Published: 05.14.2021



Real World Stories

Research, Trends, and Insights

Retaining Medicare Members During a Risky and Complex Plan Transition Period

In our Anatomy of a Solution series, we take a look at some direct challenges and disruptive solutions that Amsive has driven for clients. This week, a foundational and logistical switch for a Medicare client and its members was met with a uniquely proactive strategy and solution.

The Basics

A Medicare client had a fundamental problem. The U.S government was about to sunset a particular type of Medicare plan offering that made up the overwhelming majority of the client’s Medicare business. This one-time move forced the client to figure out how to strategically transition about 30,000 members onto new Medicare AdvantageiMedicare Advantage is part of the Medicare program, but is offered to anyone age 65 and older by private insurance companies instead of the federal government. Also referred to as Medicare Part C, these plans typically include hospital, medical and prescription drug coverage. Medicare Advantage is different from standard Medicare, which is still available even with a Part ... Read More plans over the span of one year. 

For the Centers for Medicare and Medicaid Services (CMS), the move was a cost-cutting measure. For the client, it was a potentially catastrophic and technically complex situation that meant the thousands of members who were at risk had to be moved onto a different plan type with potentially different structures.

While this was a unique scenario with a distinct Medicare audience, Amsive was uniquely positioned to help deploy proactive retentioniCustomer retention is the actions a company takes to maintain its current customer base and prevent them from switching to a competitor. Customer retention is widely seen as being less expensive than aquiring new customers, so it becomes an important element of a company's marketing efforts that are often focused on building a relationship and enhancing loyalty rather than... Read More strategies during such a foundational and unexpected shift that threatened the client’s business. 

The Challenge

The coverage disruption and transition would fundamentally change the way that these members received their health care, so effective communication was key. The problem with getting the message across was there were some very strict CMS regulations about where, when, and how to communicate to members to let them know that this point-of-no-return was coming. The other main hurdle was segmentingiSegmentation is the process of dividing a company's entire target audience into smaller segments by shared characteristics to permit more specific, personalized marketing options. A high-end, luxury car may have segmented audiences based on income or demographics such as location. That luxury car might be marketed to the income segment for its high-end finishes and luxury ... Read More out tailored messages to particular member segments that needed specific insights into the upgraded plans. 

Our successful campaign showed that Amsive’s proactive strategies can help clients pivot when those unexpected but essential shifts threaten to upend business models.

Obviously, coming out and saying everything to every member immediately would have been easiest, but there was a limited timeframe. The luckiest members simply crossed-walked into a plan and they didn’t have to do anything; others, who maybe had other options that involved drug plans through a separate provider, needed tailored touchpoints because those dual options weren’t available through Medicare Advantage. Another example of a tailored category was veterans who were technically allowed to keep drug coverage through the federal government and medical care through another carrier.

With unique customer journeysiThe customer journey is a customer’s path from discovery of your product or service to their decision to purchase. Did your customer click on an ad for a Caribbean vacation and then maybe look at additional photos of the islands? Maybe they Googled “best places to stay in the Caribbean” or asked friends on social media for feedback from their trips before returning t... Read More across highly complex member qualifications, coverage options, and situational concerns — it was increasingly important for touchpoints to get the word across that change was inevitably coming. 

The Solution

Amsive had a year’s time to begin brainstorming the process of communicating to members, with the deployment of the actual campaign taking place over the course of about nine months before the switch took effect. There was no guessing game factor at play because the entire campaign was based on existing member data. We knew who they were, where they were, and what plan they were then currently in because the client had a handle on good first-party dataiFirst-party data is information about a consumer collected directly from that person's online habits. It is an important piece of information that can help you understand your customers because it is based on actual interactions with your brand. In other words, it's not hypothetical trends but actual habits by a real consumer. This data can include everything from purchase... Read More

Based on that information there were several different paths of communication, which involved mapping out potential member journeys to be delivered within the regulatory confines. Each tailored touchpoint was progressively more detailed as we got closer to the cutoff date, with two general messaging buckets. 

  • No Action Required: This messaging was tailored to members who didn’t have to do anything. The emphasis was communicating that a change was coming because the CMS — not the client — initiated it, and the good news to them was that they were going to receive the same great coverage they were used to without having to lift a finger.
  • Legacy: This strategy attempted to communicate how important it was for members to take note because, in many cases, the reliable plans they’ve been on for the last 20 years were about to go away. Members that did not take action would not get a plan in the same structure that they were used to — or worse, end up with no coverage at all. These communications stressed the need to make an informed choice. 

To support this staggered strategy, we also developed a members-only micro-site, a dedicated call center, and supplementary checklist-type communications with all of the pertinent information that members could access to drive them to actively choose their updated plan.

With unique customer journeys across highly complex member qualifications, coverage options, and situational concerns — it was increasingly important for touchpoints to get the word across that change was inevitably coming. 

The Results

While seemingly simple, this multi-faceted effort ensured the right information at the right time got in front of members to inform them what was coming, what action — if any — was required on their part, and how to get the answers they needed on such a key offering like Medicare coverage. 

We leveraged a year-long, systematic, high-frequency messagingiA company's messaging strategy is simply how it positions itself in the market and establishes brand awareness. This message should always be consistently communicated across all channels including web copy, advertising messaging, and in-store signage. An effective messaging strategy communicates a brand's voice and purpose in a succinct and clear manner. For example, when... Read More campaign and operational challenged leading up to and during the enrollment period that made the transition complexities simple and persuaded members to stay with the current plan provider.

Ultimately, we helped the Medicare plan provider:

  • Attain 94 percent membership retention
  • Drive $235M in revenue transition
  • Establish a $3.10 cost-per-retained member

Even though this particular case was a one-time-only industry shift, our successful campaign showed that Amsive’s proactive strategies can help clients pivot when those unexpected but essential shifts threaten to upend business models.