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Effective Methods to Retain your Medicare and Medicaid Members

Posted, by Rachel (Merkin) Welt on 06/15/2021
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As Medicaid and Medicare program administrators begin planning the ensuing year’s member programs, there is an increasing need to focus on member experience in order to maintain member populations and raise retention rates within provider networks.

Repercussions of not providing quality care 

Members are savvier when choosing provider networks than ever before. Both Medicare and Medicaid members are empowered to do significant research online before selecting doctors and committing to provider networks. Often, if members commit to a network, and don’t receive the care they expect, they feel more compelled to move to a different hospital or care network covered by their plan. Not meeting member expectations could range from the level of general outreach and education they receive from the hospital network or could be as specific as interactions with individual doctors that don’t feel supportive of the member’s health goals.

For provider networks that cover Medicare and Medicaid members, patient attrition represents a real risk to the network both in reputation and revenue. With the rise of public, patient-driven doctor review sites, the more negative reviews of a specific practice or network, the higher the potential for prospective members and existing patients to leave and choose a better-rated network. Additionally, the higher the patient attrition rate, the less federal funding the network receives, making annual budgeting less predictable. Conversely, provider networks that maintain a healthy patient retention rate, may depend on federal funding to support patient programming throughout the year, helping to promote patient retention over the long term.

According to MedicareCompareUSA, Medicare members may face increased health plan disruptions in the near term. Disruptions, like those caused by mergers and acquisitions among Medicare plan providers, don’t have to mean a disruption in care for members. If provider networks are proactive in their outreach to members about the plans they cover and how those change year over year or how plan-level disruptions will affect patients, the provider network has a unique opportunity to position itself as the members trusted advisor. The provider network can help steer members to obtain plans the provider network accepts, help navigate the members’ plan adjustment, and help members maintain continuity of their care throughout that often confusing and stressful process.

Medicare and Medicaid member engagement and retention

While patient engagement may seem like less of a priority than hospital rankings and doctors’ reviews, the comprehensive education of Medicare and Medicaid members about their often complicated plans and coverage is critical to long-term patient retention. According to Optum, 30% of Medicaid members disenroll from their program completely each year, simply because they don’t understand their benefits.

This lack of education presents a unique opportunity for provider networks and their administrative teams to educate members not only on Medicaid and Medicare benefits but also to educate members on the unique benefits of using their plan with your hospital network. The opportunity for differentiation in care and coverage can be significant inpatient experience, engagement, and long-term retention.

As part of any engagement effort for patients who take desired actions, carrot incentives are a great addition to the program and a great entry point for patient engagement. Small incentives given at the time of action, like attending preventive care appointments, and both scheduling and attending key diagnostic appointments can be compelling events for patients in creating a positive association not only with a healthy lifestyle but with your hospital network particularly.

Patient engagement goes beyond doctors’ appointments. Provider networks should strive to create healthy ecosystems for patients. This includes education about their program benefits, how to maintain a healthy lifestyle, preventive care for their chronic conditions, and additional touchpoints so that patients are not just hearing from the network for appointment reminders. Provider networks should become a pillar of the member’s regular health routine.

Using rewards in your member retention strategy

Choosing the right rewards for patients is important. Rewards like gift cards not only create memorable moments but can be used to help patients build the foundation of a healthy lifestyle. Gift cards create distinct experiences for the recipient which provider networks can funnel toward health-conscious brands like Home Chef, CVS, and others. This way, members are getting rewarded, and the networks are supporting their mission to keep members healthy.

Our technology, Engage2Reward, makes it simple for healthcare providers to incentivize patients to attend doctor’s visits and engage in healthy behaviors. With Engage2Reward, providers can instantly send their gift card selection with a customized message to a mailing list and reward healthy behaviors.

The other key component to selecting the right rewards for your member engagement initiatives is always budget. Gift card-based reward programs can fit into any program budget since gift cards come in a wide variety of values. Gift cards also provide the flexibility to adjust values based on patients’ goals, allowing provider networks to give higher value gift cards for more difficult or higher effort tasks, and smaller rewards for easier-to-achieve patient goals

Providing quality care is the baseline for retaining Medicare and Medicaid members within a hospital network. In order to proactively prevent patient attrition, creating engagement opportunities between appointments and incorporating rewards to create a positive association with your organization is key to success.

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Topics: medicaid patient retention, medicare patient retention, patient retention, medicaid rewards

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