Medicare Advantage enrollment is projected to increase to 20.4 million in 2018, a 9% increase compared to 2017, and in the same time frame 34% of all Medicare enrollees are projected to be in a Medicare Advantage plan.1 All of the expense and activity occurring in the Medicare market makes it imperative that competitive excellence now be measured in terms of customer satisfaction. Health plans in this space have a significant opportunity to become more competitive by executing a strategy that not only pivots on the member experience, but is also built around understanding how those members view their plan.
J.D. Power expects to see new plan members bringing higher expectations for service and convenience from their other day-to-day retail and health care experiences as they increasingly become accustomed to digital tools; localized features; on-demand care; alternative wellness and health options; and lifestyle design.
Role of Cost Management in Building Trust among Medicare Advantage Members
Health plans that listen to their members and prioritize actions to satisfy their expectations are more likely to directly impact their overall ROI. One of the most impactful Key Performance Indicators (KPIs) in the 2017 U.S. Medicare Advantage Study was “Plan actively helps keep out-of-pocket costs low.” However, just 57% of members said their plan helped to minimize their out-of-pocket expenses. Medicare Advantage members expect more from their health plan than just timely claims payment; they are also looking for help navigating and managing the healthcare continuum.
The U.S. Medicare Advantage Study identifies five drivers of member trust in plans, of which:
- Each is focused on cost management
- Two are impacted by the interactions members have with doctors and other health professionals
The study incorporates insights from this driver analysis and additional KPI analysis to show how each service event between members and their insurer impacts overall value perceptions of the insurers and identifies critical service standards that drive higher member satisfaction and the bottom line.
Study deliverables include:
- Customized executive presentation and in-person discussion that includes data-driven, actionable recommendations for achieving strategic goals
- Net Promoter Score®—a Bain Certified study, which includes several NPS® questions that will be added to the respondent files and available on VoX and via a word cloud and rank chart
- Customized scorecards displaying comparative performance on key metrics related to member experience
- Competitive survey data and industry reports
- Access to VoX 3.0—this study is available on the interactive interface, VoX 3.0
Net Promoter System®, Net Promoter Score®, NPS® and the NPS-related emoticons are registered trademarks of Bain & Company, Inc., Fred Reichheld and Satmetrix Systems, Inc.