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Winning Medicare Advantage Go-to-Market Strategies for 2014

Co-hosted by Gorman Health Group, LLC, and Atlantic Information Services, Inc.

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Whitney St. Jean Executive Partner

Gorman Health Group, LLC

Brooke Ivey Sales Director

Bloom Marketing Group

Thursday, June 6, 20131:00 – 2:30 Eastern time12:00 – 1:30 Central time11:00 – 12:30 Mountain time10:00 – 11:30 Pacific time

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About the SpeakersWHITNEY ST. JEAN is an Executive Partner at Gorman Health Group, and is currently serving as Chief Strategy Officer at Bloom Marketing Group, Gorman Health Group’s joint venture partner and insurance services contact center and technology solutions provider. At Bloom, Whitney is responsible for overseeing and implementing corporate and product strategy, including the Bloom Call Center, Technology Solutions, National Marketing Organization and Marketing Services. Before joining the Bloom team, Whitney served as Vice President of Product Operations for Gorman Health Group. In that role, Whitney led the development and implementation of a suite of health care products. Whitney also has held multiple roles in finance, marketing and operations. She has a bachelor’s degree in finance from West Virginia University and an MBA and JD from the University of Denver. Contact Whitney at [email protected].

BROOKE IVEY is Sales Director at Bloom Marketing Group. She started as a sales agent on the phone at Bloom and worked her way up to become the leader of the business development team, both for technology and the contact center. Since 2007, Brooke has led the Bloom sales team to the successful submission of over 70,000 Medicare Advantage, Medicare supplement, Final Expense life, and dental insurance applications. She also oversees DentalInsuranceStore.com and leads Bloom’s new field sales compliance and management products, Ascend, and other business development opportunities. Contact Brooke at [email protected].

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About the Sponsors Atlantic Information Services, Inc.

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• HEALTH PLAN WEEK is the nation’s #1 source of timely, objective business, financial and regulatory news of the health insurance industry. Published since 1991, the 8-page weekly features valuable insights and strategies for health plan managers and others who must monitor the activities and performance of health insurers. Coverage includes new benefit designs and underwriting practices, new products and marketing strategies, mergers and alliances, financial performance and results, Medicare and Medicaid opportunities, disease management, and the flood of reform-driven regulatory initiatives including medical loss ratios, exchanges, ACOs and myriad benefit design changes that are mandated.

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This publication is designed to provide accurate, comprehensive and authoritative information on the subject matter covered. However, the opinions contained in this publication are those solely of the speakers and not the publisher. The publisher does not warrant that information contained herein is complete or accurate. The conference materials are published with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.

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Webinar Program• Introductions/Administrative Reminders

• Speakers’ Presentation

• 30-Minute Q&A Session

Webinar materialsHow Medicare Advantage Plans Can Successfully Navigate Go-to-Market Strategies for 2014 .........................................................................................................page 5

Presentation by Whitney St. Jean and Brooke Ivey

Selected AIS Articles ...........................................................................................................................page 27

Webinar outlinePart 1: Whitney St. Jean, Gorman Health Group, LLC, and Brooke Ivey, Bloom Marketing Group

• 2013 Agent/Beneficiary Survey Results

• 2014 Marketing Strategy and Planning

• Sales Optimization Strategies

• Finishing the Sales Continuum: Retention

Part 2: Questions and Answers

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HOW MEDICARE ADVANTAGE PLANS

CAN SUCCESSFULLY NAVIGATE

GO-TO-MARKET STRATEGIES FOR 2014

WHITNEY ST. JEAN

EXECUTIVE PARTNER

GORMAN HEALTH GROUP

JUNE 6, 2013

BROOKE IVEY

SALES DIRECTOR

BLOOM MARKETING GROUP

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Copyright © 2013, Gorman Health Group, LLC

• 2013 Agent/Beneficiary Survey Results • 2014 Marketing Strategy and Planning • Sales Optimization Strategies • Finishing the Sales Continuum: Retention

AGENDA

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2013 AGENT/BENEFICIARY

SURVEY RESULTS

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LESSONS LEARNED 2013

GHG Survey - From the Sales Agent’s Perspective

• Methodology o A web-based survey of:

• Marketing/sales health plan professionals • Sales agents

o Goal: Gain real-time insight of these different constituents during the heat of AEP

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LESSONS LEARNED 2013

GHG Survey - From the Sales Agent’s Perspective

• GHG Summary Survey Results o 64% of marketing professionals thought leads were

coming in as expected, 88% of sales agents did not o Top three sources of leads: Direct Mail/Postcards, TV and

Newspaper Run of Press (ROP) Ads o Direct Mail/Postcards showed the largest growth in

marketing leads during the last AEP

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Bloom Survey - From the Beneficiary’s Perspective

Lessons Learned 2013

Methodology

• A telephonic survey

• Beneficiaries polled who interacted with a telesales or field

sales rep during the last AEP to purchase a Medicare Advantage

plan

• Roughly 300 responders

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Bloom Summary Survey Results

• Keeping their physician was most important attribute identified by

more than 60% of respondents when selecting a plan (premium

amount was second)

• 86% of respondents prefer insurance company to communicate with

them by mail or phone

• 51% of the respondents said that use of a mobile device in

interaction with their sales agent would positively influence their

opinion of the agent

• Nearly 50% of responders preferred to purchase health insurance

somewhere else rather than with an agent in their home

Lessons Learned 2013

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2014 MARKETING STRATEGY

AND PLANNING

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2013 ANALYTICS

Driving 2014 Marketing Strategy and Planning

• Cost per lead/cost per sale trending and tracking • Make sure that your calendar starts before AEP • ROI still matters

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• Use Age-in as an opportunity to get new members and test the pulse of new material pre-AEP

• ‘Turning 65’ Campaign o Starting nine months from the prospect’s birthday o 6 months out, 3 months out and one month out

• Boomers are here for the next 20 years.

BEFORE AEP…

The Best Age-In Strategy

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MARKETING HAS CHANGED

Boomers are Still A Trend – Uniqueness is Important

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• Fall will be hectic for us and the consumers alike! • The ‘who’ needs to come before the ‘what’

o Seniors not one size fits all o Purchasing habits, lifestyle attributes & demographics

• Messaging needs to be unique so that the intended recipient knows it was for them

• Work to minimize cost per lead but maximize effect

CLUTTER WILL BE THE TREND IN 2014

Get Through the Exchange Clutter

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TIME IS OF THE ESSENCE

Timelines are Crucial

Jun Jul Aug Sept Oct Nov Dec

Benefits Filed

Marketing Materials

(Create, Submit & Print)

Sales

(License & Train)

Launch Successful AEP

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• Marketing ROI - Don’t Leave It To Chance • Unique 1-800 numbers • Online data capture • Scannable BRCs • Media optimization • Key performance metrics

o Lead volume o Cost per qualified lead o Cost per sale

PROJECTING OUTCOMES

By each identified media

BRC = business reply card

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TURNING MARKETING INTO

SALES: 2014 SALES

OPTIMIZATION

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• Easier = more confident = better sales

• You can’t manage what you can’t measure

o Real time reporting

o Dashboards for a nimble sales machine

• Don’t choose to be in the dark

o Before, during, after

The Role of Technology In Modern Day Sales

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• Multiple channels are vital

• Training/preparation excellence yields results

• Set expectations

• Measure

• Provide feedback and measurement data

EXPLOITING DISTRIBUTION TO ITS FULLEST

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• Tracking and reporting are vital

o Reporting from internal systems, CRM, etc- aggregated and usable

o Require it!

• Lead programs

o Protect your investment

o Good data lets you make changes

• Innovative technology options

o Warm Lead delivery

o Electronic scope of appointment

• Build sales best practices into your presentations

TIPS TO INCREASE CLOSE RATIOS

CRM = customer relationship management

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• Your call center is your friend

• The best use of your telesales center is…

• Best Practices

o Training and Resources

Go beyond the basics

Be specific

Empower and connect

o Meet the caller where they want to be met

• Scripting

Performance and compliance

Closing opportunities

Next steps

• Know when to walk away

TELESALES: USING YOUR CALL CENTER TO ITS FULLEST

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• Best Practices

o Concierge care beginning at the OEV/welcome call

o Specific data capture

o Monthly touches that are relevant

o Specific follow-up

o Community awareness matters

o Keep your promises

o Take time to explain

o Allow members to explain as well

FINISHING THE SALES CONTINUUM: RETENTION

OEV = Outbound Enrollment Verification

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• Your team members

o Training

o Empowerment

o Connection

• Consistency

o Brand

o Messaging

o Scripts

• Touchpoints and planning

PROACTIVE, ORCHESTRATED MEMBER EXPERIENCE

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WHITNEY ST. JEAN EXECUTIVE PARTNER

GORMAN HEALTH GROUP

303.349.4044

[email protected]

BROOKE IVEY SALES DIRECTOR 812.345.5472 [email protected]

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mailto:[email protected]

mailto:[email protected]

Copyright © 2013 by Atlantic Information Services, Inc. All rights reserved. Reproduction by any means — including photocopy, FAX or electronic delivery — is a violation of federal copyright law punishable by fines of up to $150,000 per violation.

Atlantic Information Services, Inc.

HNE Goes Heavily Into Marketing Its Five-Star CMS Quality RatingReprinted from the April 25, 2013, issue of AIS’s biweekly newsletter Medicare Advantage News. Call (800) 521-4323 for more information.

Health New England (HNE), which is the only Medicare Advantage prescription drug (MA-PD) plan in Massachusetts to have earned a five-star quality rating from CMS in both 2012 and 2013, has plunged into extensive marketing of those ratings to get MA enrollees, according to a recent conference presentation by a plan executive.

The experience, albeit involving a small MA plan sponsor with only 8,000 MA members in four western Massachusetts counties, furnishes evidence that some five-star plans are finding consumers are interested in and can understand star ratings sufficiently to merit a marketing campaign focused on that top rating. And since CMS permits five-star plans to market year round, while other MA plans may market product specifics only in a two-month fall period, this could start to have a significant impact in 2014 and beyond.

Springfield, Mass.-based HNE, which is owned primarily by provider Baystate Health, began its MA operations just in 2009, Jody Gross, director of government programs, told a session of World Congress’ Medicare Marketing & Enrollment Strategies 2013 conference in Lake Mary, Fla., last month. The plan was one of only nine MA-PDs to have earned a five-star rating for 2012 and one of 11 to do so for 2013.

The new stars marketing strategy, Gross said at the conference session, grew out of a competitive analysis HNE conducted and is in keeping with restrictions CMS places on how star ratings may be marketed (MAN 4/11/13, p. 4).

One decision that came out of that analysis, according to Gross, was to place HNE’s top star rating “everywhere.” He said this includes its website, newspaper ads, direct mail, en-velopes, pre-enrollment and post-enrollment kits, letters, television and radio ads, and even bills.

The new plan ratings become official in October, and HNE designs MA marketing cam-paigns in July to September, so that can result in a scramble to change campaigns based on the ratings, he continued. An effective campaign, he suggested, elicits emotions and the de-sire for the prestige associated with the top-rated MA plan.

So in print ads for its informational sessions late last year, HNE said in large type, “We’ve Got 5-Star Plans for You!” The same ad said below, “HNE Medicare Advantage is the only 5-Star overall rated plan for 2012 and 2013 in Massachusetts.” Another ad, titled “It’s Time to Get a 5-Star Plan,” quoted two HNE Medicare service specialists saying, “Our mem-bers get the added value of our 5-Star Service!” A third ad began, “Learn what it means to be a 5-star Member!”

Yet another ad touted the HNE plan’s ability to enroll year round by starting with “Take Advantage of Our Special Enrollment Period.” And one for informational sessions bore this message below the time-and-date specifics: “HNE is the only 5-Star overall rated plan for 2012 and 2013 in Massachusetts. This is Medicare’s highest rating for quality and performance.”

Sometimes in the ads, the five-star message was related to particular aspects of the plan, such as benefit design (“How does your Medicare Advantage Plan match up to HNE’s 5-Star

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Plans?” and services (“What does a 5-Star rating mean to you?”). And after the regular 2013 MA enrollment period ended last Dec. 7, HNE ran an ad that noted, “You can still enroll dur-ing the 5-Star Special Enrollment Period.”

HNE spokesperson Lynn Ostrowski, who is director, brand and corporate relations, declined to answer or make Gross available to answer MAN questions regarding the stars marketing campaign.

Contact Gross at (413) 233-3011 and Ostrowski at (413) 233-3383. G

Draft 2014 Marketing Guidelines Have Only Minor Changes vs. 2013Reprinted from the April 11, 2013, issue of AIS’s biweekly newsletter Medicare Advantage News. Call (800) 521-4323 for more information.

If there is a theme to the very limited number of changes included in the draft 2014 Medicare Advantage and Part D 2014 marketing guidelines that CMS released March 26, it may be that what CMS is finding as problems in plan audits is translating into specific new requirements for marketing. In particular, CMS has seen instances in which MA and Part D beneficiaries had difficulties with low-cost access to pharmaceuticals, so there are spelled-out mandates in the draft guidelines regarding communication of formulary and preferred-pharmacy information. Similarly, CMS has found problems in how plans are making the required outbound enrollment and verification (OEV) calls to new plan members, so there are new proposed restrictions on when and how those calls should be made.

That at least is what MA marketing specialists at consulting and direct-marketing firms tell MAN in interviews about the 119-page document. They generally agree with Rob Smith, vice president of Medicare sales and marketing at Independence Blue Cross, who says he didn’t see many substantive changes in the new draft guidelines that would alter the ways the plan markets.

Neither did consultant Betsy Seals, senior director of compliance at Gorman Health Group, LLC. But Seals does point to the OEV calls section of the draft guidelines as an indi-cator of what CMS is focusing on this time. Plan sponsors must make these calls, after either an independent or employed agent or broker is involved in the beneficiary’s enrollment ap-plication, to ensure that the beneficiary understands the plan chosen. Language mentioning employed brokers is new this time, as is a requirement that each of the three OEV calls spon-sors must make occur “on different days.”

Seals tells MAN that one apparent spur for the new language is that CMS found in audits that some plans were placing these calls one after another on a single day, thereby reducing the chances that a beneficiary not reached on the first one would be contacted on the subse-quent ones. OEV calls constitute “a big [compliance] risk area” for plans, she cautions. CMS also added proposed language in the OEV section stating that both the telephone script and the enrollment verification letter, which plans must send out if the first two OEV calls don’t connect with the beneficiary, specify time frames by which the beneficiary must notify the sponsor if he or she wishes to cancel the enrollment before it takes effect.

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The increasing focus on pharmacy, according to Seals, is occurring in the guidelines as it is in CMS audits because of the potential risks to beneficiaries if they don’t understand the pharmacy benefit or have access to the pharmaceuticals they need.

Preferred-Pharmacy Trend Leads to Changes

New language in the draft guidelines includes that “if the [pharmacy] network consists of preferred and non-preferred pharmacies, the sponsor must identify the preferred phar-macies and indicate that members may save on cost-sharing at preferred pharmacies.” As is the case with several other instances of added language in the pharmaceutical sections, the requirement here is not new, but there is a change in how it is being spelled out in the mar-keting guidelines. Another example is new language in the formulary section stating that “a sponsor may market enhancements (such as adding a newly available drug to the formu-lary), but not negative changes, to its formulary prior to receiving CMS approval.”

A more substantively new change relates to marketing by MA prescription drug plans that are assigned the Low Performer Icon (LPI) by CMS because they have had either Part C or D summary ratings below three stars for the past three years. Such organizations, CMS says in the draft guidelines, “must clearly indicate their LPI status” and explain what it means in any stars-related marketing, even if their overall rating is three stars or above. Seals says she is unaware of any LPI plan that has tried to mask its status in stars marketing, but the inclusion here suggests CMS may have gotten questions about such marketing.

This is the only significant change in the stars marketing section of the guidelines, ac-cording to Linda Armstrong, executive vice president and health insurance practice leader at direct-marketing firm DMW Worldwide. Similarly, she says, there is only one change in the section on use of studies or statistical data in marketing. CMS clarified that its restrictions on plans that mention a study apply not just to “informational scripts” but instead to all market-ing pieces.

Overall, Armstrong tells MAN, she is “not seeing anything major here at all…knock on wood” in terms of changes in the draft guidelines, and neither are her clients. Many of the modifications in some sections, she explains, are principally clarifications, although this could change in the final guidelines due out in June.

Contact Seals at (916) 838-0044 and Armstrong at (610) 407-0407. View the draft guidelines at www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/index.html?redirect=/ManagedCareMarketing. G

AEP Marketing Preview: More ‘Preheating,’ Star-Ratings Advertising Are Seen as LikelyReprinted from the Sept. 6, 2012, issue of AIS’s biweekly newsletter Medicare Advantage News. Call (800) 521-4323 for more information.

As the second year of the accelerated Medicare Advantage and Part D Annual Election Period (AEP) approaches, the early indications are that both MA plans and CMS itself are better prepared for the new environment than was the case a year ago.

Plan marketing executives and their consultants say they’re paying much more attention this year than last to “preheating” efforts that precede the Oct. 1 start of product-specific

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marketing. The goal is to get prospects to “raise their hands” as interested enough to war-rant plan follow-up once AEP enrollment for 2013 begins Oct. 15. The early efforts are necessary, they say, not only because this fall’s elections will complicate advertising and direct-mail efforts during the product marketing period (MAN 5/24/12, p. 1) but also because the indications are that MA plans will not impose major benefit changes for 2013, thereby making it hard to get current MA beneficiaries to switch plans.

There are some advantages, though, that MA plans have going into the season this year that they didn’t in last year’s first installment of the accelerated AEP (Oct. 15-Dec. 7 instead of the previous Nov. 15-Dec. 31) ordained in the health reform law. For one thing, the mar-keters note, beneficiaries now generally have heard and believe that they must decide on MA plans by 24 days earlier than was formerly the case. For another, some plan marketers and consultants tell MAN CMS has accelerated its response times for reviewing MA marketing materials and has become clearer about what it expects — although another disagrees based on a local experience.

Time appears to be everybody’s mantra heading into this MA marketing season. What used to be called “pre-heating” now is being called “engagement,” says, for instance, Scott Overholt, vice president and group account director for marketing firm Harte-Hanks. This is because MA sponsors realize that if they can get beneficiaries to in effect “opt in” before October to receive marketing materials beginning Oct. 1, the plans will have a much better chance of landing those persons as members. He predicts the percentage of marketing bud-gets shifted into that earlier period, when only non-product-specific messages are allowed, will be bigger this year, partly because MA plans are concerned they may not be able to get or afford the television ad time they want in October and early November because of the elections.

MA plans, Overholt tells MAN, might look to get 20% of their sales leads from this pre-AEP engagement period, a much higher percentage than a year ago, when the pre-October period just aimed at “awareness.” This time, “companies are trying to find out early who’s going to be shopping,” and it is those persons who’ll get the bulk of the attention during the AEP, he explains.

He also is recommending another change to MA plans, and it relates to the marketing media mix. “We’re advising people not to do postcards since that’s what politicos do” in an election season, Overholt says. The way to stand out in the mail this fall “is to be an envelope — it sounds goofy” but is necessary in 2012, he adds.

Overholt reports also developing contingency plans for putting freestanding inserts into newspapers that are prominent in MA plans’ service areas if the results of TV ads aren’t OK. The prime markets for getting MA prospects, according to Overholt, still are TV, direct mail and print, but he predicts “digital” will soar again this fall, albeit from a low point — per-haps accounting for nearly 10% of sales leads versus half that level a year ago.

Some Say CMS Review Times Shortened

Aiding MA plans in all their fall marketing efforts, he says, is CMS’s shortening of mar-keting materials review times. Overholt recalls that material in the past would need to be in before the middle of August, but now MA plans apparently can wait until later and still get a timely response from the agency, he asserts.

John Sowell, vice president of marketing for Windsor Health Plan, Inc., a multistate MA unit of Munich North America, also praises “positive changes” in CMS “turnaround time”

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and clarity about what it is seeking. Part of the improvements, he says, stems from MA plans learning what CMS wants, but another part is the agency working better with plans.

Like the others queried, Sowell anticipates relatively few significant benefit changes by MA plans, and notes that for the second straight year there are no major MA plans subject to CMS marketing and enrollment sanctions as they head into the main marketing period. So this puts a premium on “retention programs,” and Sowell tells MAN he expects to see more of them by MA plans this fall than last time.

Many plans tried to get out early with their messages last year, he says, but frequently they didn’t have success because the dates change “wasn’t yet real” in beneficiaries’ minds and because weak economic conditions helped lower responses to direct mail. This year, some of those factors have lessened, he suggests, and “we have to be visible with those reten-tion efforts” in the month MA members receive their Annual Notice of Changes (ANOC) document from the plan. CMS now requires ANOCs to be sent to beneficiaries by the end of September, which is when seniors will have begun to evaluate whether to shift to another plan, according to Sowell.

These efforts, of course, must compete with a “lot of noise” related to both the election and competitors, he explains, and it will be a “challenge” for MA plans to have their mes-sages received frequently enough, especially in October and November. While Sowell won’t disclose how “we’ve adjusted accordingly” to deal with that, he does say plans need to look at MA marketing this year in nontraditional ways and not, for example, be locked into the 60-second TV spots that have been the “cornerstone of MA.” The changes, he adds, could include shorter but more frequent spots and not “numbing” the marketplace with too much direct mail.

Stars Marketing Is Seen Growing

Like most others queried, Sowell says he expects CMS star quality ratings to be a “more important” factor in MA plan marketing this AEP than they were last time. He forecasts that star-related aspects “will permeate marketing messaging” for MA more than ever before and not just with overall plan ratings — which CMS now says must be mentioned along with any other star marketing a plan does — but also “individual areas of strength” in star scores.

Nevertheless, he adds, it has been more the satisfaction ratings than the star ratings that have been used in Windsor’s marketplace, which is mainly “underserved” rural and/or poor areas, and he’s not sure this will change in the coming AEP. Sowell says the research he’s seen indicates the only meaningful star-rating drivers for marketing success are for 4.5- and 5-star plans, which neither Windsor nor its principal competitors are.

Essence Healthcare, which has a 4.5-star rating in its principal service area (St. Louis), did begin stars marketing about a year ago and expects that to be a “featured” part of its marketing this AEP, says Andy Shea, senior director of marketing. Shea contends there is a “general underappreciation” of how important star ratings have become to Medicare benefi-ciaries, who generally understand the concept since they’re exposed to it in such other are-nas as restaurants and hotels. As the MA industry keeps getting “closer to parity” in benefits and payments, stars become more important, Shea tells MAN.

But stars constitute just one of the aspects Essence expects to plug this fall, according to Shea. Many MA plans appear to be “planning to be pretty aggressive on benefits” for 2013, partly in response to the MA medical loss ratios that begin in 2014 under the health reform law (MAN 5/19/11, p. 1). This requirement in effect will penalize companies spending less

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than 85% of their net premium revenue on anything other than medical care and quality improvement. The benefits Essence thinks CMS is likely to approve for its MA plans, he says, are “pretty aggressive” and “will surprise some competitors,” Shea adds, so that figures to be a selling point along with its local roots and stability for the Missouri and Illinois service areas.

Med Supp Customers Will Be Targeted

A perennial target of Essence marketing is Medicare supplement policyholders, and that figures to be the case again this fall, he suggests. He points to findings by Deft Research that at a $200 monthly premium such Med supp customers are willing to look elsewhere for cov-erage, and notes that in many areas Medigap premiums are approaching and even exceed-ing this amount, especially if prescription drug coverage is included.

However, Shea, like others, is concerned about the possibility of seniors again becoming reluctant to make changes if they hear too much about uncertainties regarding the future of Medicare or MA as the elections draw near.

Such concerns notwithstanding, about three-quarters of MA plans will have preheating campaigns this AEP versus perhaps one-half in the AEP for 2012, says Lindsay Resnick, chief marketing officer of KBM Group Marketing Services, based on what he’s seeing with that firm’s many MA clients. He attributes this partly to MA reaching the “mature market stage” with premiums and benefits being relatively level among plans, thereby making it harder to induce switches.

There are effective means to sell even in such a market, Resnick asserts, citing such means as predictive modeling to determine which kinds of beneficiaries are most apt to switch. He also predicts a big boost this fall in digital marketing, especially geared toward the baby boomers now aging in to Medicare. They’re a key MA prospect group that Shea also earmarked as a target and that can also be marketed to outside the AEP.

MA plans that are not among perhaps the biggest 15 in the nation are realizing “they can’t match the spending” on marketing of the “big dogs,” so there may not be a “signifi-cant” hike in overall spending on MA marketing this fall, he forecasts. Some clients, he says, instead are looking to “narrowcast,” so that they are mailing to a more targeted group of prospects than previously.

Contact Overholt at (215) 944-9605, Sowell at (615) 782-7938, Shea at (314) 209-2864 and Resnick at (314) 590-8376. G

UCare Finds That Stars Marketing Is Starting to Boost UnderstandingReprinted from the Aug. 23, 2012, issue of AIS’s biweekly newsletter Medicare Advantage News. Call (800) 521-4323 for more information.

A not-for-profit Medicare Advantage plan operator in Minnesota said it is beginning to have success marketing its high CMS star quality ratings to potential enrollees and is tailor-ing the media and messages about them to various segments of its audience, according to a top executive of the plan. And Ghita Worcester, senior vice president, public affairs and

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marketing for UCare, says its providers are helping to get the word out about the importance of the star measures.

Nevertheless, acknowledges Worcester in an interview with MAN, “the average con-sumer isn’t really looking for or understanding star ratings yet.” Partly with this in mind, she suggests, a portion of UCare’s strategy is to communicate the importance of star ratings in conjunction with preventive care.

UCare is a 28-year-old organization (formed by faculty members at the University of Minnesota) that is the parent of UCare for Seniors, a 4.5-star MA plan with more than 100,000 members in Minnesota and 26 counties of western Wisconsin. The organization also has a four-star MA Special Needs Plan (SNP) that serves more than 9,000 Medicare-Medicaid dual eligibles in a 57-county area of Minnesota as a participant in the state’s Minnesota Senior Health Options program.

In a presentation at the Star Ratings Congress for Medicare Advantage Plans, spon-sored by Global Media Dynamics, in Las Vegas last month, Worcester described UCare’s star ratings “communications strategy.” It is designed, she said, to raise awareness for both members and prospective members, and to “integrate the quality message across all com-munications channels.” She added that UCare seeks to draw a “connection between quality service and quality health outcomes.”

With this in mind, she continued, UCare educates members about star ratings and why they matter, seeks to “engage members in star ratings improvement initiatives” and pro-motes preventive care.

UCare Sees Need to Change Member Attitudes

The organization faces several challenges in doing this, Worcester tells MAN. For one thing, she explains, consumers see CMS’s Consumer Assessment of Health Providers and Systems (CAHPS) survey and preventive care in general as something for the health plan. UCare in its stars communications strategy needs to convey that this is about how the mem-bers themselves access and get care — “it’s not like buying a car,” she says.

Part of what UCare communicates involves print documents, including newsletter articles and messages from the CEO, plus an annual report for members that features its high star ratings. For prospects, notes Worcester, there are direct-mail brochures, includ-ing about preventive care, and sales-presentation materials. With the aid of those, UCare is “beginning” to see “a little more savvy consumer” in terms of understanding star ratings, but it will take numerous ratings cycles to foster good understanding and engagement, she suggests.

In light of this, she continues, its member advisory committee recently recommend-ed that a calendar of when preventive services should be obtained would be helpful to distribute.

For the SNP, Worcester adds, “you’re starting at a different point.” Sending flyers won’t work with much of this audience, so UCare for instance might focus on different media, such as a cable television program aimed at the area’s substantial Somali population (MAN 8/2/12, p. 8), she says. The organization seeks and obtains help from providers in fostering aware-ness of such efforts.

UCare also uses “hold” messages about its star ratings for customers telephoning its customer-service department, but Worcester points out that they are useful only for people

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calling in, and need to be supplemented with other phone and online efforts. The organiza-tion includes star-rating information on its website’s home and product pages and uses star-related data as a “core talking point” during sales and customer-service calls, according to Worcester.

As an additional outreach effort, UCare has morning radio drive-time messages this summer related to its high CAHPS rating in an effort to appeal to baby boomers.

Asked how the organization’s star-related communications efforts will be affected by CMS’s 2013 marketing guidance (MAN 6/21/12, p. 1), which includes requiring updates of star-related promotional materials within 15 days — instead of the previous 30 — of get-ting the 2013 star ratings, Worcester cites potential problems in getting the new information printed and incorporated in so short a time.

However, she stresses that the changes don’t affect UCare’s overall stars and preventive care communications strategy, and the new requirement to include the overall star rating if any individual-category ratings are used in marketing is in keeping with what UCare al-ready has done.

The organization, she says, conducts well-attended meetings throughout the year just to educate the community about Medicare in general and star ratings in particular. “We’re in that period of time when the eligible beneficiaries are still learning what is involved in star ratings,” Worcester asserts. UCare’s effort to communicate the relationships between stars and quality is important in that, she maintains, and also “it’s the right thing to do.”

Contact Worcester at (612) 676-3634 or [email protected]. G

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