Medicare Advantage

Medicare Advantage AEP is almost underway are you working towards creating the proper Member Experience for newly enrolled members?

Posted by admin_user

As soon as the summer weather turns and fall begins all Medicare Advantage healthcare companies have finalized their marketing strategies, and have begun their execution, all in preparation for the busiest time of year…AEP. BUT… Now that the member enrollment plan is complete it is time to shift your thinking towards creating an exceptional member experience. Since Sales and Marketing have worked so hard acquiring new members it is of the utmost importance to create a proper member engagement strategy in order to keep them enrolled in your plan for life! This engagement strategy needs to be based on the demographics on your members. Members like communication but they definitely don’t like over communication.


As seniors continue to age into Medicare the number of eligible enrollees that have a smart phone and access to the internet is increasing considerably. Therefore, your communication methodology must incorporate, phone calls, mail, email, social media, text messages and in-person community events. It is extremely important to determine the preferred communication method of your member base. Once you understand the communication methods you can implement a touch point strategy. These strategies can be geared towards increasing the members’ health and wellness education, ensuring that they are staying healthy and out of the hospital, and fully understand all the plan benefits and tools that are available to them.


Some member engagement touch point ideas are:

Welcome Call

Welcoming the member to your plan, answering questions, reviewing benefits, completing HRA, assigning primary care physician, scheduling annual wellness visit.

Closing Gaps in Care

Scheduling the necessary annual screenings that can reduce the risk of long term health issues and hospital stays (Blood Pressure, Cholesterol, Breast Cancer, A1C, Colorectal, MA and more.)

Medication Adherence

Contacting members to discuss their medications, refill prescriptions, complete mail order re-fills, conferencing in clinical telephonic staff members.


Calling members to review the annual changes within their healthcare coverage.


Some items to remember when creating these touch point efforts:

Ensure that these communications are coordinated internally so different areas within organization aren’t duplicating efforts.

Always attempt to combine reasons for calling so you can cut down on the number of members’ communications (i.e. Welcome Call/HRA, Closing multiple gaps per call).

Make all of your communications easy to understand and following and are approved by CMS (i.e. font size, scripting).

Understand your member base, ask them for feedback on the various communication methods. Hold focus groups. Talk to your members!

When calling your members make sure you limit the amount of attempts, and understand the time of day that you call and day of the week.

A proper member engagement strategy can have a huge positive impact for your members and for your health plan.


Some of the benefits of member engagement are:

Increase STAR Rating

Improve Member Health and Health Awareness

Increase PMPM Reimbursement Rates

Increase Compliant Members (medication adherence, screenings, and close gaps in care).

Decrease Operating Costs

Call AXION CONTACT Today at 833-201-7044 to learn more about our customized member engagement strategies and how we have helped other health plans improve their STAR rating!

Axion Contact, a healthcare services company, is the only solution you need!

Leave a Reply