Delivering an Effective Medicare Advantage Communication Strategy

Whitepaper | Maureen Strojny
Regional Vice President, Communications Solutions, Change Healthcare

Members are Dissatisfied With Generic Communications

Communication has long been a critical challenge, and the rapid growth of Medicare Advantage enrollment has likely contributed to lower satisfaction scores. Payers may experience difficulty keeping up with new member needs and changing trends in how consumers wish to interact with their healthcare plans.

In the J.D. Power 2019 Medicare Advantage Study,SM members reported that communication from their healthcare plans is often impersonal and difficult to understand. We know, for example, that healthcare jargon can make it difficult for members to understand what’s covered under their plans, which providers they can access, and what resources are available to them. Additionally, if communications appear to be mass-generated, members may not perceive much value.

Evolving Regulatory Requirements Create Challenges For Payers

The complexities of Content Management System’s (CMS’s) communication requirements and annual changes to the Medicare Communications and Marketing Guidelines exacerbate the issue for MA carriers. Payers must adhere to what CMS allows regarding contacting beneficiaries and “marketing” to them. That can be challenging when you want to create and provide personalized, engaging communications. Fortunately, the guidelines were loosened in 2019 and further relaxed in 2020, giving plan representatives broader permission to contact potential enrollees, the opportunity to sell services after educational events, and more leeway with marketing and sales events.

The following are some of the critical updates to the MCMG for the 2020 plan year:

Permission to initiate contact

Subsection 30.6 – Electronic Communication Policy 42 CFR §§ 422.2268(b), 423.2268(b)

A Plan/Part D sponsor may initiate contact via email to prospective enrollees and to retain enrollment for current enrollees.

Broadened permission to contact

Subsection 40.2 – Marketing Through Unsolicited Contacts 42 CFR §§ 422.2268(b)(13), 423.2268(b)(13)

Plans/Part D Sponsors can make unsolicited direct contact with potential enrollees using the following methods: conventional mail and other print media (e.g., advertisements, direct mail, etc.) and email, provided that all emails contain an opt-out function.

Fewer materials are subject to CMS review

Section 20 – Communications and Marketing Definitions

Marketing materials must be submitted to Medicare for review, but not all communication materials are subject to Medicare approval. Communications refer to “activities and use of materials to provide information to current and prospective enrollees. This means that all activities and materials aimed at prospective and current enrollees, including their caregivers and other decision-makers associated with a prospective or current enrollee, are ‘communications’ within the scope of the regulations at 42 CFR Parts 417, 422, and 423.”² Marketing is defined by Medicare as activities or materials that are meant to influence a beneficiary’s decision-making process when selecting a plan. Marketing messaging includes:

• Information about benefits or benefit structure
• Information about premiums and cost-sharing
• Comparisons to other Plan(s)/Part D sponsor(s)
• Rankings or measurements in reference to other Plan(s)/Part D sponsor(s)
• Information about Star Ratings

According to the MCMG, communication materials are distinguished from marketing materials in both their intent and content. Consider this example from Section 20.1:

“A letter is sent to enrollees to remind them to get their flu shot. The body of the letter says, ‘Swell Health enrollees can get their flu shot for $0 copay at a network pharmacy…’ This would be considered communication. According to the MCMG, “While the letter mentions cost-sharing, the intent is not to steer the reader into making a plan selection or to stay with the plan, but rather to encourage existing enrollees to get a flu shot. The letter contains factual information about coverage and was provided only to current enrollees.”²

Plan administrators must ensure that the intent and content of their message is clear and aligned with the MCMG’s definitions of communication and marketing to remain in compliance.

Developing An Effective MA Member Communications Strategy

When devising your member communications strategy, a personalized approach is best—both for content as well as delivery. Members want to receive information that is personally relevant, and in the channel that they prefer—whether print, digital, phone, etc. Digital options provide an enhanced ability to personalize communications based on analytics. It’s now possible to meet these member expectations, promote your brand, and remain CMS-compliant.

Meeting member expectations

Payers now have a multitude of channels to engage MA members. According to a Media Logic survey of seniors’ media habits, 94% of seniors use the internet every day, and 87% use social media daily (93% of seniors who are active on social media use Facebook, 25% use Twitter, and 24% use Instagram³). While the survey showed most Medicare members prefer communication via phone, nearly a third indicated they preferred email, text, website, or apps. This is all good news for insurers offering MA Plans, as you can deploy an omni-channel strategy to reach members in the channels they prefer—and gain time-and-cost efficiencies by leveraging the newer modes of communication. For example, when it’s time to promote flu, pneumonia, and shingles vaccinations in the fall, you might alert members via social media and text, and direct them to watch for details via printed literature being mailed to their homes.

Timing of messaging

Various milestones throughout the year provide opportunities for valuable member communication. New enrollee outreach and age-ins provide marketing opportunities, while birthday campaigns can serve as a reminder to schedule wellness visits. Personalize communications to those at risk with important seasonal information and recommendations for different times of the year. For example:

• Spring: For members not taking prescription allergy medications, provide recommendations for over-the-counter (OTC) allergy medications and outdoor activities.
• Summer: Remind those members who have not recently had a cancer screening of the importance of sunburn prevention and skin-cancer screenings
• Fall: Send flu and pneumonia vaccine reminders to only those members who have not been vaccinated.
• Winter: Provide recommendations for cold and flu OTC treatments, and inform members of the availability of telehealth services.

Follow-up communication after a provider visit is another frequently overlooked opportunity to engage with members and improve satisfaction. Of the Medicare beneficiaries surveyed, 53% said that they received no communication from their health plan after a provider visit. Prompt follow-up can help improve treatment or medication compliance and may aid in retention.

Where to use member communications

Making printed communication materials available at various events and locations can help reach more members and potential enrollees. Flyers for brokers and sales agents can be distributed at educational events, and pamphlets can be handed out at community engagements and philanthropic events. There is an opportunity to provide educational material with compliance mailings.

Communication Topics

In addition to seasonal messaging, members can benefit from information that helps them make the most of their healthcare plans. Beneficiaries are not always aware of the services or resources available through their health plans. For example, if you have a MAPD plan and see prescription utilization, ensure that the member is aware of medication therapy management. If the member does not have recurring prescriptions, do not send that information. Too many communications, particularly communications that aren’t relevant to the member, create noise and can diminish the effectiveness of other communications.

Use short, focused member communications to deliver information about plan resources, provider directories, educational events in the community, and supplemental benefits.

Consider including some of the following tactics in your member communication strategy:

• Increase communication to members with chronic conditions to help them improve health outcomes.
• Provide a list of new providers when their provider is no longer in-network.
• Provide information on tools and strategies for preventive care and health behavior change.
• Inform members of plan resources such as websites, member portals, and smartphone and tablet apps. Take a good look at your member portal as well; 47% of Medicare beneficiaries feel that their plan's portal "rarely or never" answers their questions.⁴
• Provide information on digital tools such as fitness trackers or blood sugar monitors.
• Provide price-comparison tools and other recommendations to help members save money. Almost half of members surveyed in the 2017 HealthMine Medicare Survey said that they wanted information on how to lower their healthcare costs, but only 11% currently receive this information.⁴
• Provide a "Medicare 101" feature that explains topics such as Medicare FFS vs. Medicare Advantage and defining Parts A, B, C, and D.
• Educate members on available supplemental benefits, such as dental, vision, transportation, hearing, chiropractic, OTC, medication therapy management, telehealth services, and Silver Sneakers.
• Advertise educational events in the community.
• Provide education on fraud, waste, and abuse prevention, and member rights and responsibilities.
• Provide information on preventive care such as mammograms, cancer screenings, and flu shot reminders to the right individuals at the right time.

Delivering a clear and concise message

More than half of Medicare-aged adults read at a “basic” or “below basic” level, according to a report from VisibleThread.⁵ Yet 86% of plans deliver Medicare communications with complicated language, complex word density, and excessive use of passive voice. Two-thirds of payers deliver communications that are more difficult to read than Moby Dick.⁵

Plans are required to send materials like Summaries of Benefits and Evidence of Coverage, but members rarely read the dry legalese. You can make your member communications more valuable and helpful by sending smaller, more frequent, and more targeted messaging. Provide a clear and concise message in your communications. Use plain language to build trust and include infographics and illustrations where possible to catch the eye and demonstrate concepts.

Why A Member Communication Strategy Is Worth the Investment

Seniors are becoming busier and more technologically savvy. Healthcare plans need to capture their attention immediately and provide information in small, easily digestible communications.

Members who think their insurer/plan is a proactive partner in their healthcare are more likely to remain loyal. Regular, relevant communication delivered in preferred channels conveys your interest in helping members to stay healthy, control healthcare costs, and make good healthcare decisions.

Medicare Advantage populations are also becoming increasingly diverse with growing segments and many with specific communication needs for Persons with Disabilities (PWD). By improving the accessibility of your communications, you can appeal to a growing and influential market while helping ensure compliance with federal accessibility regulations such as Section 508 and 504 of the Rehabilitation Act of 1973 along with the Americans with Disabilities Act.

Routine communication can also aid in member retention. Seniors are likely to switch plans if their healthcare needs change, according to a 2018 survey from Deft Research.6 Tracking changes in their provider visits, sending prompt follow-up communication, and providing additional resources can help assure members that their healthcare plan is making their needs a priority and provide member insights to guide annual benefit updates, which may keep them from switching plans.

Change Healthcare: Inspiring A Better Healthcare System

At Change Healthcare, we’re helping payers broaden and enrich their communications with innovative strategies and technology. This includes personalized digital solutions along with stateof- the-art printing and fulfillment services as well as digital solutions that can help you exceed both member and provider expectations. Ultimately, our services facilitate a communications strategy aimed at improving engagement and satisfaction while simultaneously helping to reduce costs.

Our customizable communications suite allows healthcare plans to do the following:

• Ensure delivery of the right materials to the right members at the right time.
• Capture the member's preferred language and preferred method of accessing information.
• Create a differentiated member experience through personalized, timely, omnichannel communications. Work to improve retention and foster trust with high-quality, customizable content.
• Transform member communication into meaningful, interactive engagement channels.
• Produce materials in accessible formats that are compliant with Federal Accessibility Legislation (large print, braille, foreign language, machine-readable).
• Market-leading technology for management of content that drives to automated workflows.
• Track material generation and delivery with transparent and reportable methods that are CMS audit ready. We offer audit-ready, operational, and fiscal reporting for your communications.
• Access a comprehensive repository of your materials, including compliance transactional materials and marketing materials.

We customize engagement strategies utilizing our core set of solutions to help create a positive first impression and instill member confidence. All of our communication processes are HiTrust certified and support HIPAA compliance with a FISMA-certified environment for organizations needing higher levels of security.

Enhance your member engagement, satisfaction, and retention with targeted, regular communications that demonstrate your commitment to your members’ health and wellness goals. Change Healthcare makes it easy to implement a fully compliant solution to meet the diverse member communication needs that can be easily customized to meet your requirements.

<sup>1. Medicare Advantage Plan Member Satisfaction Holds Steady as Cost Drives Plan Selection, J.D. Power Finds: https://www.jdpower.com/business/press-releases/2019- medicare-advantage-study
2. Medicare Communications and Marketing Guidelines: https:// www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/CY2019-Medicare-Communications-and-Marketing-Guidelines_Updated-090518.pdf
3. Medicare Marketing Insights: Senior Media Preferences: https://www.medialogic.com/blog/healthcare-marketing/medicaremarketing- senior-mediapreferences/
4. The HealthMine Medicare Report: http://ww2.healthmine.com/clients/healthmine/uploads/PDF/Healthmine_Medicare_Report_V8.pdf
5. 86.6% of Medicare Documents Are Not Accessible To Those 65 Years And Older: https://www.prnewswire.com/news-releases/86-6-ofmedicare- documents-are-notaccessible-to-those-65-yearsand-older-300781648.html
6. Medicare Shopping and Switching Study: https://www.deftresearch.com/senior-market-intelligenceservice</sup>