Aug
26
Written by:
Peter Rodes
8/26/2011 12:09 PM
Each and every year Medicare Advantage star rating program rules have changed in an attempt to continually increase the quality of care to Medicare beneficiaries. In this latest round of revisions, long overdue SNP specific metrics are being added as well as other clinical metrics. The new details on potential star rating changes came from Liz Goldstein, Ph.D., director of CMS’s Division of Consumer Assessment & Plan Performance, in the Part C & D User Group Call July 27.
However, the addition of the retention metric is the one that I predict that will receive the most attention from health plan Sales and Marketing executives.
Over the past 12 months, we have been working with a number of leading health plans to help them improve their member experience across the lifecycle… from new member on-boarding, accessing care and renewal. The goal has been to increase member engagement and thereby improve star ratings while also boosting retention rates.
In these leading plans, a great deal of emphasis has been placed on member retention. It has always made good business and financial sense to “fix the leaky bucket” rather than having to replace them through an expensive new business acquisition process. Now, CMS has raised the stakes by including the disenrollment metric as part of the star rating.
Despite the evolution of the star program, our counsel remains the same. Adopt the continuous quality improvement mentality: understand your current customer experience and always be working to improve it. To help you with that journey we recommend the rigorous adoption of direct marketing discipline in all communications to include: member targeting to improve relevancy and timing, clear communication with a calls to action, and timely response measurement. Or, as one of the legends of direct response market puts it, “acquire with the intention to retain, and retain with the intention to grow.”
To find out more information on how retention affects Star ratings, contact KBM Group’s Peter Rodes at Peter.Rodes@kbmg.com. Also, don’t forget to ask for a copy of Peter’s recent exclusive Webinar entitled, “Three Key Points for More Profitable Healthcare Member Relationships”.