Patient experience and satisfaction are critical components for Medicare plans. This has recently been reinforced with the elevation in the experience and satisfaction weights for Medicare Advantage Star Ratings. Satisfaction not only is directly related to the Star Ratings and corresponding plan rebates, but also enrollment and renewal rates. A McKinsey customer survey titled “Great customer experience: A win-win for consumers and health insurers,” found that satisfied members are five times more likely to renew their health insurance coverage than their unsatisfied peers.
Icario wrote about the impact in the recent blog 2021 Star Ratings: A Year For Member Experience where it layed out the impact for the weight changes referenced below.
| Impact of Changes |
|---|
| Increase the Proportion of these Measures |
| Year | Change in Weight | MA Change | Part D |
|---|---|---|---|
| 2021 | 1.5 to 2 | 7% | 9% |
| 2023 | 2 to 4 | 23% | 22% |
| Overall ’21 to ’23 | 1.5 to 4 | 28% | 27% |
By 2023, Medicare Advantage (MA) satisfaction will account for 46%, and Part D 40%, of all Star Ratings. However, in 2018, health plans had a net promoter score (NPS) of 19%—lower than every other sector in the survey except for utilities. But despite the comparatively low score, seniors have a high degree of satisfaction with MA plans compared to traditional Medicare fee-for-service since many MA plans have no premiums, limited cost-sharing, and provide many non-healthcare benefits such as food delivery, gym memberships, and supplies to accommodate limitations in activities of daily living. This was affirmed by a poll conducted by the Better Medicare Alliance finding 62% of seniors call Medicare Advantage a “better choice” compared to traditional fee-for-service Medicare.
With the Star Rating change elevating a focus on member experience, plans are laser focused on improving satisfaction. Icario has developed sophisticated programs to measure and improve satisfaction. Part of the success is from understanding, directly from members in different forms and settings, sentiments and drivers for satisfaction. Recently, Icario commissioned The Harris Poll to conduct an online study among over 1,200 Medicare subscribers to understand consumer sentiments around Medicare that could impact satisfaction. This poll measured whether a member:
- Has a Medicare plan that currently meets their healthcare needs
- Wants more personalized communications, care, and services to meet all of the health needs (e.g., medical, physical, mental)
- Would feel more positive about their Medicare plan if it offered rewards and incentives for certain activities or behaviors (e.g., exercising, quitting smoking)
- Wants to receive more communication (e.g., mail, email) from the Medicare plan about the additional benefits available (e.g., gym membership, meal delivery, home health, community resources, alternate places, and ways to access care such as telehealth, new benefits, and programs)
- Believes their Medicare plan provides information and support specifically designed for their personal health needs (e.g. managing their health conditions, programs to support their health goals)
- Clearly understands the health benefits included with their current Medicare plan
- Stayed in the same type of Medicare plan, but changed health plan providers (e.g., switched from Aetna to Cigna)
- Switched to a different type of Medicare plan (e.g., changed from Traditional to Advantage)
The following is a summary of some of the key findings among Medicare Advantage subscribers:
Graph Description
This bar graph represents a summary of some of the key findings among Medicare Advantage subscribers.
- 87% of Medicare Advantage subscribers feel their plan currently meets their healthcare needs
- 86% of Medicare Advantage subscribers want their plan to personalize communication, care, and services to meet all of their health needs (e.g., medical, physical, mental)
- 83% of Medicare Advantage subscribers believe they clearly understand the health benefits included with their current plan
- 75% of Medicare Advantage subscribers would feel more positive about their Medicare plan if it offered them rewards and incentives for certain activities or behaviors (e.g., exercising, quitting smoking)
- 69% of Medicare Advantage subscribers want to receive more communication for their Medicare plan about additional benefits available to them (e.g., gym membership, meal delivery, home health, community resources, alternative places, and ways to access care)
- 40% of Medicare Advantage subscribers made changes to their plans for 2021, 25% say they stayed in the advantage plan but changed commercial/medical providers
In addition, Medicare subscribers with an Advantage plan are more likely than those with a Traditional or Supplement plan to say their plan provides information and support specifically designed for their personal health needs (e.g., managing their health conditions, programs to support their health goals) (83% vs. 66% and 71%, respectively).
While beneficiaries may be satisfied with their current plan, and understand their benefits, there is a desire for greater personalization around their care. Icario often experiences plans generically engaging members through the same message, modality, and approach which doesn’t universally resonate or inspire health action. The directive for greater personalization is consistent with Icario’s experience where member engagement is directly correlated to a member’s personal and sentimental association with the message, and calls to action that are aligned with a member’s values.
Although supplemental benefits are increasingly offered by plans, and members want more information about these benefits, the survey exposes that future drivers of satisfaction would also be derived from rewards and incentives. Supplemental benefits can be positive experience drivers, being that tangible benefits can be immediately utilized by members and have a more easily defined financial or intrinsic value. Similarly, rewards and incentives naturally assign a defined value that is easily understood by the member, are more readily available than a more difficult to understand plan health benefit, and provide a motivating and more ubiquitous currency.
This Icario/Harris Poll survey demonstrates why a focus on satisfaction is central to a health plan’s success, and why Icario is playing a fundamental role in helping drive improvements. High satisfaction and a positive member experience helps prevent churn at a time when membership growth is central to financial success, and competition between plans greater than ever. With voluntary churn rates among those with an Advantage plan at 25%, as measured by the Icario/Harris Poll survey and other independent surveys, profitability can depend on retaining members since there is a greater ability to manage a member, make longer term investments, and influence their medical costs and outcomes, the longer someone is enrolled in the same plan. Even if a plan is neutral in terms of member enrollment and losses, financial performance may be encumbered if there is excessive churn and transient membership.
As described above, with satisfaction being central to Star Rating performance, and the corresponding rebate payment, it can drive a cycle for growth or persistent decline. Plans with higher rebates can allocate a greater amount to premium subsidies or supplemental benefits. These member benefits persist satisfaction and cyclical improvement. However, lower rebate payments impede the ability to compete in the market and can result in a less favorable benefit offering.
In addition, satisfaction also corresponds to a member’s understanding of their benefits, covered services, and decision making around benefits. Ease associated with this can lower administrative costs thereby improving a health plan’s medical loss ratios (MLR) and free up the ability to offer additional member-facing benefits.
Members want to continue to get information, and derive value, from their health plan. Each member finds value in different areas and benefits, and with that, personalization is fundamental to inform and engage the member. Generic and vanilla messaging that doesn’t relate to a member’s needs are ignored, potentially associating future messages as similarly irrelevant and dismissed. Having a constant pulse on member satisfaction is central to understanding changing orientations and needs, and flexing to help drive improved performance. The Icario research, programs, and performance provide insights for plans to continue to understand and engage its membership to make thoughtful investments and decisions that, while being accretive to satisfaction, ultimately improve a member’s health.
Survey Method
This survey was conducted online within the United States by The Harris Poll on behalf of Icario from December 21-23 and December 28-30, 2020 among 1,279 are Medicare subscribers, and 535 are Medicare Advantage subscribers. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated.
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