From coast to coast, patients and providers alike are seeing frightening disruptions to their local payer landscape. These include tremendous upticks in mergers and acquisitions, narrowing of health plan provider networks, plans vacating markets that aren’t profitable, and plan terminations when contracts collapse.
While such changes are troubling to the patient and threaten their continuity of care, they cause significant organizational disruption and distress to the affected hospital or medical group, as well. The very real possibility of losing patients and important revenue to an insurer that has provided necessary coverage and developed member trust is painful to providers. Nowhere is this truer than when it comes to the Medicare population, an audience to whom Medicare Advantage plans aggressively and continuously market. But losing these vulnerable patients when health plan disruption occurs need not be the case.
An increasing number of hospitals and medical groups are preparing for these “compelling events” by having a strategy in place that allows them to retain their patients through marketplace upheavals.
Here’s how they are doing it.
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First, they are recognizing waiting until contract termination occurs is too late to begin positioning as the patients’ trusted source for insurance information. Shifting this paradigm means no longer defaulting to health plans the year-round insurance communication with patients. Providers need to engage in regular outreach with patients, especially those aging into Medicare, so patients get accustomed to receiving important insurance information, check-up reminders, and healthy lifestyle suggestions from their provider; not just from their health plan.
Second, providers are increasingly recognizing the value of establishing a Medicare insurance helpline, so, patients have a trusted and singular go-to resource throughout the year—especially upon facing a contract termination. The helpline can provide critical information and support for coverage and continued access.
Source: Managed Healthcare Executive