Differentiating On Outcomes With Medicare Advantage Populations

How an approach to unlock member and business value can drive higher retention and acquisition.

Healthcare Perspective

The following report draws on the results of two North Highland-sponsored surveys conducted in October 2018. 

Open Enrollment Research

100 consumer respondents from California, Florida, New York, and Texas were surveyed in October 2018. Respondents were all aged 65 and older and were participating in health plan open enrollment at the time the survey was conducted. Survey questions gauged the experiences, challenges, and influencing factors in health plan selection.

Industry Beacon Research

100 cross-functional decision-makers in Healthcare Payor organizations with annual revenues in excess of $1B were surveyed in October 2018. Survey questions gauged leadership sentiment, priorities, and strategic planning focus for 2019.

Key Takeaways 

  • The problem: As value-based care raises the stakes on delivering quality and value, payors and providers alike are sharpening their focus on improving outcomes with members and patients while deploying preventive health strategies to keep members and patients engaged and out of the doctor’s office.
  • The analysis: To stand out in this environment, payors have an opportunity to differentiate by solving for both member experience and cost challenges with their Medicare Advantage plans.
  • The solution: Focusing on the recent momentum in the Medicare Advantage (MA) market, we offer an examination backed by primary and secondary research of how payors can design MA offerings to differentiate on the quality and outcomes that a value-based world necessitates. Our approach zeroes in on the following critical considerations: 
    • Identify and build partnerships with key industry players.
    • Deliver value beyond the premium.
    • Connect data for holistic insights.

As value-based care raises the stakes on delivering quality and value, payors and providers alike are sharpening their focus on improving outcomes with members and patients while deploying preventive health strategies such as wellness programs and educational tools to keep those members and patients engaged and out of the doctor’s office. By reading this report, you will learn how new payment models, emerging delivery methods, and evolving customer expectations are catalyzing change in response to critical cost and quality-related challenges in the healthcare industry. As disruption accelerates, patients are playing a defining role in shaping the future of healthcare. 

We’ve developed the following piece for growth-minded executives leading large payor organizations. Focusing on the recent momentum in the Medicare Advantage (MA) market, we offer an examination backed by primary and secondary research of how payors can design MA offerings to differentiate on the quality and outcomes that a value-based world necessitates.

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