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.

One of the biggest surprises from the Annual Enrollment Period (AEP) last fall was the widespread problems that local and regional Medicare Advantage (MA) plans experienced when seniors responded to television commercials featuring celebrities who promoted rich health benefits for MA plans. Individual plans thought they were the only ones with the problem–that is until the community got together at recent RISE conferences, including the Medicare Marketing & Sales Summit in February and the AEP Medicare Readiness Summit in June.

RISE MAE community members learned that other MA plans had also experienced issues after the television spots ran and seniors called a 1-800 number for more information. The result? Thousands of seniors unknowingly switched plans, only finding out weeks later when their new identification cards arrived in the mail.

Controversial Joe Namath Medicare television commercials

Here’s an example of one of the commercials featuring Joe Namath that ran during the AEP.  

The advertisement for the “Medicare Coverage Helpline” tells viewers that they are entitled to eliminate premiums and copays and get dental care, dentures, eyeglasses, in-home health services prescriptions, unlimited transportation, and home delivered meals at no additional cost. It also touts a give-back benefit for those who live in certain ZIP codes that adds money back to their monthly Social Security check.

Viewers often think they are calling the federal agency for information. But in tiny print, the commercial states that they aren’t affiliated with a government agency or program and that callers will be directed to a licensed insurance agent or to a third-party partner of TogetherHealth PAP, which owns the registered trademark “Medicare Coverage Helpline.” The advertisement has been flagged as misleading by the watchdog website, which is run by a nonprofit organization based in Madison, Conn. that is dedicated to helping consumers protect themselves against false advertising and deceptive marketing.

MAE advisers noted that the commercial violates Centers for Medicare & Medicaid Services’ (CMS) marketing guidelines on how MA products may be marketed, including specific “can say/can’t say” words in the regulations. CMS can only regulate MA plans using these regulations. The agency has no jurisdiction over the electronic marketing organization (EMO) putting out the advertisements because they are not contracted with CMS. However, the agency can sanction MA plans for using these leads if they buy them from the EMO.

The commercial pushes benefit descriptions and promotion of benefits that are only found in counties where there is intense MA competition and has forced plans to offer rich benefits. But the commercials also aired in geographic markets where these types of benefits are not available. It appears that this led competing lead generation companies to step up activities and aggressively promote their lead sales to e-brokers who were not always vetting vendors for how they obtained the leads.

As a result, the ads drove rapid disenrollments at some MA plans with members not understanding the implications of plan switching or what they might be giving up. One RISE member said his plan identified close to 550 members who switched to a national carrier unknowingly.

RISE workgroup to review compliance issues

In response, the MAE advisory board has created a workgroup under the leadership of MAE Community Chair Kevin Mowll, to address Medicare marketing compliance for the RISE association and our community of member health plans. Workgroup members include representatives from DMW, Experience Health, Guided Medicare Solutions, and HealthCompare. 

The workgroup is taking steps to:

  • Advise RISE on best practices around health plan contracting and vetting processes with their distribution channel partners
  • Create a compliance pledge for vendors in the marketing and sales space
  • Outreach to CMS around changes and revisions to marketing guidelines and standards for compliance

Second workgroup to focus on KPIs on marketing and sales

In addition, Mowll is overseeing another workgroup to create surveys on KPIs around marketing and sales. The workgroup, which includes representatives from DMW and Engagys, is working on metrics plans to launch a survey to community member MA plans every year so RISE can provide benchmarks for the community, against which members can gauge their own performance. As we currently do with the annual member engagement survey conducted by Engagys on behalf of RISE, we will publish the results and present our findings at our annual conferences, including the Medicare Marketing & Sales Summit

 Medicare Marketing and Sales Summit

Look for updates and announcements here regarding the launch of these surveys. Mowll said the workgroup aims to get one representative from each MA plan to complete the surveys (one for marketing and another for sales) so the participation creates useful and valuable benchmark insights. In response to the survey findings, as we determine where the community needs a boost, Mowll said RISE can design and develop programs (conference topics, seminars, webinars, articles, etc.) to help with performance improvement.