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Increase Your Medicare Advantage Plan Star Rating with Customer Experience Member Lifecycle Management

Your Medicare Advantage Plan Star Rating is critical because a rating of 4.0 or higher results in eligibility for quality bonus payment (QBP) reimbursement, with plans rated 5.0 receiving the largest bonuses. Increasing your Star Rating can significantly boost overall revenue and profit, with an additional win that improved member satisfaction can help improve retention.

While there are many strategies for improving your Star Rating, focusing on Customer Experience can be a strong and fast path to boosting your rating.

Why Does Customer Experience Matter So Much for Medicare Advantage Plan Star Ratings?

The Centers for Medicare & Medicaid Services (CMS) changed their quality score methodology in 2020, putting heightened emphasis on Customer Experience. By 2023, Customer Experience, which is determined by the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys, will represent 57 percent of the Star Rating, up 25 percentage points from 2020.

With Customer Experience driving more than half of the Star Rating, it’s a massive lever than can either hurt or help, and thus it’s worthy of your intense focus.

But it’s also important to recognize that Customer Experience is not the same as Customer Satisfaction.

As stated by CMS: “Patient experience surveys focus on how patients experienced or perceived key aspects of their care, not how satisfied they were with their care.”

Customer Satisfaction, which typically would measure how pleased your members are with the care they received, is not what will impact your Star Rating. Instead, it’s how your members perceive your plan, and the accompanying service they receive, that will be measured by Customer Experience.

This means that, even if they didn’t get the health outcome they hoped for from a course of treatment, they may still be pleased with how your plan supported them throughout the process.

How is Your Members’ Perception of Your Medicare Advantage Plan Formed?

Your Medicare Advantage plan has many components and service points that touch your members throughout their healthcare journey, and their cumulative positive and negative experiences form your members’ perceptions.

Unfortunately, members can have widely differing expectations, and therefore it’s impossible to know the criteria by which each member is measuring their Customer Experience.

A specific plan offering or service experience can please one member, while disappointing another.

Or, one member may weigh a single factor heavily in forming their overall perception, while another member considers that same factor trivial.

While these dynamics pose a significant challenge, there is a strategy that can help consistently reinforce a strong Customer Experience perception across your member base.

Member Lifecycle Management: A Strategy for Strengthening Customer Experience for Medicare Advantage Plans

A strong membership lifecycle management program can have a significant positive impact on your members’ Customer Experience and overall perception of your plan, and therefore can improve your Star Rating.

While there are various definitions of member lifecycle management for service businesses, one that’s particularly applicable to Medicare Advantage plans identifies three stages of the member lifecycle: attract, engage, and retain.

  1. Attract, also known as acquisition, is the process of marketing to prospective members and converting them to enrolled members. Consistently adding new members is the primary way to increase your revenue over time, therefore this stage is critical to your long-term growth.

  2. Engage is the most complex and opportunity rich stage, as it’s focused on getting your existing members to actively embrace all the facets of your plan that are beneficial to them. A strong engagement program will help your members recognize and appreciate the value they receive by being members, and they’ll likely rate their Customer Experience high.

  3. Retain is keeping as many members from year-to-year as possible. While there will always be turnover, some of which you cannot control, the members you retain are the foundation of your plan’s future revenue and profit base. For Medicare Advantage plans it’s almost always less expensive to retain members than it is to attract new ones.

Each of these three stages present many opportunities for enhancing touch points with prospective and current members.

For instance, during the attract stage, your plan has an opportunity to highlight and reinforce unique features and benefits you offer versus your competitors, in order to win over new members.

During the engage stage, you can create a plan with deliverables that are designed to encourage certain member actions that allow them to maximize the benefits of your plan, like taking advantage of covered screenings and vaccines.

Finally, in the retain stage, you can remind members of the incredible benefits they received throughout the current plan year, and highlight next year’s new features, to create a fear of missing out if they were to leave for a competitor’s plan.

While there are many options in creating a Member Lifecycle Management program, most can be expensive and time consuming, or require many months or even years to see positive movement in your Customer Experience scores.

But there is an approach that can be deployed quickly and inexpensively.

How to Create a Member Lifecyle Management Program to Maximize Customer Experience at Every Stage

Implementing a proven, well-thought, and successfully executed member lifecycle management program can maximize your members’ perception of your plan across all three lifecycle stages. At each stage members may have a different focus in terms of what will enhance their Customer Experience, and a successful program will consider this evolving focus.

The core of a member lifecycle program that delivers results is a communication plan that’s personalized to each member’s behaviors and needs. Members will be most pleased when they receive communication that makes their overall Customer Experience better.

To achieve this requires both relevance and great timing.

The member data you gather, starting from the very first touch point, can help you create a responsive experience that reflects a member’s needs and preferences, and then enables you to communicate at just the right time.

With a responsive communication cadence framework in place, a powerful strategy that’s proven to amplify Customer Experience gains is to include relevant and attractive rewards and incentives, at key touchpoints, in order to reinforce members’ strong perception of your plan.

Rewards and incentives can be a highly cost-effective way to quickly improve your members’ Customer Experience.

But success requires you to choose carefully, as some rewards and incentives, like gift cards, can be too costly, a poor fit for some members’ needs, or difficult to execute.

Entertainment® Delivers Proven, Cost-Effective Medicare Advantage Plan Member Lifecycle Management Programs that Maximize Customer Experience

For over a decade, Entertainment Rewards & Incentives has worked extensively with dozens of healthcare clients to generate strong Customer Experience results with our Healthy Living Rewards programs.

Our rewards and incentives help your members feel:

  • Informed and educated
  • Engaged with all facets of your plan
  • Digitally activated and savvy
  • Appreciated and supported
  • Healthier and happier

Our customized programs, which can be seamlessly integrated into your existing communication channels and digital platforms, are designed to support your plan growth objectives, as well as the three phases of the Member Lifecycle:

  • Incentivize acquisition and retention
  • Enhance membership engagement and overall Customer Experience
  • Encourage proactive behaviors for health and wellness
  • Incentivize registration, email capture, and opt-ins
  • Drive traffic to your website
  • Increase plan revenue and profit

What makes Entertainment unique is that we are able to create a comprehensive, highly effective program at a fraction of the cost of gift card and other incentive programs.

In fact, we can provide an entire Member Lifecycle incentive and rewards program for as little as $5 per member, per year, and deliver the entire program in as few as 30 days.

The key to our success is that the foundation of all our rewards and incentive programs is a large and unmatched savings network,  filled with offers that are especially valued by senior citizens, many of whom are on fixed incomes.

Our programs, which can be customized to your specific needs, are optimized for each stage of the Member Lifecycle so that relevant rewards and incentives will surprise and delight, as well as motivate your members to take specific actions.

We can deliver our incredible offers using online, mobile, card-linked offers, and print. 

Through our Healthy Living Rewards program, we offer a wide range of deliverables, all of which can include targeted and curated discount offers, including:

  • Printed welcome and launch booklets
  • Printed calendars
  • Member birthday cards
  • Printed customized coupon books, valid for 12-18 months
  • Direct mail focused on new member acquisition during annual enrollment
  • Customized health screening and medication adherence communication and incentives, print or digital
  • Medicare booklets including tips, education, and personalized health goals
  • Newsletters, print or digital
  • Customized materials to support in-person and virtual events
  • A private-label, hosted, mobile responsive site that provides 500,000+ high value discounts, across North America, so your members can save on everyday expenses like dining out, services, shopping, activities, travel and more

And we have the resources to project manage and execute every program detail, big and small, so that you can focus what you do best, which is to deliver a great Medicare Advantage plan!

Reach out to us today so we can leverage our extensive healthcare expertise to help you reach your Star Rating, revenue, and profitability goals, while delighting your members with best-in-class savings on things they do every day.