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 Advantage[amsive_tooltip term=”medicare-advantage”] 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 retention[amsive_tooltip term=”customer-retention”] 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 segmenting[amsive_tooltip term=”segmentation”] 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 journeys[amsive_tooltip term=”customer-journey”] 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 data[amsive_tooltip term=”first-party-data”].
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 messaging[amsive_tooltip term=”messaging-strategy”] 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.
