Medicare Advantage client retention

[RunnerDude]

As I review my book of business pre-AEP, I once again find way too many clients that have fallen off. Many are on the same plan- but with a different agent (likely due to a one- month switch and then rewriting back on the same plan). Others have been changed to plans that are not as good as the one I wrote them on. Some are due to changes in their healthcare status (i.e. gain or loss of Medicaid). The frustrating thing is that I know the agents who are doing this likely do not have "permission to contact". I do send birthday and Christmas cards and always answer my phone to deal with issues. I obviously need a better retention strategy. I know that a lot of agents will monitor their book of business on a monthly basis to see who is about to fall off, and then contact the client to cancel the enrollment. This illegal according to CMS- but apparently effective. I have not engaged in this practice (as of yet). Does anyone have a (legal) solution that works?

 

[somarco]

way too many clients that have fallen off

The study analyzed disenrollment patterns for 82.4 million individuals enrolled in Medicare Advantage between 2011 and 2020. After one year, 13.2 percent of enrollees in non-dual-eligible plans disenrolled from the plan, and 15.9 percent of beneficiaries in dual-eligible special needs plans disenrolled.

After five years, 48.3 percent of enrollees in non-dual-eligible MA plans had left the plan, and 53.4 percent of D-SNP enrollees had disenrolled.

payers are not incentivized to invest in long-term strategies to improve members' care outcomes

https://www.beckerspayer.com/payer/...ll-from-their-plans-within-5-years-study.html

 

[straightnochaser]

"Most beneficiaries who disenrolled from one MA plan enrolled in a different MA option rather than traditional Medicare, the study found. "

 

[DonP]

As I review my book of business pre-AEP, I once again find way too many clients that have fallen off. Many are on the same plan- but with a different agent (likely due to a one- month switch and then rewriting back on the same plan). Others have been changed to plans that are not as good as the one I wrote them on. Some are due to changes in their healthcare status (i.e. gain or loss of Medicaid). The frustrating thing is that I know the agents who are doing this likely do not have "permission to contact". I do send birthday and Christmas cards and always answer my phone to deal with issues. I obviously need a better retention strategy. I know that a lot of agents will monitor their book of business on a monthly basis to see who is about to fall off, and then contact the client to cancel the enrollment. This illegal according to CMS- but apparently effective. I have not engaged in this practice (as of yet). Does anyone have a (legal) solution that works?

It’s the market your in . Dual / lis etc are many times flippers . There’s nothing you can do outside contact with cards or phone calls now and then to say hello .It’s getting worse and worse the last 6 months as call centers attacking hard . You must try to get more referrals from existing clients and T-65 ‘s. You got a lot of your low income clients with some type of lead .There always looking for a better deal .

 

[Midlevel]

Has anyone else seen the new benefit on one of the MAPD plans that offers fitness reimbursement. Can use the pool of money to buy tennis shoes, golf shoes, pickleball racquet, reimburses green fees and driving range for golfing and pays for golf clubs. Pays for State and Federal park permits, tents, hiking sticks, etc. Pretty sweet new benefit. And still no premium.

 

[straightnochaser]

Has anyone else seen the new benefit on one of the MAPD plans that offers fitness reimbursement. Can use the pool of money to buy tennis shoes, golf shoes, pickleball racquet, reimburses green fees and driving range for golfing and pays for golf clubs. Pays for State and Federal park permits, tents, hiking sticks, etc. Pretty sweet new benefit. And still no premium.

Who's that one with? Sounds very Florida centric?

 

[RunnerDude]

The study analyzed disenrollment patterns for 82.4 million individuals enrolled in Medicare Advantage between 2011 and 2020. After one year, 13.2 percent of enrollees in non-dual-eligible plans disenrolled from the plan, and 15.9 percent of beneficiaries in dual-eligible special needs plans disenrolled.

After five years, 48.3 percent of enrollees in non-dual-eligible MA plans had left the plan, and 53.4 percent of D-SNP enrollees had disenrolled.

payers are not incentivized to invest in long-term strategies to improve members' care outcomes

https://www.beckerspayer.com/payer/...ll-from-their-plans-within-5-years-study.html

Thanks for the information. It's horrible, but it helps me to understand what's going on. My disenrollment numbers are right in line with the study results. I need to find a way to ensure that my clients always contact me when they want to change- rather than listening to anyone dangling a carrot in front of their face. I do tell them that I am contracted with every Medicare plan in their area, so there is no need to work with anyone else. Nothing has really worked so far.

 

[Midlevel]

Who's that one with? Sounds very Florida centric?

I will tell you on 10/1. Ha.

 

[RunnerDude]

It’s the market your in . Dual / lis etc are many times flippers . There’s nothing you can do outside contact with cards or phone calls now and then to say hello .It’s getting worse and worse the last 6 months as call centers attacking hard . You must try to get more referrals from existing clients and T-65 ‘s. You got a lot of your low income clients with some type of lead .There always looking for a better deal .

Technically speaking, you are correct. Unfortunately, I know many agents who choose to ignore CMS rules completely- and get away with it every day. It almost seems like, if you aren't willing to "bend" the law, you can't be successful. I know several agents that always contact clients in the process of disenrolling (and actually succeed in cancelling almost every disenrollment- thus keeping the client), uses enrollment codes (such as "change of address") to enroll new clients- even when it doesn't apply, uses leads that are 3-5 years old, and approaches individuals without "permission to contact". They have been doing it for years, and nobody seems to care. CMS doesn't seem to have the manpower or ability to do anything about it.

 

[DonP]

Technically speaking, you are correct. Unfortunately, I know many agents who choose to ignore CMS rules completely- and get away with it every day. It almost seems like, if you aren't willing to "bend" the law, you can't be successful. I know several agents that always contact clients in the process of disenrolling (and actually succeed in cancelling almost every disenrollment- thus keeping the client), uses enrollment codes (such as "change of address") to enroll new clients- even when it doesn't apply, uses leads that are 3-5 years old, and approaches individuals without "permission to contact". They have been doing it for years, and nobody seems to care. CMS doesn't seem to have the manpower or ability to do anything about it.

Nothing you can do to change the % of Disenrollments on low income by much . They’re getting 100 calls a week min . They might not answer the phone 99 out of the 100 times . But when they answer that 1 time they very well could be flipped .Its a function of being lonely and wanting attention, For the first time in their life people are fighting over them . I was knee debt in duals 2 yrs ago. I’ve cut my dual book down to 30%. I got 2 calls after 10 pm lat night . Let’s talk about death claims of duals. 13 of my 15 mapd deceased this yr duals .