September 21, 2022
A new Kaiser Family Foundation review of 62 studies published since 2016 compares Medicare Advantage (MA) and traditional Medicare on measures of beneficiary experience, affordability, utilization, and quality.
September 19, 2022
The RISE workgroup on third-party marketing organizations (TPMO) recently developed an analysis and set of recommendations for Medicare Advantage Organizations (MAOs) to consider in light of advertising tactics that mislead and confuse MA beneficiaries. We hope you’ll embrace these recommended Medicare marketing compliance steps.
September 09, 2022
RISE and Engagys, a health care consumer engagement consultancy, have once again joined forces to survey the health care industry to discover the current state of consumer engagement and learn what tactics and channels are effective, which programs are ineffective, and where there are pockets of excellence.
September 07, 2022
Beware if your plan has already printed marketing materials for the upcoming annual enrollment period. A new Centers for Medicare & Medicaid Services (CMS) memo, released on Tuesday, provides Medicare Advantage and Part D sponsors with instructions for updating Part D member materials for contract year 2023.
September 07, 2022
The studies are part of a series that examines the use of telehealth in Medicare and the characteristics of beneficiaries who used telehealth during the pandemic.
August 31, 2022
Enrolling in a higher-cost Medicare Advantage (MA) plan may not always provide seniors with better-quality health care, according to a new RAND Corporation study, which took a retrospective look at quality measures among plans in 2016 and 2017.
August 25, 2022
As Medicare Advantage (MA) continues to grow, a new Kaiser Family Foundation (KFF) analysis finds a gradual but significant reshaping of the Medicare program is taking place.
August 24, 2022
Senate Finance Committee Chair Ron Wyden, D-Ore., has launched an inquiry into potentially deceptive Medicare Advantage (MA) marketing tactics that may take advantage of seniors looking for Medicare coverage.
August 18, 2022
A new study released by J.D. Power finds that overall member satisfaction with Medicare Advantage (MA) plans is on the rise, but the plans appear to miss the mark on mental health and substance abuse disorder services.
August 16, 2022
Deft Research recently published its 2022 AEP Gut Check Study based on a survey of 2,250 seniors in Original Medicare, Medicare Supplement, or Medicare Advantage (MA). The study findings can help MA plans make decisions about how to best reach seniors prior to the 2023 Annual Enrollment Period (AEP).
August 15, 2022
In recent years, the Centers for Medicare & Medicaid Services has maintained the general structure of the model Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents, making only relatively minor changes. However, this May, CMS published the Annual Enrollment Period (AEP) 2023 model documents, and the changes are anything but minor.
August 12, 2022
The legislation, which the House is expected to pass Friday, would allow the federal government, for the first time, to negotiate the price of some drugs that Medicare buys. It also would extend the enhanced subsidies for people who buy insurance on the Affordable Care Act marketplaces.
August 08, 2022
UPDATED August 12, 2022: The landmark legislation will lower health care costs for people across the country, according to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. Here’s a look of the health care aspects included in the bill and what was left out.
August 02, 2022
Five panelists who will speak about health policy at the upcoming RISE West 2022 conference join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.
August 01, 2022
RISE summarizes recent regulatory-related news.
July 26, 2022
A KHN and PolitiFact HealthCheck: The advocacy group American Commitment said empowering Medicare to negotiate drug prices would raid it of billions of dollars. Drug pricing experts say that that’s not the case and that such policies would instead reduce costs for the Medicare program and seniors.
July 20, 2022
Here’s a look at what we’ve planned for the Medicare Product Design Master Class and the RISE Part D Master Class. Both live, in-person events will take place August 25-26 at the Omni Nashville Hotel.
July 20, 2022
The 2022 report from the Better Medicare Alliance (BMA), a research and advocacy organization that supports Medicare Advantage, gathers the latest data to provide a picture of the Medicare Advantage experience today–from beneficiary demographics and enrollment trends to supplemental benefit offerings and consumer savings, to health outcomes and bipartisan support in Washington.
July 19, 2022
RISE summarizes recent regulatory-related news.
July 12, 2022
RISE summarizes recent regulatory-related news.
July 08, 2022
The Centers for Medicare & Medicaid Services (CMS) on Thursday issued the Calendar Year 2023 Physician Fee Schedule proposed rule. If finalized, the rule would make significant changes to the Medicare Shared Savings Program and expand access to behavioral health services, cancer screening, and dental care, particularly in rural and underserved areas.
July 06, 2022
RISE summarizes recent regulatory news.
July 05, 2022
Here are three ways to increase premium accuracy, close gaps in care, improve the member experience, and increase member retention.
July 05, 2022
The two-day virtual seminar will focus on strategies to improve member outreach, engagement, experience, and benefits.
June 15, 2022
RISE summarizes recent regulatory headlines.
June 06, 2022
The live-streaming virtual event will be held July 11-13 and will feature a four-part preconference workshop, 15 key sessions, and more than 20 industry leaders who will share critical insights on all components of the conditional payment process, including operational best practices and implementable solutions to improve your current workflows.
May 31, 2022
RISE rounds up the latest regulatory headlines.
May 25, 2022
Deft Research’s 2022 Medicare OEP and Disenrollment Prevention Study surveyed more than 2,400 Medicare Advantage (MA) members to better understand what causes many of them to reexamine their coverage during the 90-day rapid disenrollment period. The study provides insight so MA plans can better tackle short-term AEP prep as well as long-term AEP/OEP retention goals.
May 10, 2022
The 7th annual event, live streamed June 7-8, will feature strategies to improve ODAG & CDAG outcomes, a review of the latest changes to Centers of Medicare & Medicaid Services (CMS) regulations, and strategies to improve member satisfaction.
May 03, 2022
Even the savviest Medicare drug plan shoppers can get a shock when they fill prescriptions: That great deal on medications is no bargain after prices go up.
May 02, 2022
The Centers for Medicare & Medicaid Services (CMS) late Friday released its final rule for the Medicare Advantage (MA) and Part D prescription drug programs. The final rule revises MA and Part D regulations related to marketing and communications and makes changes to quality ratings, medical loss ratio reporting, special requirements during disasters or public emergencies, and reduces out-of-pocket costs for prescription drugs under Part D.
April 28, 2022
The 2023 Notice of Benefits and Payment Parameters Final Rule (final 2023 Payment Notice) finalizes many of the changes announced in the proposed rule.
April 28, 2022
When it comes to health policy, former Utah Republican Sen. Orrin Hatch, who died April 23 at age 88, leaves a complex legacy of major legislative achievements, changing positions, compromises, and fierce opposition. In many ways, though, Hatch’s evolution and leadership on health policy during his four decades in the U.S. Senate mirror that of the Republican Party.
April 25, 2022
The proposed rule aims to expand Medicare coverage and establishes five special enrollment periods.
April 20, 2022
A 2021 survey of more than 3,500 seniors by the consulting firm McKinsey & Company found that most were dissatisfied with their onboarding experience. But health plans can use the gaps in their onboarding experience to differentiate themselves among ever increasing competition in the market.
April 19, 2022
A new analysis conducted by ATI Advisory for Better Medicare Alliance finds that Medicare Advantage (MA) beneficiaries report a 35 percent lower rate of cost burden compared to fee-for-service (FFS) Medicare.
April 19, 2022
Survey results show that Medicare Advantage Organizations recognize the critical need to improve communications with members and are finding new ways to create and manage the required Medicare marketing materials.
April 14, 2022
Xavier Becerra, secretary of the Department of Health and Human Services (HHS), extended the COVID-19 public health emergency (PHE) another 90 days. The extension will allow most of the emergency waivers to remain in place through July.
April 11, 2022
Supercharge your plan’s sales and marketing communications and retention strategies for AEP 2023 at RISE’s live-streaming event June 13-14.
April 04, 2022
The Centers for Medicare & Medicaid Services (CMS) has expanded access to free over-the-counter COVID-19 testing for people with Medicare Part B, including those enrolled in a Medicare Advantage (MA) plan.
April 01, 2022
RISE summarizes the latest regulatory headlines.
March 30, 2022
To stay competitive in tomorrow’s Medicare Advantage (MA) marketplace, plans need finely tuned strategies for each of these four MA opportunities.
March 24, 2022
During an hour-long press conference late last week, Department of Health and Human Services (HHS) Secretary Xavier Becerra discussed a wide range of topics, including risk adjustment in Medicare Advantage, COVID, and telehealth.
March 23, 2022
RISE summarizes the latest regulatory headlines.
March 22, 2022
RaeAnn Grossman, EVP, Cotiviti, who co-chaired RISE National 2022 with Kevin Healy, CEO, Allymar Health Solutions, reflects on her experience at this year’s conference, which returned to Nashville as a live, in-person event for the first time since March 2019.
March 17, 2022
The data brief provides insight into the use of telehealth in both Medicare fee-for-service and Medicare Advantage (MA) during the first year of the COVID-19 pandemic from March 2020 through February 2021.
March 16, 2022
Better Medicare Alliance (BMA), a research and advocacy organization that supports Medicare Advantage, says MedPAC’s recommendations don’t consider data that shows lower per-beneficiary government spending in Medicare Advantage, even as Medicare Advantage maintains lower consumer costs and better health.
March 15, 2022
Many Medicare Advantage plans send caregivers to the homes of seniors periodically to help with housework and provide companionship. But the workers may also prod seniors into activities that boost the plans’ Medicare ratings and federal reimbursements.
March 11, 2022
RISE summarizes the latest regulatory headlines.
March 02, 2022
Here are the health care highlights from Biden's address.
March 02, 2022
The actuarial consulting firm findings indicate that 5,311 of 5,312 Medicare Advantage (MA) plans (99.9 percent) will offer supplemental benefits unavailable in fee-for-service Medicare for 2022. The most common benefits include vision, hearing, fitness, and dental care.
February 25, 2022
RISE summarizes the latest regulatory headlines.
February 24, 2022
Not everything that happens in Vegas, stays in Vegas! We’re back from last week’s 2022 Medicare Marketing & Sales Summit at Caesars Palace with a summary of what we learned during key conference sessions.
February 08, 2022
Don’t miss your chance to register your team and join RISE for the Medicare Marketing & Sales Summit, February 16-18, at Caesars Palace. Here’s why this year’s event is breaking attendance records.
February 04, 2022
After it became increasingly clear that the White House’s efforts to expand access to free testing didn’t make it easy for older Americans who need the tests the most, the administration has decided to rectify it.
February 02, 2022
Deft Research’s annual national market research report examined the shopping and switching habits of more than 3,300 Medicare beneficiaries during the most recent Annual Election Period (AEP). The insights on what triggers led seniors to shop for other plans and ultimately choose a new carrier can help Medicare Advantage (MA) plans better prepare for the 2023 AEP.
February 02, 2022
RISE summarizes this week’s regulatory-related news.
January 24, 2022
The laws governing Medicare don’t provide coverage for self-administered diagnostic tests, which is precisely what the rapid antigen tests are and why they are an important tool for containing the pandemic.
January 20, 2022
Two new studies on Medicare Advantage (MA) supplemental benefits indicate that more and more plans are taking advantage of the ability to use non-medical incentives to differentiate themselves among the increasing competition. While one report looks at the number of plans across the country offering these new non-medical benefits, the other study uncovers member preferences when it comes to common supplemental benefits.
January 20, 2022
The annual AEP preparation is a complex, human intensive and costly process for MAOs. To handle these challenges, MAOs employ a wide variety of approaches and solutions for managing their plan materials.
January 18, 2022
The findings of the latest Engagys-RISE survey on consumer engagement practices highlight the focus health plans place on consumer health engagement, effective communication channels, and the ways they measure engagement effectiveness. The following column analyzes the key results and maps them to industry trends to illustrate the reasons behind the newer results.
January 18, 2022
Insurers that offer Medicare Part D prescription drug program plans (PDP), beware. Member use of a prescription drug discount card is associated with lower intent to stay with their plan,
January 13, 2022
The Supreme Court on Thursday blocked a key Biden administration COVID-19 initiative—putting a stop, for now, to a rule requiring businesses with more than 100 workers to either mandate that employees be vaccinated against COVID or wear masks and undergo weekly testing.
January 13, 2022
RISE summarizes this week’s regulatory news from the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), and Office of Inspector General (OIG).
January 07, 2022
The proposed rule would revise Medicare Advantage (MA) and Medicare Part D regulations related to marketing and communications, Star ratings, the criteria used to review applications for new or expanded plans, provider network adequacy requirements, medical loss ratio reporting, special requirements during disasters or public emergencies, and the use of pharmacy price concessions to reduce the out-of-pocket costs for prescription drugs under Part D.
January 04, 2022
Here are our predictions for the health care industry in 2022 based on interviews with industry experts in 2021, presentations at RISE conferences, and observations from our editorial team.
December 30, 2021
Whether you want to learn more about health policy, COVID, health care costs, or the latest news, we’ve gathered our picks for health care podcasts to add to your listening library in 2022. And a shameless plug – of course RISE Radio is on the list!
December 20, 2021
Our editorial team has had the pleasure of conducting dozens of interviews during 2021. We enjoyed them all and learned so much. Here’s a look back at a few of our favorite conversations.
December 20, 2021
As we head into 2022, here’s a look back at our most viewed articles of 2021. Trending topics included fraud lawsuits, Star ratings, and federal investigations into overpayments.
December 20, 2021
Member engagement was a priority for health plans this year, but consumers proved hard to reach, according to the Sixth Annual Survey of Healthcare Consumer Engagement Practices, which is conducted each year as a joint effort between RISE and Engagys. The annual survey tracks the consumer engagement tactics, budgets, challenges, and priorities of the nation’s leading health plans.
December 17, 2021
RISE summarizes the latest headlines that impact Medicare, Medicaid, and Medicare Advantage (MA).
December 10, 2021
In West Virginia, older residents often go without dental care, and a quarter of people 65 and older have no natural teeth, the highest rate of any state in the country. But a powerful senator from West Virginia, Joe Manchin, has rebuffed efforts to add a dental benefit to Medicare.
December 09, 2021
In a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, the Better Medicare Alliance proposed strategies to better serve Medicare Advantage (MA) members. The letter was sent as CMS prepares its Calendar Year 2023 MA rate and policy-setting process.
December 06, 2021
A new report from the U.S. Department of Health and Human Services (HHS) found that massive increases in the use of telehealth helped maintain some health care access during the COVID-19 pandemic, with specialists like behavioral health providers seeing the highest telehealth utilization compared to other providers.
November 23, 2021
The 6th Annual CMS Bid Bootcamp will return as a live, in-person event, January 13-14, 2022 at the Luminary Hotel & Co. in Fort Myers, Fla. From a pre-conference workshop on bid essentials to strategies that support and improve Star ratings, here’s everything we’ve planned to help you create, update, and execute your own CMS bid roadmap to set your organization up for plan growth year after year.
November 19, 2021
A new brief commissioned by Better Medicare Alliance (BMA), and prepared by the actuarial consulting firm Milliman, finds 2022 offers more availability of home-based palliative care, in-home support services, caregiver support, and therapeutic massage.
November 19, 2021
The House of Representatives on Friday voted 220-213 in favor of President Joe Biden’s Build Back Better Bill. Although it’s significantly scaled back from the originally proposed $3.5T package, it’s unclear whether it will pass the Senate, where it needs 51 votes.
November 10, 2021
Medicare officials say complaints are rising from seniors lured into private plans with misleading information or enrolled without their consent.
November 09, 2021
TV ads and mailings targeting seniors tout Medicare Advantage plans this time of year, but millions choosing traditional Medicare make a costly and difficult decision about Medigap coverage, which gets much less attention.
November 08, 2021
The research shows how capitation and faster claim payment in Medicare Advantage (MA) helped maintain cash-strapped physician practices, while risk stratification methods allowed health plans to quickly reach seniors most in need.
November 04, 2021
The Centers for Medicare & Medicaid Services (CMS) has been busy. Here is a roundup of the agency’s recent news and actions.
October 29, 2021
RISE rounds up the latest regulatory headlines that impact Medicare, Medicare Advantage, and Medicaid.
October 28, 2021
As lawmakers weigh new spending provisions to cover dental, hearing and vision services for Medicare beneficiaries, a group supporting Medicare Advantage plans is airing commercials that raise concerns about the funding for those private plans.
October 27, 2021
Medicare plans’ ‘free’ dental, vision, hearing benefits come at a cost
October 22, 2021
Medicare marketers are making connected TV (CTV) an integral part of their media mix during AEP (it is easy to include as a mid-AEP boost). In addition, it’s also a great low-cost channel to leverage throughout the year. So, what is CTV? And why is it important?
October 22, 2021
A recent panel of Medicare beneficiaries revealed that every beneficiary wanted and welcomed communications from their health plan. Here's how to make communications the most effective in driving action.
October 21, 2021
RISE rounds up the latest news involving Medicare Advantage (MA) plans.
October 20, 2021
Licensed Medicare agents, or brokers, can help beneficiaries choose the right coverage, but financial incentives also can influence which plans they highlight, according to a Commonwealth Fund blog post.
October 20, 2021
A new survey released by Medicare Advantage.com prior to the Annual Election Period finds a widespread lack of knowledge among beneficiaries about Medicare enrollment and basic health insurance terms.
October 19, 2021
Digital health startup nirvanaHealth this week launched Aria Medicare, a Medicare Advantage-in-a-box solution that runs on Amazon Web Services.
October 18, 2021
The Centers for Medicare & Medicaid Services (CMS) issued a long-awaited memo outlining best practices for Medicare marketing campaigns conducted by third parties. But does it go far enough? RISE weighs in.
October 15, 2021
RISE summarizes recent regulatory headlines.
October 14, 2021
The new Kaiser Family Foundation (KFF) analysis examines how many seniors compared different health plans during the 2018 Medicare open enrollment period for coverage in 2019 (the most recent year available).
October 14, 2021
RISE will return to Caesars Palace, Las Vegas, Feb. 16 to 18, 2022 for the 15th annual Medicare Marketing & Sales Summit. Here’s what you need to know about planned preconference workshops, networking opportunities, keynote presentations, general sessions, track sessions, roundtables, and our health and safety protocols.
October 07, 2021
RISE is excited to return to in-person conferences. To ensure the health and safety of attendees, speakers, exhibitors, and staff, RISE will require proof of full COVID-19 vaccination status to attend the events. Here’s everything you need to know before you make your travel arrangements.
September 30, 2021
The Centers for Medicare & Medicaid Services (CMS) announced Wednesday that the average premium for Medicare Advantage (MA) plans will be $19 per month in 2022. The agency also projects enrollment in MA plans to spike to 29.5 million people in the upcoming year.
September 28, 2021
Daniel “Rudy” Ruettiger will share his message on how to “dream big” and the importance of building relationships at the RISE Medicare Marketing & Sales Summit, February 16-18, 2022, at Caesars Palace.
September 28, 2021
Nominations are now open for RISE’s annual Martin L. Block Award for Innovation & Excellence. RISE’s highest honor recognizes excellence and clinical leaders’ passion to improve patient care.
September 22, 2021
The Department of Justice (DOJ) said 42 doctors, nurses, and other licensed medical professionals are among the 138 defendants facing criminal charges for their alleged involvement in health care fraud schemes that resulted in nearly $1.4 billion in alleged losses.
September 22, 2021
A new Kaiser Family Foundation (KFF) analysis provides context about existing coverage and costs as Congress debates adding dental, hearing, and vision benefits to Medicare.
September 20, 2021
The plans are designed for people who don’t get dental coverage through their jobs and can’t afford an individual plan. For about $300 to $400 a year, patients receive certain preventive services at no charge and other procedures at a discount.
September 09, 2021
In a new blog post, Chiquita Brooks-LaSure, administrator, Centers for Medicare & Medicaid Services (CMS), reflects on her first 100 days in office and her vision for the future.
September 09, 2021
The Centers for Medicare & Medicaid Services (CMS) said the new action will protect patients, providers, and health care workers in Medicare and Medicaid settings.
September 01, 2021
The Office of Inspector General (OIG) said the findings may help hospitals and health officials better prepare for and address the wide-ranging and extensive needs of COVID-19 patients, particularly when local communities experience a surge in cases.
August 31, 2021
RISE summarizes the latest regulatory headlines that impact Medicare, Medicare Advantage (MA), and Medicaid.
August 25, 2021
A new study by Deft Research uncovers how Medicare members use digital health tools provided by their insurers, their providers, and other third parties to manage their health and navigate their coverage.
August 25, 2021
A new analysis from Wakely Consulting Group, funded by AHIP, finds that adding dental, hearing, and vision benefits to traditional Medicare without adjusting the benchmark for Medicare Advantage (MA) could result in fewer benefit dollars for MA plans to pay for supplemental benefits, including those that address social determinants of health.
August 11, 2021
When the program began half a century ago, backers believed the benefits would expand over time, but politics and concerns about money have stymied most efforts. Now congressional Democrats are looking to add vision, dental, and hearing care.
August 09, 2021
In an August 5 memo to all Medicare Advantage (MA) plans, the agency announced that the COVID-19 public health emergency significantly impacted the validity of measures related to physical and mental health currently used in the Star Ratings.
August 09, 2021
Learning will take place at RISE West even before the main conference begins.
August 06, 2021
How behavioral science, segmentation, and hyper-personalization helps health plans activate their members.
August 05, 2021
A new report conducted by NORC at the University of Chicago on behalf of Better Medicare Alliance’s Center for Innovation in Medicare Advantage (MA) highlights innovative approaches that MA plans are doing to address social determinants of health (SDoH) for beneficiaries. However, researchers acknowledge that barriers remain.
August 02, 2021
Medicare Advantage (MA) beneficiaries in the last year of life dropped their coverage to join traditional Medicare at more than twice the rate of all other MA beneficiaries, according to a new Government Accountability Office (GAO) report.
July 29, 2021
Many people enrolled in Medicare go without dental care, especially beneficiaries of color, according to a new Kaiser Family Foundation analysis of dental coverage and costs for people with Medicare.
July 28, 2021
RISE looks at recent headlines concerning social determinants of health (SDoH).
July 20, 2021
Sen. Ron Wyden (D-Ore.), who is helping to negotiate the health care spending framework for the Democrats' budget plan, said lawmakers may have to settle for very basic versions of programs deployed in the package. But the key, he added, is to get the "architecture of these changes, bold changes," started and show people what is possible.
July 19, 2021
RISE West 2021 will bring together senior leaders from Medicare Advantage health plans, commercial marketplace sponsors, Part D health plans, providers groups, pharmacy benefit managers, and accountable care organizations to discuss the hot topics facing the industry. We talked to four of the 50 speakers about their sessions to learn what attendees can expect at this year’s hybrid event, which will take place live in Colorado Springs and virtually via livestream August 30-September 2.
July 16, 2021
Recommendations to help Medicare Advantage Organizations to effectively address challenges of timelines, quality, and user fatigue associated with Annual Enrollment Period update cycles.
July 15, 2021
Angela G. Huskey, PharmD, CPE, senior vice president and chief clinical officer at Millennium Health, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.
July 14, 2021
The Centers for Medicare & Medicaid Services (CMS) released the proposed 2022 Physician Fee Schedule on Tuesday. In addition to proposed payment rates for Medicare next year, the agency included policy proposals to address health equity and expand patient access to comprehensive care.
July 14, 2021
RISE rounds up the latest health care headlines that impact Medicare, Medicaid, and the Affordable Care Act.
July 13, 2021
HHS Secretary Xavier Becerra says the administration is eager for Congress to make changes to Medicare that will provide more benefits and make more older adults eligible for the program.
July 09, 2021
A coalition of more than 100 organizations have expressed their support for the reintroduction of the bipartisan bill.
July 08, 2021
Learn about the innovative strategies special needs plans (SNPs) can leverage to support individuals with significant, complex social needs while advancing health equity.
July 08, 2021
The new workgroups will address issues of most concern to members of RISE’s Medicare Member Acquisition & Experience (MAE) community. Up first, the fallout from Joe Namath’s Medicare television commercials and key performance indicators (KPIs) around marketing and sales.
July 02, 2021
For the second year in a row, Deft Research has found a higher proportion of age-ins lean toward selecting a Medicare Advantage (MA) plan when they enter Medicare. Although the balance of interest between MA and MedSupp may have changed during the COVID-19 pandemic, it doesn’t appear to be reversing, according to an executive summary of the 2021 Age-In Study.
June 30, 2021
RISE rounds up the latest regulatory headlines involving emerging infectious disease emergencies; mental health, deceitful health plan marketing practices, health care cost-related problems and racial disparities, health literacy, and the American Hospital Association’s lawsuit on site-neutral payments.
June 29, 2021
A new study indicates social determinants of health (SDoH) are associated with an increase in Medicare per beneficiary spending in certain geographic variations.
June 21, 2021
The annual study, conducted by J.D. Power, measures member satisfaction with Medicare Advantage (MA) plans based on six factors: coverage and benefits; provider choice; cost; customer service; information and communication; and billing and payment.
June 21, 2021
Three Kaiser Family Foundation (KFF) analyses examine the latest data trends in Medicare Advantage (MA). Among the findings: Enrollment is way up, premiums have dropped, and more members are in plans with Star ratings of 4 or higher.
June 17, 2021
RISE summarizes recent headlines that impact the health care industry.
June 17, 2021
The Supreme Court on Thursday dismissed a challenge to kill the Affordable Care Act (ACA) and saved health care coverage for millions.
June 08, 2021
The latest data reveals 31 million Americans are enrolled in health coverage through the Health Insurance Marketplaces and Medicaid expansion under the Affordable Care Act (ACA).
June 03, 2021
The new head of the Centers for Medicare & Medicaid Services said the administration will focus on getting more people insured and is interested in finding a way to alleviate the gap keeping low-income families in states that haven’t expanded Medicaid from enrolling in Affordable Care Act health plans.
June 03, 2021
The latest episode of our new podcast series explores the positive aspects of working from home as well as the challenges of managing a remote workforce.
May 25, 2021
The Senate voted 55-44 on Tuesday to confirm President Joe Biden’s nominee to oversee the Centers for Medicare & Medicaid Services (CMS).
May 21, 2021
RISE looks at the latest news from the Department of Health and Human Services as well as studies that impact Medicare.
May 20, 2021
The annual report compiles the latest data to provide a full picture of the Medicare Advantage (MA) landscape from beneficiary demographics and enrollment trends to consumer savings and improved outcomes, as well as MA’s response to COVID-19 and the continued drive to health equity.
May 18, 2021
A little-discussed, long-term toll of the pandemic is that large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves after sheltering in place.
May 17, 2021
The event, held on June 22-23, is the only non-association yearly gathering for Special Needs Plan (SNP) professionals who are mid- to senior-level management to stay current in a highly regulated and evolving environment.
May 14, 2021
Health plans can help advance the goal of achieving health equity.
May 06, 2021
RISE examines the latest research news on Medicare, Medicare Advantage, and Medicaid.
April 29, 2021
Without certification, health insurers will no longer be able to run advertisements on Google’s platform after June 2.
April 29, 2021
RISE summarizes recent headlines that impact Medicare, Medicare Advantage, and Medicaid.
April 23, 2021
New research from the Commonwealth Fund explores the role agents play in influencing Medicare beneficiary plan choices. But without financial incentives, agents don’t’ necessarily offer information on Medicare Advantage plans not in their contracts.
April 16, 2021
Get your sales, marketing, member communications and enrollment teams ready for a successful AEP! This year’s annual conference will run June 21-22 as a live-streaming virtual event and will feature sessions that address strategies for member acquisition and retention and best practices for onboarding.
April 15, 2021
RISE summarizes the latest headlines that impact Medicare and Medicare Advantage.
April 08, 2021
RISE reviews recent headlines in the news that impact Medicare and Medicare Advantage.
April 08, 2021
Members diagnosed with depression tend to have comorbidities and often report more access issues and show less satisfaction with their health plan than other members.
April 02, 2021
This growing market segment represents a big opportunity for Medicare Advantage Organizations.
March 26, 2021
Bipartisan legislation introduced this week would expand telehealth services for seniors during the COVID-19 pandemic.
March 25, 2021
RISE rounds up the latest headlines from the White House and the Centers for Medicare & Medicaid Services (CMS).
March 22, 2021
RISE summarizes the latest regulatory news that impacts Medicare and Medicare Advantage.
March 19, 2021
Xavier Becerra was narrowly confirmed as secretary of the Department of Health and Human Services (HHS) on Thursday but health care organizations across the country applauded the move.
March 18, 2021
RISE reviews the latest headlines that have an impact on Medicare and Medicare Advantage.
March 11, 2021
RISE reviews the latest headlines that impact Medicare and Medicare Advantage.
March 08, 2021
This benefit season, more than any other, it’s critical to address medical services that target complex medical needs and non-medical services that target social factors, to stay competitive.
March 08, 2021
Join us for the third episode of RISE Radio, our new podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.
March 05, 2021
RISE summarizes the latest news involving Medicare, Medicare Advantage, and the Affordable Care Act.
February 25, 2021
If you missed this year’s virtual summit, we’ve got you covered. Here’s a recap of what we learned during each day of the jam-packed conference.
February 25, 2021
Engagys and RISE presented results, insights from fifth annual survey of health care consumer engagement practices during this week’s virtual RISE Medicare Marketing & Sales Summit.
February 25, 2021
Stakeholders across the spectrum convened for a state of the industry address during RISE’s virtual Medicare Marketing & Sales Summit this week to discuss their strategies to stand-out from the crowd, increase members’ accessibility to products and services, and ensure a friendly user experience. Here are the key takeaways from their conversation.
February 18, 2021
RISE summarizes the latest headlines that impact Medicare, Medicare Advantage, and Medicaid.
February 08, 2021
The new report notes a dramatic increase in the number of Medicare Advantage (MA) beneficiaries who have access to additional supplemental benefits to individuals with chronic illnesses in 2021. Last year a little more than one million MA members were enrolled in plans offering the chronic care benefits. That number grew to more than three million in 2021.
February 01, 2021
Deft Research surveyed more than 3,000 seniors to better understand their shopping and switching behavior during the most recent Annual Enrollment Period (AEP). RISE looks at three of the findings that indicate reasons members may shop around and switch carriers.
January 28, 2021
RISE reviews the latest headlines that impact Medicare, Medicare Advantage, and the Affordable Care Act marketplace.
January 27, 2021
The Better Medicare Alliance’s Center for Innovation in Medicare Advantage today released new research that examines the current limitations of measuring patient experience in the Medicare Advantage and Prescription Drug (MA-PD) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Based on those findings, the advocacy group proposes changes to modernize the measurement tool.
January 26, 2021
Customer experience expert Dean Lindsay will present the opening keynote at the virtual Medicare Marketing & Sales Summit 2021 on Monday, Feb. 22, the first day of the main conference. In this exclusive Q & A, Lindsay answers questions about the common mistakes marketing professionals make when it comes to member engagement and what they can do to inspire loyalty.
January 20, 2021
For the first time, RISE will offer pre-conference workshops at the Medicare Marketing & Sales Summit. Two three-hour virtual workshops will be offered the afternoon of Friday, Feb. 19, followed by a welcome reception and a keynote address by former Disney executive Louie Gravance.
January 16, 2021
The Centers for Medicare & Medicaid Services late Friday announced it released Medicare Advantage (MA) and Part D payment information due to COVID-19. The Rate Announcement includes final policies on risk adjustment for 2022.
January 15, 2021
Engagys and RISE have collaborated once again to release our 5th annual State of Healthcare Engagement Survey. Here’s a sneak peek on what the 2020 findings revealed. Engagys Managing Director Kathleen Ellmore will review the full survey findings during the RISE 2021 Medicare Marketing & Sales Summit, a live-streaming virtual event, Feb. 22-23.
January 15, 2021
2020 was truly a year for the ages. The COVID-19 pandemic caused tragic illness, lockdowns, and untold economic consequences. Simultaneously, it also spurred technology adoption like telemedicine, and life-changing realizations, such as work-from-home works. And Medicare plans were affected too—with marketing experiencing a shift to digital strategies, data insights, and more that are likely to continue into 2021, and beyond.
January 14, 2021
A former Disney executive, an award-winning business author, and a Hall of Fame motivational speaker will present keynote addresses at the 2021 Medicare Marketing & Sales Summit, a live-streamed virtual event, which includes pre-conference workshops and a member reception on Feb. 19 and the main event. Feb. 22-23.
January 08, 2021
What’s in store for the RISE Association communities in 2021? We asked experts in Medicare Advantage, quality and revenue, consumer engagement, and social determinants of health for their predictions on trends that will impact the industry in the upcoming year. Spoiler alert: COVID-19 will continue to play a big role.
December 21, 2020
The live-streaming event will be held on February 9-10, 2021 and will feature 16 sessions and more than 20 industry leaders who will discuss critical topics and developments related to mandatory reporting, legislative updates, conditional payments, and Medicare set-asides.
December 18, 2020
AEP 2020 shopping trends and lessons learned, regulatory changes that impact sales and marketing, and strategies that small and regional plans can use to compete with national plans are just a few of the sessions planned for the live-streamed virtual event in February.
December 18, 2020
RISE reviews the latest headlines that impact Medicare, Medicare Advantage, and Medicaid.
December 17, 2020
Industry leaders shared exclusive insights and best practices during RISE’s 11th Annual Star Ratings Master Class held virtually mid-December. Here are five actionable tips to ensure a positive member experience while improving quality scores.
December 17, 2020
New research offers insight into how high-need, high-cost beneficiaries in Medicare and Medicare Advantage fare on a broad range of quality measures, including pneumonia and flu vaccines to diabetic eye exams, post-acute care, and avoidable hospitalizations.
December 08, 2020
Xavier Becerra, President-elect Joe Biden’s choice to head the Department of Health and Human Services, is set to be a pandemic-era secretary with no public health experience. Whether that matters depends on whom you ask.
December 08, 2020
We were looking forward to our return to Vegas, but due to uncertainty around the COVID-19 pandemic, the RISE 2021 Medicare Marketing & Sales Summit will now become a live-streaming virtual experience.
December 04, 2020
RISE reviews the latest headlines from the Centers for Medicare & Medicaid Services (CMS).
December 04, 2020
The live-streaming virtual event offers actuaries, product managers, and CMS bid stakeholders interactive discussions, comprehensive updates, and key strategies for the CMS bid process from start to finish.
November 19, 2020
A new data brief finds that in 2021 more and more Medicare Advantage (MA) plans will offer supplemental benefits like adult day care services, home-based palliative care, in-home support services, and career support.
November 18, 2020
If you’ve been tasked with championing member experience measures at your organization, consider organizing and launching an improvement team along with a well-defined game plan for how that group will work together to manage the endeavor.
November 10, 2020
The U.S. Supreme Court will hear arguments today in a case that could overturn the Affordable Care Act. California Attorney General Xavier Becerra, who is defending the law with the backing of more than 20 other states, told California Healthline that he predicts the justices will uphold it.
November 09, 2020
The United States on Monday became the first country to surpass 10 million cases and public health experts warn numbers may continue to climb unless the Trump administration takes steps now to stop the spread of the deadly virus.
November 09, 2020
The Supreme Court on Tuesday will hear oral arguments in a case that, for the third time in eight years, could result in the justices striking down the Affordable Care Act (ACA).
November 06, 2020
The RISE team is looking forward to seeing conference attendees live and in person when the time is right. Here are the measures RISE has taken to create a healthier and safer conference experience− let us know when you’re ready.
November 04, 2020
As the votes continue to be counted in the tight battle between President Donald Trump and former Vice President Joe Biden, the federal role in health care is at stake.
November 02, 2020
The Centers for Medicare & Medicaid Services (CMS) released the second part of its 2022 Medicare Advantage advance notice three months earlier than usual to help Medicare Advantage (MA) plans prepare their bids for 2022.
October 30, 2020
COVID-19 cases are spreading across the United States with a new case added every second, according to the latest Johns Hopkins University data.
October 28, 2020
RISE reviews the latest headlines that have an impact on Medicare and Medicare Advantage.
October 21, 2020
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.
October 21, 2020
RISE reviews the latest headlines that impact Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act marketplace.
October 21, 2020
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.
October 20, 2020
RISE will once again take over Las Vegas in February 2021 for the can’t-miss Medicare Marketing & Sales event of the year.
October 20, 2020
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.
October 16, 2020
RISE looks at recent headlines in the news that impact the health care industry.
October 14, 2020
Learn more about one of the exciting benefits of joining the RISE Association.
October 08, 2020
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.
October 07, 2020
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.
October 02, 2020
RISE looks at the latest headlines that impact Medicare and Medicaid.
September 29, 2020
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.
September 25, 2020
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).
September 25, 2020
RISE summarizes the latest headlines that impact Medicare, Medicare Advantage, and Medicaid.
September 22, 2020
The innovative model of care saves money, improves patient satisfaction, and may boost Medicare Advantage plan enrollment.
September 15, 2020
Learn best practices to improve outcomes for hard to reach and at-risk populations during a live-streamed virtual event on Oct. 27-28.
September 14, 2020
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.
September 11, 2020
RISE Managing Director Ellen Wofford made the following announcement during RISE West on Friday:
September 01, 2020
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.
August 27, 2020
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.
August 26, 2020
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.
August 20, 2020
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.
August 13, 2020
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.
August 11, 2020
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.
July 29, 2020
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.
July 22, 2020
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.
July 20, 2020
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.
July 20, 2020
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.
July 17, 2020
Many variables can impact the member/patient experience—but some are more controllable than others.
July 17, 2020
RISE reviews the latest headlines that have an impact on Medicare and Medicaid.
July 16, 2020
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.
July 15, 2020
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.
July 15, 2020
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.
July 14, 2020
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.
July 08, 2020
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.
June 24, 2020
Learn about the strategies BlueCross BlueShield NC uses to build positive relationships, goal alignment, and a problem-solving approach among the three departments.
June 09, 2020
Here’s how Indiana University (IU) Health Plans elevated customer service and member communications when COVID-19 hit.
June 04, 2020
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.
May 28, 2020
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.
May 21, 2020
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.
May 13, 2020
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.
April 30, 2020
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.
April 27, 2020
User group members discussed the impact of COVID-19 on Medicare sales strategies, the annual election period (AEP), and broker loyalty.
April 23, 2020
Here are five findings from the latest Kaiser Family Foundation (KFF) report.
April 17, 2020
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.
April 16, 2020
DMW staff offer their impressions from RISE’s 13th annual Medicare Marketing & Sales Summit in February.
April 16, 2020
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.
April 07, 2020
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.
March 27, 2020
Please take this short survey developed by RISE and Engagys that looks at member communication strategies in response to COVID-19.
March 24, 2020
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.
March 18, 2020
RISE looks at recent headlines concerning social determinants of health (SDoH), including the impact social distancing has on those already most vulnerable.
March 17, 2020
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.
March 17, 2020
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.
February 25, 2020
The new Medicare Member Acquisition & Experience Community will help local and regional Medicare Advantage health plans grow and retain their membership base.
February 13, 2020
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.
February 12, 2020
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.
January 10, 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.
January 06, 2020
Here is a six-point checklist for 2020 election planning throughout the year.
January 03, 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.
December 18, 2019
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.
December 12, 2019
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.
December 06, 2019
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.
November 12, 2019
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.
November 07, 2019
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.
November 04, 2019
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.
August 06, 2019
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.
July 22, 2019
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.
July 16, 2019
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.
July 01, 2019
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.
June 20, 2019
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.
June 19, 2019
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.
June 19, 2019
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.
June 14, 2019
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.
June 12, 2019
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.
May 31, 2019
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.
May 29, 2019
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.
May 13, 2019
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.
May 01, 2019
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.
April 30, 2019
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.”
April 30, 2019
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.
April 30, 2019
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.
April 30, 2019
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.
April 26, 2019
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.
April 25, 2019
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.
April 22, 2019
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.
April 11, 2019
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.
March 22, 2019
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.
March 22, 2019
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.
March 20, 2019
New research shows seniors want more health and well-being support from Medicare plans
March 15, 2019
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.
March 11, 2019
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.”
March 08, 2019
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.
March 01, 2019
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.
February 14, 2019
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.
January 15, 2019
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.
January 15, 2019
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.
January 14, 2019
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.
December 07, 2018
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.
November 05, 2018
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.
October 12, 2018
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.
September 20, 2018
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.
July 11, 2018
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.
July 10, 2018
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.
April 20, 2018
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.
April 11, 2018
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.
April 11, 2018
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.
March 05, 2018
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.
March 01, 2018
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.