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Healthcare Consumerism and the Role of Medicare Advantage Plans


Healthcare consumerism has been a much-talked about factor in healthcare provider and payer organizations for years. While the concept was slow to evolve, we’re now seeing the tipping point—when healthcare consumers (some prefer the word “patients”) are gaining more control over their health insurance as well as everyday health and wellness decisions.

In our world of improving healthcare engagement, consumer-centricity initiatives are typically focused on the four areas where healthcare is often lacking: 

  • Personalization: Providing experiences and flexible offerings tailored to individual needs
  • Access: Giving consumers access to convenient, most-appropriate care when they need it
  • Incentives: Offering rewards to healthcare consumers that will enable and encourage them to have a more proactive role in their healthcare choices
  • Innovation: Having plans in place to continuously improve and change … to solve for evolving consumer needs and expectations

In the payer world, Medicare Advantage plans have been on the forefront of meeting these demands for new ideas, flexibility and convenience.

Personalization is at the heart of Medicare Advantage plans

Early-market-entry Medicare Advantage plans took their commercial flexibility, focus on value and the idea of healthcare as a customer service industry to new levels, incorporating innovation and heightened personalization into their design plans. Others have followed suit, and consumers are taking notice. MA enrollment was around 22 million in 2019. And more MA developments have rolled out during the past year.

In 2019, CMS issued rules allowing Medicare Advantage health plans to offer more supplemental benefits that address the personalized lifestyle and care needs of enrollees. For example, plans can provide members with services such as structural home improvements (for better bathroom access, entry ramps, etc.), transportation to care visits and home-delivered meals.

Telehealth and digital health options are also being leveraged as a convenient form of care and care management access in MA plans. In fact, those plans recognized early on that digital services are critical to happy consumers, even in senior populations. Garnering health-checks and remote monitoring through smartphones, personal health devices and video chats are helping:  

  • Identify care issues before they become more serious
  • Remove costly trips to the doctor’s office, urgent care and ER
  • Patients receive on-demand and around-the-clock services no matter where they are located (original Medicare only offered this service to individuals who lived in rural areas)
  • Increase consumer satisfaction

MA plans have also embraced data-driven personalization. Predictive analytics are being used to achieve better high-risk population health management results. And improved member engagement programs are high on the priority list—including refining consumer preferences for communications channels, frequency and more.

Carenet Health has been working with Medicare Advantage plans since they were first developed as a market option. We’ve helped many of the top plans make personal and lasting connections that drive member loyalty and enrollment renewals. Learn more about our services and let us know if we can help your organization.