by number of sales.

Medicare Market

Health care consumer engagement: 7 insights from the 2018 RISE/Engagys Survey

One of the many highlights at this year’s RISE Star Ratings Master Class was the results of the 2018 RISE/Engagys Survey on Healthcare Consumer Engagement. The survey, now in its third year, included 140 participants who represent the top health plans, provider systems, and pharmacy benefit managers. More than 70 percent of the respondents work in risk adjustment and almost half of them said they also work on Stars and HEDIS. In addition, more participants were from regional health plans, an increase of 26 percent compared to last year. This greater representation of regional plans may indicate their increased interest in consumer engagement, according to Kathleen Ellmore, managing director of Engagys. Here are seven takeaways from the survey results.

Medicare Market

2019 Medicare OEP Update

Editor’s Note: The original version of this story, 2019 Medicare OEP: You Never Get a Second Chance to Make a First Impression, was published by RISE in July 2018, Open Enrollment Period (OEP) regulations have since changed and Wunderman has updated the article to reflect current requirements.

Medicare Market

CMS’ relaxed Medicare marketing guidelines give insurers more wiggle room but also serve as a reminder of past unethical practices

RISE previously reviewed the biggest changes contained in updated Medicare Communication and Marketing Guidelines, which include a new definition of marketing, the addition of the term communication, and guidance for the pre-enrollment checklist. The Centers for Medicare & Medicaid Services relaxed its previously stringent requirements and made what many consider to be long, overdue changes, just in time for the 2019 open enrollment period. RISE Executive Director Kevin Mowll looks back at the complex history of the guidelines, questionable health plan sales practices, and why now is the right time for CMS to have released the updated guidelines.

Medicare Market

The impact of Trump administration’s actions on the ACA: Silver plan premiums higher than they have to be

The good news: 2019 premiums in the Affordable Care Act (ACA) marketplace are flat or falling in many parts of the country. The bad news: A Kaiser Family Foundation (KFF) analysis finds that the premiums would be substantially lower still if the Trump administration didn’t make a series of changes to private insurance markets.

Medicare Market

6 things you need to know about the 2019 Medicare Open Enrollment Period

Medicare Open Enrollment is right around the corner. It’s formally known as the Annual Election Period, or AEP. However, in layman’s terms, the AEP is commonly known as the Open Enrollment Period. As noted below, the Centers for Medicare & Medicaid Services has expanded the OEP, which happens during the first quarter of 2019. In this article, RISE looks at what’s new for the upcoming year to make sure health plans are prepared to hold on to their existing members and attract new ones.

Medicare Market

The biggest changes in CMS’ updated Medicare Communications and Marketing Guidelines

The Centers for Medicare & Medicaid Services (CMS) discussed its updated communications and marketing guidelines during its annual Medicare Advantage and Prescription Drug Plan fall conference on Sept. 6. In this article, we look at the most notable changes.

Medicare Market

2nd Annual RISE Survey Results

Engagys conducted our second annual examination of healthcare consumer engagement practices to further understand the rate at which the techniques pioneered by consumer marketing firms have been adopted by healthcare organizations.

Medicare Market

2019 Medicare OEP: You Never Get a Second Chance to Make a First Impression

Starting January 1st, 2019 there will be an Open Enrollment Period (OEP) that will allow Medicare beneficiaries to make “like plan” changes until March 31st, 2019. This is not just an extension of the Annual Enrollment Period (AEP) (which is between October 15th and December 7th each year); rather the OEP should be likened to a “grace period,” where Medicare beneficiaries are allowed the opportunity to disenroll from their current plan and select a new plan with their existing carrier or competitor.

Medicare Market

Medicare Advantage Plans Cleared To Go Beyond Medical Coverage — Even Groceries

Air conditioners for people with asthma, healthy groceries, rides to medical appointments and home-delivered meals may be among the new benefits added to Medicare Advantage coverage when new federal rules take effect next year.

Medicare Market

Boomerquake

Medicare products are expected to be the fastest growing insurance sector over the next 10-years. At the same time, Boomers are transforming care delivery, from aging-at-home services to convenience-driven alternate sites of care such as retail clinics, telemedicine and wearables to anti-aging nutraceuticals.

Medicare Market

Prescription Drug Costs Play a Significant Role in Switching Medicare Health Plans

For the past 12 years, Deft Research has tracked Medicare consumer shopping and switching behavior during each fall’s annual enrollment period, or the fall AEP. The results of these national studies have many uses including predictive modeling, but most people first become familiar with them through the annual report Medicare Shopping and Switching.

Medicare Market

Evaluating The Results Of The Enrollment Seasons

The annual review and selection of health insurance for one’s self and family has become an American tradition. During these annual enrollment periods (AEP’s, but referred to under various names), employees, Medicare recipients, and those in the individual and family markets conduct their own variations of the due diligence necessary to assure they will be in the right plan in the coming year.

Medicare Market

CMS Releases 2019 Advance Notice & Call Letter for MA Plans: What You Need to Know

On February 1, the Centers for Medicare & Medicaid Services (CMS) released Part II of the 2019 Advance Notice and Call Letter (ANCL). The ANCL is an annual regulatory policy document that describes the agency’s proposed payment and coverage policies for Medicare Advantage (MA) and Part D plans for the upcoming plan year. While normally a single document, this year’s ANCL was separated into 2 parts.