Due to social distancing restrictions, broker and member engagement during 2020 Medicare open enrollment will look very different than previous years.
The unpredictable impacts of the coronavirus pandemic on Medicare open enrollment will require both broker and member engagement to be technology-enabled, transparent, and streamlined.
Britta Orr, chief Medicare officer at Allina Health l Aetna, told HealthPayerIntelligence that she could see the pandemic having two disparate effects on member decision-making during this open enrollment season.
“There’s been sort of a shift in the market and the mindset around insurance,” said Orr. “We see a lot of employers in small and large group plans really choosing to stay put right now with what they’re offering their employees.”
DistilINFO Healthplan Market Intelligence Report
Your monthly roundup of the US healthplan industry.
These employers and members may be more hesitant to switch out of their current plan given the unpredictable economy and uncertain healthcare environment. Instead of shifting to an untested plan, those in this category prefer to stay in a plan where they already have an idea of what their costs will be. This could improve retention in the health payer industry, Orr noted.
Meanwhile, other employers and members may be more eager to switch plans and may be more interested in educating themselves about their options than in previous years, given the possibility that they may catch COVID-19.
With COVID-19 treatment costs potentially ranging from $9,000 to more than $20,000, members and employers will want to ensure that their plan leaves them with the least amount of cost-sharing possible for relevant treatments and procedures.
“It’s a really critical time to find the best product to meet your needs, especially when you have unpredictable needs that maybe none of us could have foreseen a year ago,” Orr added.
Whether members choose to stay on their current plan or explore other options, payers need to ensure that their communication styles are transparent, simple, and strategically employ virtual platforms.
BE CLEAR ABOUT COVID-19 BENEFITS
Whereas last year the changes to Medigap Plan F stirred up a lot of confusion among members, brokers, and navigators alike, this year there have been no major regulatory shifts to trigger uncertainty.
Instead, in the 2020 open enrollment period, payers will need to be aware of their messaging around coronavirus-related benefits, which are most likely to cause the most confusion, Orr predicted.
Members will want to know what their maximum out-of-pocket healthcare spending on coronavirus treatment might be, whether or not they are diagnosed and whether or not they are hospitalized, Orr predicted. They will also be wondering about laboratory test and potential vaccine coverage.
“Those will be very common questions this year and different providers or carriers might have different answers in terms of how they administer some of those COVID-related pieces,” said Orr. “We’re ensuring that brokers understand what’s offered in terms of telemedicine coverage, for example, because that’s another potential point of confusion.”
As of August 2020, almost seven in ten payers (69 percent) are covering COVID-19 treatment and only eight percent said that they would not be covering COVID-19 treatment costs, according to an Insights report by Xtelligent Healthcare Media.
Medicare covers COVID-19 lab testing, antibody tests, medically necessary hospitalizations and hospital quarantines—though some copays may apply—, and the potential COVID-19 vaccine. Medicare Advantage plans cover many of these same services and may provide coverage for additional benefits, such as telehealth and meal delivery.
However, some of these benefits are not permanent. For example, according to a Peterson-Kaiser Family Foundation brief published in August, coronavirus waivers for a little over 31 percent of payers on the individual and fully-insured markets will end in December 2020. This extends to some Medicare Advantage plans as well.
Thus, payer messaging around coronavirus-related benefits—what they cover and how long waivers will last—needs to be transparent and simple.
“It’s really all about that relationship with the broker and ensuring that we make them the expert and a trusted source of information on our plans. Then, we leave it to them to find out what’s most suitable for the prospects in the market,” explained Orr. “And our plan might not always be the most suitable. We want them to know exactly what we offer and how that matches up with the beneficiary’s needs.”
ELIMINATE THE EXTRA NOISE IN MESSAGING
This is a time for payers to streamline and focus their messaging, Orr emphasized. The coronavirus pandemic creates a lot of noise for members. In order to support careful, informed decision-making during open enrollment, payers need to pare down their messaging for both members and brokers to the most relevant content.
“It’s an election year, COVID creates a lot of noise and potential for confusion, so we’ve dropped a lot of communications with both our members and our brokers, if we felt they weren’t necessary are critically important right now,” Orr shared. “We’re not working in a ‘nice-to-have’ environment. We’re really trying to make sure that they get the most important information, in the easiest to understand format possible right now.”
For Allina Health l Aetna, this meant backing away from less time-sensitive campaigns, such as their wellness programming messages.
However, this does not mean that coronavirus pandemic and enrollment information are the sole focus of payer communications. Orr considers preventive care messaging, specifically flu shot campaigns, as equally critical information.
For the first half of the year as the country struggled to manage the pandemic, preventive and direct, clinical care fell lower on the priority list for payers and members alike. Humana recently reported a sharp decline in preventive care when COVID-19 struck.
Now, however, preventive care and primary care services are more important than ever. The payer has resumed its emphasis on these services by participating in Aetna’s Time for Care campaign. The campaign informs members about how to get wellness checks and safely meet with their providers.
ENABLING VIRTUAL BROKER AND MEMBER ENGAGEMENT
With social distancing restrictions in place, broker and member engagement will look different this year than in any previous open enrollment.
“Now more than ever, we’re emphasizing those virtual pathways to get to and understand coverage options,” Orr shared.
Apart from training brokers on benefits information, Allina Health l Aetna also provided brokers with new technologies and platforms through which they can safely engage members.
Allina Health l Aetna will employ electronic enrollment kits to inform brokers about its health plans’ capabilities. Additionally, members can access brokers by phone to enroll in a health plan. The payer also permits some more traditional face-to-face meetings, as long as participants adhere to social distancing protocols.
Orr anticipated that this may mark a significant shift in enrollment—not only technologically, but also culturally by placing more of an emphasis on the individual.
“Since large groups formatting is a little more challenging, I’m hopeful that with all that we’ve ramped up and how the industry will adapt, folks might even get more one-on-one counseling and support about what will best fit their needs in 2021,” Orr said.
“You’re not sitting at the back of a crowded room in a sales seminar, but you’re online, connecting with that broker, able to ask specific follow questions in the chat box—maybe even a little bit more anonymously—or able to request a follow-up conversation.”
Source: Healthpayer Intelligence