What's unique about the Medicare Advantage plans top-rated by members? 5 executives explain

How do the top-rated plans for Medicare Advantage member satisfaction keep members happy? Simplifying healthcare, going above and beyond in customer service and offering strong basic benefits, executives told Becker's. 

Most Medicare beneficiaries can choose between dozens of Medicare Advantage plan options, and nearly half will disenroll from their current plan within five years, according to a study in JAMA Health Forum. 

Becker's asked leaders at four of J.D. Power's top rated Medicare Advantage plans for customer satisfaction in 2023 how they approach customer service, care outcomes and more. Here's what they said: 

Karen Bodley, vice president of Medicare at Excellus Blue Cross Blue Shield, said the plan views members as partners and tries to address their health holistically. 

"One of the things that makes us unique is our employees live and work in the same community where our members live and where our members are seeking services," Ms. Bodley said. "So when we're designing solutions, we're all familiar with the intricacies of our communities and the intricacies of our local healthcare systems." 

Medicare Advantage members place a high value on supplemental dental and vision coverage, something Excellus has heard loud and clear from its members, Ms. Bodley said. 

"There's a lot of plans, including ourselves, that are looking at different types of supplemental benefits, whether it be nutrition benefits, transportation, things of that nature," she said. "I think those are things that can be attractive to populations within Medicare, but not necessarily ranking quite as high as some of the more traditional benefits on the dental and vision side, that it seems like this population is really looking for when they're shopping for plans." 

One key to meeting members expectations is finding ways to help with challenges that might not be directly within a health plan's control, Ms. Bodley said. 

"For example, if there was an access issue, somebody's having trouble making an appointment. Maybe that's not specifically about the health plan, but it is a health plan member," Ms. Bodley said. "It's something that the health plan needs to take the next step to be able to help remediate that particular issue for a member. So as things become more complex in general, that can change [members'] expectations of what we need to do to be able to meet their needs." 

Angela Perri, chief Medicare officer at UPMC Health Plan, said the plan is focused on value-driven service. 

"We really empower our people to be service-oriented in what we do. Unlike others — I've worked at many other health plans and Fortune 100 companies in my career — we don't have things like our customer service that have to be off the phone in under a minute. All of our staff are Pennsylvania-based," Ms. Perri said. 

Older adults want opportunities to engage with their plan digitally and to connect through the phone and face-to-face. 

"It used to be that most seniors really were telephonically driven and not so digitally driven. We had a lot of assumptions as an industry, pre-pandemic. The pandemic really changed that." 

Medicare Advantage members are also looking for clear, straightforward answers to complicated questions, Ms. Perri said. 

"Our number one goal is to always operate in that service mindset, but also operate with integrity and telling the truth. 'Here's what this means' — as best we can explain and provide in our print materials, through our member services, and just answer their questions as best we can," she said. 

Manda Sanders, vice president of Medicare Advantage retention at Highmark Health, said that member experience is the plan's driving motivation. 

"What we've built up over time is the ability to listen to our members at regular intervals, throughout the year through different ways, solicit their feedback, and really listen to them and use that to help us develop plans, service, processes that make it a really good experience for our members. It's not based on what we think they want or need, it's based on what they're telling us they want or need," Ms. Sanders said. 

Medicare Advantage members strongly value customer service and human interaction, Bill Rayball, vice president of government quality at Highmark, said. 

One example of this high-value service, Mr. Rayball said, is connecting a customer who calls about a billing issue to a cancer screening they may be due for or a primary care provider in the same phone call. 

"Really going above and beyond the reasons for the call in the first place, to make sure the call is member-centric, thinking about the whole member, rather than just the particular reason they called that day," Mr. Rayball said. 

The healthcare industry is complex, and it's a challenge to try and simplify it, Ms. Sanders said. Highmark is working on ways to help members better understand their benefits and how to use their health plans, she said. 

"We want to help our members learn how to use digital tools, which have real value to members, but there's a learning curve, especially for audiences who maybe haven't been using digital tools most of their lives," Ms. Sanders said. "I would say there are challenges, but I think we at Highmark view them as awesome opportunities to try to find new ways to get our members better informed and better engaged with their healthcare." 

Karen Schulte, president of SCAN Group's Medicare division, said SCAN has the advantage of being completely focused on only Medicare Advantage plans. 

The plan considers themselves experts in aging, Ms. Schulte said. 

"We want to make sure we're there to support people, whether it's their first fall, or the death of a spouse. Those are the things we think of, I think that because we are focused just on the Medicare population, it affords us the ability to do that," she said. 

Care has evolved beyond visiting a physician's office, and this means Medicare members have become "more savvy and demanding" of health plans, Ms. Schulte said, to make sure they understand their needs. 

"Now it's, is [care] going to be in a physician's office? Is it going to be in the home? Is it going to be telephonic, video, is it after hours, on weekends? So it's really making sure that we offer a multidimensional care delivery portofolio. It's urgent care, it's regular care. It's really meeting the members where they are, and staying up with those needs," she said. 

Her best advice? Listen to members and get back to basics. 

"Provide benefits and services that provide healthcare, not just those bright shiny things that attract people like the squirrel over here, but really, truly providing healthcare. Healthcare is what we're called. Let's provide it," Ms. Schulte said. 

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