THE 'EDGE REPORT BLOG

Three Takeaways from the 2nd Annual Medicare Advantage Leadership Innovations Conference

On January 28-30, 120 Medicare Advantage health plan executives, industry experts and vendors gathered for the 2nd Annual Medicare Advantage Leadership Innovations Conference in Phoenix, Arizona to discuss the latest trends and innovations for building a top quality, high performing Medicare Advantage plan. Here are three takeaways from this year’s conference.

Communication is Key to Success for Acquiring and Retaining Medicare Advantage Members

Communication was a strong theme and cited as a critical criteria for success in order to address members’ needs and deliver a successful payer/provider partnership. Members not only demand clear, meaningful, ongoing communication, but the form in which it’s delivered, and the channel utilized are just as important. Communication needs to be bidirectional and the ability to stimulate this engagement is imperative. Customer satisfaction increases when members feel well informed and engaged in their healthcare process.

This also holds true within healthcare organizations. Silos are still affecting payers’ and providers’ ability to maximize the strength of interdisciplinary approaches to these complex issues. It’s the old adage, “One hand doesn’t know what the other hand is doing”.  All the data in the world cannot reduce duplicated efforts or missed opportunities to engage the provider or member. HealthSun Health Plan of Florida shared their approach to building a 5 STAR program. The approach included a companywide effort with cross departmental teams sharing data. Building cross functional teams will expand your ability to bring in new ideas. Whether in claims, physician relations or medication distribution, HealthSun found greater and lasting improvements resulting from engagement from all departments.

Supplemental Benefits are a Necessity to Managing Social Determinants of Health

Payers and providers are making it a top priority to tackle social determinants of health (SDOH). John Lovelace, President, UPMC for You Inc., spoke about how the U.S. needs to follow the lead of other countries that are spending more on social services and have better population health outcomes. Many health plans and vendors discussed the necessity of addressing SDOH by introducing supplemental benefits to improve member health and address savings. Piyush Gupta, Regional Medical Officer of Caremore Health Plan addressed the need of building benefits into health plans that address “whole life care” and not just short-term medical needs.

Ultimately, addressing SDOH may help minimize or eliminate gaps of care, especially in high-risk, high-cost members. How do we address these disparities? Offer care at the local level. Plans offering care solutions like at-home testing kits and testing at local retail locations are helping to provide members with alternative solutions and community resources to fill care gaps. ALC, a vendor, was touting their partnership with Lyft, providing critical transportation services. Even with these options available, health plans need to empower their members to engage with new supplemental benefits and create benefits for SDOH that are left unaddressed.

Is Technology the Silver Bullet?

Throughout the conference technology played a key role in all presentations. How to interpret the abundance of data in a meaningful way? Are there specific technologies that help improve patient engagement? If so, how should it be deployed?  How do we harness the best of all types of engagement to maximize impact?  Humana discussed an analysis they conducted on 145 companies and the role technology plays in engaging members in a meaningful way in their healthcare. Over 10 million new baby boomers will use Google’s Alexa and other voice activated assistance this year. Their findings showed that engaging the audience and building relationships were difficult as the novelty wore off after 2 weeks. The implementation of AI, telemedicine and other technology also requires the consideration of member communication, readiness for change and lasting engagement. Leveraging automation and data to deliver meaningful care pathways is not one size fits all. Though AI is still in the early stage of use in healthcare, the potential impact is promising.

Medicare Advantage health plans have big plans to address payer, provider and member needs in the new year. We’re excited to see how the healthcare community rallies together to improve care and create new opportunities for Medicare Advantage members.

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