Due to social distancing restrictions, broker and member engagement during 2020 Medicare open enrollment will look very different than previous years.
October 07, 2020 - 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.”
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.”
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