Tailoring Supplemental Benefits to Enhance Dual Member Retention

Over the past decade, enrollment in Dual Eligible Special Needs Plans (D-SNPs) has exhibited steady growth, nearly doubling in the past five years. This growth presents new market opportunities for Medicare Advantage Organizations (MAOs). However, a recent survey estimates that 30% of dual eligibles are switching plans over the course of a year.

So, how can payers capitalize on this growing market and improve retention rates? The answer lies in tailored supplemental benefits.

Tailored Supplemental Benefits

Medicare Advantage (MA) and D-SNP beneficiaries often have complex healthcare needs that require customized solutions. Tailored supplemental benefits are crucial in meeting these needs and insurers are leading the way by aligning benefits with individual health circumstances. This improves the well-being of the member and anchors the member to the plan in the long run.

Flexible Technology Architecture

With the growing need for tailored supplemental benefits, many health plans have concerns about the ability of their systems to manage the increased volume and variability of the data and the increased workload on resources. Product Management systems helps alleviate such concerns by providing the single source of truth for product data that health plans need to personalize the Dual Member experience. Advantages offered by such systems include:

• Flexibility to identify, configure, and deploy products that include complex data such as VBID and other optional/mandatory supplemental benefits.
• Automation to identify the best fit plan, tailor it to meet the specific needs and preferences of the Dual Member and create a tailored set of benefits.
• A central data repository so MAOs can have the vast library of supplemental benefits but with data that is organized, accurate, and easily accessible.
• Integration across the organization, ensuring seamless and accurate communication from what is sold to claims and member service, eliminating manual data transfer bottlenecks.
• Scalability to ensure that the benefits provided can expand without compromising quality or efficiency.

In an era where the healthcare industry is witnessing transformative changes, one thing remains constant – the need for quality care, especially for Medicare Advantage and D-SNP beneficiaries. The shift toward more comprehensive and individualized healthcare solutions for these beneficiaries has never been more critical, and the key to achieving this lies in recognizing the importance of supplemental benefits and harnessing the power of product management technology. Insurers who invest in such software gain the ability to customize, adapt, scale, and address the critical social determinants of health, thus contributing to member acquisition and retention. As the industry continues to evolve, those who embrace this technology are poised to lead the way in providing the best care to the beneficiaries who need it most.