the quest for member satisfaction
TRANSCRIPT
The Quest for Member SatisfactionWHY MEMBER SATISFACTION IS BOTH A PRIORITY AND A PUZZLE FOR HEALTH PLANS
icariohealthcom | goicariohealthcomConnecting people to health
Executive SummaryItrsquos been more than 20 years since the Centers for Medicare amp Medicaid Services (CMS) first began measuring member satisfaction among Medicare Advantage (MA) plans For nearly a decade since that time the Consumer Assessment of Healthcare Providers and Systems (CAHPSreg) has been an integral part of a planrsquos Star Rating
And even though CMS announced in early 2020 that plans donrsquot have to submit CAHPS data for 2021 Stars in light of the COVID-19 pandemic member satisfaction still matters for plans perhaps now more than ever
In mid-2020 CMS refined the Medicare Advantage Star Ratings system (and Part D Star Ratings) by giving CAHPS measures more weight in determining ratings Specifically CMS increased measure weights for CAHPS patient experience and access measures from 2 to 4 This change takes effect for the 2021 measurement year and will be reflected in the 2023 Star Ratings As a result of this change a plans bonus and rankings will becoming increasingly dependent on the member experience and improving member satisfaction and the overall experience has become a top priority for leading MA plans nationwide
However while member satisfaction is growing increasingly important for plans all too often the member experience is treated as an afterthought rather than seamlessly integrated into health plansrsquo DNA To stay competitive plans today need to prioritize the member experience and take a holistic approach to CAHPS and member satisfaction
TABLE OF CONTENTS
Executive Summary 2
The High Stakes of Low 4 Member Satisfaction
When satisfaction drops 5 retention follows
Happy members 7 = high HEDIS scores
Low CAHPS scores cost you 9
Why is Member 11 Satisfaction so Elusive
What exactly do your 12
members want
The link between 13 member satisfaction and engagement
5 Steps Plans Should 14 Take to Improve Member Experience
Icarios Proactive 15 Approach to CAHPS and Satisfaction
References 16
2025
2019 2021+CAHPS as a Percentage
of Star Ratings
icariohealthcom | 2
DID YOU KNOW Market research from JD Power shows health plans falling far behind other industries in the area of customer experience and Net Promoter Scoresmdashjust above cable companiesmdashwith little improvement over the past few years in plansrsquo ability to improve the customer experience 2
Net Promoter Scores by Industry
43
AutoDealers
36
Super-markets
31
Retailers
26
Banks
12
Utilities
3
Cable +Internet
18
HealthPlans
icariohealthcom | 3Connecting people to health
The High Stakes of Low Member SatisfactionThese days members are more discerning about the service they expect more savvy about their ability to switch plans and more likely to complain to othersmdashincluding on the CAHPS surveymdashif they are unhappy All of which can eventually impact a planrsquos Star Rating and bottom line Today plans that ignore their membersrsquo satisfaction do so at their own peril
Whats more during a pandemic when members are feeling more stress and isolation they may have higher expectations of their health plan and may be more critical of their plan if those expectations are not met How plans engage and interact with their members can greatly impact member satisfaction retention and overall health long term
icariohealthcom | 4Connecting people to health
Members in plans rated in the bottom 10 were
4x more likely to disenroll
than members in plans rated in the top 103
When Satisfaction Drops Retention FollowsResearch shows that CAHPS scores are a bellwether for voluntary disenrollment One study found that members in plans rated in the bottom 10 were four times more likely to disenroll than members in plans rated in the top 103
Another study painted an even more dire picture plans with poor ratings were nearly 12 times more likely to see high disenrollment compared to those with high ratings while those with poor customer service were about 45 times more likely to see high disenrollment than their peers4
Whats more a health plans Star Rating Measure C29 (Members Choosing to Leave the Plan) is publicly available data So its not difficult for members and potential members to determine how a plan stacks up against its competition in the area of member satisfaction and retention
icariohealthcom | 5Connecting people to health
18
2014
18
2015
19
2016
19
2017
21
2018
24
2019
28
2020
DID YOU KNOW
Increased Ease and Choice Make Switching Plans Easy
Switching health plans has become far easier for members in recent years In a 2018 survey of 1000 MA enrollees nearly 60 said they would consider switching their plans in 20195
One contributing factor MA members have a lot of choices In fact the average Medicare member now has access to 28 plans a steady increase since 2014 and the most since 20106
Members also have two opportunities to switch during the open enrollment period (OEP) and the annual enrollment period (AEP) And theyrsquore getting savvier about using both
In August 2018 just a quarter of MA members knew about OEP Deft Research the firm that conducted the survey predicted a resulting switch rate of 3 A short eight months later the percentage of members who knew about OEP more than doubled to 66 resulting in an estimated switch rate of 45 Deft predicts an even higher percentage of MA members who understand OEP in 2020 leading to an even higher switch rate7
Average Number of Medicare Advantage Plans Available to Beneficiaries 2010-2020
Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
icariohealthcom | 6Connecting people to health
Happy Members = High HEDIS ScoresAnother key reason for plans to focus on the customer experience health plans that provide better access and customer service also provide better clinical care and receive higher HEDIS scores9
The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of measures designed to identify the healthcare services provided and how they impact member health According to the National Committee for Quality Assurance (NCQA) 90 of health plans rely on HEDIS data to compare their performance with other plans
HEDIS scores help a plan gauge the quality of the care it provides members There are significant financial incentives for insurers if a score exceeds certain thresholds One reason that health plans with better access and service receive higher HEDIS scores could be that engaged and satisfied members are more likely to engage in programs designed to improve health outcomes
icariohealthcom | 7Connecting people to health
DID YOU KNOW
About 72 of All MA Members Belong to a 4+ Star-Rated Plan
The Majority of the Growth Today is Dominated by Four National Plans
Source Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
Distribution of Medicare Advantage Enrollees by Plan Star Rating 2015-2019
Medicare Advantage Enrollment by Firm or Affiliate 2019
icariohealthcom | 8Connecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
Executive SummaryItrsquos been more than 20 years since the Centers for Medicare amp Medicaid Services (CMS) first began measuring member satisfaction among Medicare Advantage (MA) plans For nearly a decade since that time the Consumer Assessment of Healthcare Providers and Systems (CAHPSreg) has been an integral part of a planrsquos Star Rating
And even though CMS announced in early 2020 that plans donrsquot have to submit CAHPS data for 2021 Stars in light of the COVID-19 pandemic member satisfaction still matters for plans perhaps now more than ever
In mid-2020 CMS refined the Medicare Advantage Star Ratings system (and Part D Star Ratings) by giving CAHPS measures more weight in determining ratings Specifically CMS increased measure weights for CAHPS patient experience and access measures from 2 to 4 This change takes effect for the 2021 measurement year and will be reflected in the 2023 Star Ratings As a result of this change a plans bonus and rankings will becoming increasingly dependent on the member experience and improving member satisfaction and the overall experience has become a top priority for leading MA plans nationwide
However while member satisfaction is growing increasingly important for plans all too often the member experience is treated as an afterthought rather than seamlessly integrated into health plansrsquo DNA To stay competitive plans today need to prioritize the member experience and take a holistic approach to CAHPS and member satisfaction
TABLE OF CONTENTS
Executive Summary 2
The High Stakes of Low 4 Member Satisfaction
When satisfaction drops 5 retention follows
Happy members 7 = high HEDIS scores
Low CAHPS scores cost you 9
Why is Member 11 Satisfaction so Elusive
What exactly do your 12
members want
The link between 13 member satisfaction and engagement
5 Steps Plans Should 14 Take to Improve Member Experience
Icarios Proactive 15 Approach to CAHPS and Satisfaction
References 16
2025
2019 2021+CAHPS as a Percentage
of Star Ratings
icariohealthcom | 2
DID YOU KNOW Market research from JD Power shows health plans falling far behind other industries in the area of customer experience and Net Promoter Scoresmdashjust above cable companiesmdashwith little improvement over the past few years in plansrsquo ability to improve the customer experience 2
Net Promoter Scores by Industry
43
AutoDealers
36
Super-markets
31
Retailers
26
Banks
12
Utilities
3
Cable +Internet
18
HealthPlans
icariohealthcom | 3Connecting people to health
The High Stakes of Low Member SatisfactionThese days members are more discerning about the service they expect more savvy about their ability to switch plans and more likely to complain to othersmdashincluding on the CAHPS surveymdashif they are unhappy All of which can eventually impact a planrsquos Star Rating and bottom line Today plans that ignore their membersrsquo satisfaction do so at their own peril
Whats more during a pandemic when members are feeling more stress and isolation they may have higher expectations of their health plan and may be more critical of their plan if those expectations are not met How plans engage and interact with their members can greatly impact member satisfaction retention and overall health long term
icariohealthcom | 4Connecting people to health
Members in plans rated in the bottom 10 were
4x more likely to disenroll
than members in plans rated in the top 103
When Satisfaction Drops Retention FollowsResearch shows that CAHPS scores are a bellwether for voluntary disenrollment One study found that members in plans rated in the bottom 10 were four times more likely to disenroll than members in plans rated in the top 103
Another study painted an even more dire picture plans with poor ratings were nearly 12 times more likely to see high disenrollment compared to those with high ratings while those with poor customer service were about 45 times more likely to see high disenrollment than their peers4
Whats more a health plans Star Rating Measure C29 (Members Choosing to Leave the Plan) is publicly available data So its not difficult for members and potential members to determine how a plan stacks up against its competition in the area of member satisfaction and retention
icariohealthcom | 5Connecting people to health
18
2014
18
2015
19
2016
19
2017
21
2018
24
2019
28
2020
DID YOU KNOW
Increased Ease and Choice Make Switching Plans Easy
Switching health plans has become far easier for members in recent years In a 2018 survey of 1000 MA enrollees nearly 60 said they would consider switching their plans in 20195
One contributing factor MA members have a lot of choices In fact the average Medicare member now has access to 28 plans a steady increase since 2014 and the most since 20106
Members also have two opportunities to switch during the open enrollment period (OEP) and the annual enrollment period (AEP) And theyrsquore getting savvier about using both
In August 2018 just a quarter of MA members knew about OEP Deft Research the firm that conducted the survey predicted a resulting switch rate of 3 A short eight months later the percentage of members who knew about OEP more than doubled to 66 resulting in an estimated switch rate of 45 Deft predicts an even higher percentage of MA members who understand OEP in 2020 leading to an even higher switch rate7
Average Number of Medicare Advantage Plans Available to Beneficiaries 2010-2020
Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
icariohealthcom | 6Connecting people to health
Happy Members = High HEDIS ScoresAnother key reason for plans to focus on the customer experience health plans that provide better access and customer service also provide better clinical care and receive higher HEDIS scores9
The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of measures designed to identify the healthcare services provided and how they impact member health According to the National Committee for Quality Assurance (NCQA) 90 of health plans rely on HEDIS data to compare their performance with other plans
HEDIS scores help a plan gauge the quality of the care it provides members There are significant financial incentives for insurers if a score exceeds certain thresholds One reason that health plans with better access and service receive higher HEDIS scores could be that engaged and satisfied members are more likely to engage in programs designed to improve health outcomes
icariohealthcom | 7Connecting people to health
DID YOU KNOW
About 72 of All MA Members Belong to a 4+ Star-Rated Plan
The Majority of the Growth Today is Dominated by Four National Plans
Source Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
Distribution of Medicare Advantage Enrollees by Plan Star Rating 2015-2019
Medicare Advantage Enrollment by Firm or Affiliate 2019
icariohealthcom | 8Connecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
DID YOU KNOW Market research from JD Power shows health plans falling far behind other industries in the area of customer experience and Net Promoter Scoresmdashjust above cable companiesmdashwith little improvement over the past few years in plansrsquo ability to improve the customer experience 2
Net Promoter Scores by Industry
43
AutoDealers
36
Super-markets
31
Retailers
26
Banks
12
Utilities
3
Cable +Internet
18
HealthPlans
icariohealthcom | 3Connecting people to health
The High Stakes of Low Member SatisfactionThese days members are more discerning about the service they expect more savvy about their ability to switch plans and more likely to complain to othersmdashincluding on the CAHPS surveymdashif they are unhappy All of which can eventually impact a planrsquos Star Rating and bottom line Today plans that ignore their membersrsquo satisfaction do so at their own peril
Whats more during a pandemic when members are feeling more stress and isolation they may have higher expectations of their health plan and may be more critical of their plan if those expectations are not met How plans engage and interact with their members can greatly impact member satisfaction retention and overall health long term
icariohealthcom | 4Connecting people to health
Members in plans rated in the bottom 10 were
4x more likely to disenroll
than members in plans rated in the top 103
When Satisfaction Drops Retention FollowsResearch shows that CAHPS scores are a bellwether for voluntary disenrollment One study found that members in plans rated in the bottom 10 were four times more likely to disenroll than members in plans rated in the top 103
Another study painted an even more dire picture plans with poor ratings were nearly 12 times more likely to see high disenrollment compared to those with high ratings while those with poor customer service were about 45 times more likely to see high disenrollment than their peers4
Whats more a health plans Star Rating Measure C29 (Members Choosing to Leave the Plan) is publicly available data So its not difficult for members and potential members to determine how a plan stacks up against its competition in the area of member satisfaction and retention
icariohealthcom | 5Connecting people to health
18
2014
18
2015
19
2016
19
2017
21
2018
24
2019
28
2020
DID YOU KNOW
Increased Ease and Choice Make Switching Plans Easy
Switching health plans has become far easier for members in recent years In a 2018 survey of 1000 MA enrollees nearly 60 said they would consider switching their plans in 20195
One contributing factor MA members have a lot of choices In fact the average Medicare member now has access to 28 plans a steady increase since 2014 and the most since 20106
Members also have two opportunities to switch during the open enrollment period (OEP) and the annual enrollment period (AEP) And theyrsquore getting savvier about using both
In August 2018 just a quarter of MA members knew about OEP Deft Research the firm that conducted the survey predicted a resulting switch rate of 3 A short eight months later the percentage of members who knew about OEP more than doubled to 66 resulting in an estimated switch rate of 45 Deft predicts an even higher percentage of MA members who understand OEP in 2020 leading to an even higher switch rate7
Average Number of Medicare Advantage Plans Available to Beneficiaries 2010-2020
Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
icariohealthcom | 6Connecting people to health
Happy Members = High HEDIS ScoresAnother key reason for plans to focus on the customer experience health plans that provide better access and customer service also provide better clinical care and receive higher HEDIS scores9
The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of measures designed to identify the healthcare services provided and how they impact member health According to the National Committee for Quality Assurance (NCQA) 90 of health plans rely on HEDIS data to compare their performance with other plans
HEDIS scores help a plan gauge the quality of the care it provides members There are significant financial incentives for insurers if a score exceeds certain thresholds One reason that health plans with better access and service receive higher HEDIS scores could be that engaged and satisfied members are more likely to engage in programs designed to improve health outcomes
icariohealthcom | 7Connecting people to health
DID YOU KNOW
About 72 of All MA Members Belong to a 4+ Star-Rated Plan
The Majority of the Growth Today is Dominated by Four National Plans
Source Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
Distribution of Medicare Advantage Enrollees by Plan Star Rating 2015-2019
Medicare Advantage Enrollment by Firm or Affiliate 2019
icariohealthcom | 8Connecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
The High Stakes of Low Member SatisfactionThese days members are more discerning about the service they expect more savvy about their ability to switch plans and more likely to complain to othersmdashincluding on the CAHPS surveymdashif they are unhappy All of which can eventually impact a planrsquos Star Rating and bottom line Today plans that ignore their membersrsquo satisfaction do so at their own peril
Whats more during a pandemic when members are feeling more stress and isolation they may have higher expectations of their health plan and may be more critical of their plan if those expectations are not met How plans engage and interact with their members can greatly impact member satisfaction retention and overall health long term
icariohealthcom | 4Connecting people to health
Members in plans rated in the bottom 10 were
4x more likely to disenroll
than members in plans rated in the top 103
When Satisfaction Drops Retention FollowsResearch shows that CAHPS scores are a bellwether for voluntary disenrollment One study found that members in plans rated in the bottom 10 were four times more likely to disenroll than members in plans rated in the top 103
Another study painted an even more dire picture plans with poor ratings were nearly 12 times more likely to see high disenrollment compared to those with high ratings while those with poor customer service were about 45 times more likely to see high disenrollment than their peers4
Whats more a health plans Star Rating Measure C29 (Members Choosing to Leave the Plan) is publicly available data So its not difficult for members and potential members to determine how a plan stacks up against its competition in the area of member satisfaction and retention
icariohealthcom | 5Connecting people to health
18
2014
18
2015
19
2016
19
2017
21
2018
24
2019
28
2020
DID YOU KNOW
Increased Ease and Choice Make Switching Plans Easy
Switching health plans has become far easier for members in recent years In a 2018 survey of 1000 MA enrollees nearly 60 said they would consider switching their plans in 20195
One contributing factor MA members have a lot of choices In fact the average Medicare member now has access to 28 plans a steady increase since 2014 and the most since 20106
Members also have two opportunities to switch during the open enrollment period (OEP) and the annual enrollment period (AEP) And theyrsquore getting savvier about using both
In August 2018 just a quarter of MA members knew about OEP Deft Research the firm that conducted the survey predicted a resulting switch rate of 3 A short eight months later the percentage of members who knew about OEP more than doubled to 66 resulting in an estimated switch rate of 45 Deft predicts an even higher percentage of MA members who understand OEP in 2020 leading to an even higher switch rate7
Average Number of Medicare Advantage Plans Available to Beneficiaries 2010-2020
Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
icariohealthcom | 6Connecting people to health
Happy Members = High HEDIS ScoresAnother key reason for plans to focus on the customer experience health plans that provide better access and customer service also provide better clinical care and receive higher HEDIS scores9
The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of measures designed to identify the healthcare services provided and how they impact member health According to the National Committee for Quality Assurance (NCQA) 90 of health plans rely on HEDIS data to compare their performance with other plans
HEDIS scores help a plan gauge the quality of the care it provides members There are significant financial incentives for insurers if a score exceeds certain thresholds One reason that health plans with better access and service receive higher HEDIS scores could be that engaged and satisfied members are more likely to engage in programs designed to improve health outcomes
icariohealthcom | 7Connecting people to health
DID YOU KNOW
About 72 of All MA Members Belong to a 4+ Star-Rated Plan
The Majority of the Growth Today is Dominated by Four National Plans
Source Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
Distribution of Medicare Advantage Enrollees by Plan Star Rating 2015-2019
Medicare Advantage Enrollment by Firm or Affiliate 2019
icariohealthcom | 8Connecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
Members in plans rated in the bottom 10 were
4x more likely to disenroll
than members in plans rated in the top 103
When Satisfaction Drops Retention FollowsResearch shows that CAHPS scores are a bellwether for voluntary disenrollment One study found that members in plans rated in the bottom 10 were four times more likely to disenroll than members in plans rated in the top 103
Another study painted an even more dire picture plans with poor ratings were nearly 12 times more likely to see high disenrollment compared to those with high ratings while those with poor customer service were about 45 times more likely to see high disenrollment than their peers4
Whats more a health plans Star Rating Measure C29 (Members Choosing to Leave the Plan) is publicly available data So its not difficult for members and potential members to determine how a plan stacks up against its competition in the area of member satisfaction and retention
icariohealthcom | 5Connecting people to health
18
2014
18
2015
19
2016
19
2017
21
2018
24
2019
28
2020
DID YOU KNOW
Increased Ease and Choice Make Switching Plans Easy
Switching health plans has become far easier for members in recent years In a 2018 survey of 1000 MA enrollees nearly 60 said they would consider switching their plans in 20195
One contributing factor MA members have a lot of choices In fact the average Medicare member now has access to 28 plans a steady increase since 2014 and the most since 20106
Members also have two opportunities to switch during the open enrollment period (OEP) and the annual enrollment period (AEP) And theyrsquore getting savvier about using both
In August 2018 just a quarter of MA members knew about OEP Deft Research the firm that conducted the survey predicted a resulting switch rate of 3 A short eight months later the percentage of members who knew about OEP more than doubled to 66 resulting in an estimated switch rate of 45 Deft predicts an even higher percentage of MA members who understand OEP in 2020 leading to an even higher switch rate7
Average Number of Medicare Advantage Plans Available to Beneficiaries 2010-2020
Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
icariohealthcom | 6Connecting people to health
Happy Members = High HEDIS ScoresAnother key reason for plans to focus on the customer experience health plans that provide better access and customer service also provide better clinical care and receive higher HEDIS scores9
The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of measures designed to identify the healthcare services provided and how they impact member health According to the National Committee for Quality Assurance (NCQA) 90 of health plans rely on HEDIS data to compare their performance with other plans
HEDIS scores help a plan gauge the quality of the care it provides members There are significant financial incentives for insurers if a score exceeds certain thresholds One reason that health plans with better access and service receive higher HEDIS scores could be that engaged and satisfied members are more likely to engage in programs designed to improve health outcomes
icariohealthcom | 7Connecting people to health
DID YOU KNOW
About 72 of All MA Members Belong to a 4+ Star-Rated Plan
The Majority of the Growth Today is Dominated by Four National Plans
Source Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
Distribution of Medicare Advantage Enrollees by Plan Star Rating 2015-2019
Medicare Advantage Enrollment by Firm or Affiliate 2019
icariohealthcom | 8Connecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
18
2014
18
2015
19
2016
19
2017
21
2018
24
2019
28
2020
DID YOU KNOW
Increased Ease and Choice Make Switching Plans Easy
Switching health plans has become far easier for members in recent years In a 2018 survey of 1000 MA enrollees nearly 60 said they would consider switching their plans in 20195
One contributing factor MA members have a lot of choices In fact the average Medicare member now has access to 28 plans a steady increase since 2014 and the most since 20106
Members also have two opportunities to switch during the open enrollment period (OEP) and the annual enrollment period (AEP) And theyrsquore getting savvier about using both
In August 2018 just a quarter of MA members knew about OEP Deft Research the firm that conducted the survey predicted a resulting switch rate of 3 A short eight months later the percentage of members who knew about OEP more than doubled to 66 resulting in an estimated switch rate of 45 Deft predicts an even higher percentage of MA members who understand OEP in 2020 leading to an even higher switch rate7
Average Number of Medicare Advantage Plans Available to Beneficiaries 2010-2020
Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
icariohealthcom | 6Connecting people to health
Happy Members = High HEDIS ScoresAnother key reason for plans to focus on the customer experience health plans that provide better access and customer service also provide better clinical care and receive higher HEDIS scores9
The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of measures designed to identify the healthcare services provided and how they impact member health According to the National Committee for Quality Assurance (NCQA) 90 of health plans rely on HEDIS data to compare their performance with other plans
HEDIS scores help a plan gauge the quality of the care it provides members There are significant financial incentives for insurers if a score exceeds certain thresholds One reason that health plans with better access and service receive higher HEDIS scores could be that engaged and satisfied members are more likely to engage in programs designed to improve health outcomes
icariohealthcom | 7Connecting people to health
DID YOU KNOW
About 72 of All MA Members Belong to a 4+ Star-Rated Plan
The Majority of the Growth Today is Dominated by Four National Plans
Source Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
Distribution of Medicare Advantage Enrollees by Plan Star Rating 2015-2019
Medicare Advantage Enrollment by Firm or Affiliate 2019
icariohealthcom | 8Connecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
Happy Members = High HEDIS ScoresAnother key reason for plans to focus on the customer experience health plans that provide better access and customer service also provide better clinical care and receive higher HEDIS scores9
The Healthcare Effectiveness Data and Information Set (HEDIS) is a set of measures designed to identify the healthcare services provided and how they impact member health According to the National Committee for Quality Assurance (NCQA) 90 of health plans rely on HEDIS data to compare their performance with other plans
HEDIS scores help a plan gauge the quality of the care it provides members There are significant financial incentives for insurers if a score exceeds certain thresholds One reason that health plans with better access and service receive higher HEDIS scores could be that engaged and satisfied members are more likely to engage in programs designed to improve health outcomes
icariohealthcom | 7Connecting people to health
DID YOU KNOW
About 72 of All MA Members Belong to a 4+ Star-Rated Plan
The Majority of the Growth Today is Dominated by Four National Plans
Source Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
Distribution of Medicare Advantage Enrollees by Plan Star Rating 2015-2019
Medicare Advantage Enrollment by Firm or Affiliate 2019
icariohealthcom | 8Connecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
DID YOU KNOW
About 72 of All MA Members Belong to a 4+ Star-Rated Plan
The Majority of the Growth Today is Dominated by Four National Plans
Source Jacobson G Freed M Damico A Neuman T A Dozen Facts About Medicare Advantage in 2019 Kaiser Family Foundation 20198
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
5 Stars
UHC26
Humana18
BCBS15
CVS (Aetna)
10
KaiserPermanente
7
Wellcare2
Cigna2
All otherInsurers
1962
2015
68
2016
67
2017
74
2018
72
2019
45 Stars4 Stars35 Stars3 Stars25 StarsNo Rating
Distribution of Medicare Advantage Enrollees by Plan Star Rating 2015-2019
Medicare Advantage Enrollment by Firm or Affiliate 2019
icariohealthcom | 8Connecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
Low CAHPS Scores Cost YouJust as higher HEDIS scores can benefit a health plan low CAHPS scores can come at a high cost You know that a poor CAHPS rating affects your overall Star Rating which in turn affects your bonus and your ability to capture new membersmdashitrsquos a continuous downward spiral So of course therersquos a cost to your plan at a macro level But what about the individual cost of losing a member
We worked with the actuarial and consulting firm Milliman to determine just thatndashthe value of a retained member and conversely the cost of a lost member Our work with Milliman and our internal research suggests that every member you lose is equivalent to a loss of about $6782 in gross profit over four years Can you afford that
X
Every member you lose
= $6782 in gross profit loss
over 4 years
icariohealthcom | 9Connecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
Why is Member Satisfaction So ElusiveItrsquos not easy being a health plan in todayrsquos environment After 40 years of managed care your customers have some entrenched perceptions of health insurance that you have to overcome
In addition too often the memberrsquos only interaction with the health plan is when something goes wrong mdasha procedure test or medication is denied Or they are hit with a deductible or co-insurance they werenrsquot expecting Or they try to call member relations and have to work their way through five prompts before reaching a real person Therersquos paperwork confusing language and the fact that health care is stressful enough these days
A 2020 JD Power study of commercial health plans revealed a serious member engagement problem among plans The study found that plans lack customer centricity overall with only 36 of plan members reporting that their plan acts in their best interest always or most of the time11
icariohealthcom | 10Connecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
73
would stay with the plan
82
would advocate for the brand
82
would consider the brand for their
next plan
So What Exactly Do Your Members WantIn a nutshell they want to feel appreciated respected and valued At least thatrsquos the finding from the 2019 Forrester Health Insurers Customer Experience Index which surveyed nearly 13000 US health plan members from 17 large health plans
A whopping 73 of those who felt respected said they would stay with the plan 82 would advocate for the brand and 82 would consider the brand for their next plan Yet less than half of those surveyed felt their plan ldquorespected them as a customerrdquo 14
Of the members who said they felt respected by their plan
icariohealthcom | 11Connecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
The Link Between Member Satisfaction and EngagementNumerous studies have tried to suss out why members leave health plans One key reason that arises regularly is satisfaction with the level of engagement and communication members receive from their plan
The 2020 JD Power study of commercial health plans found that proactive member engagement efforts by a plan can result in significant improvement in overall member satisfaction11 But many plans fall short in this area Another study found that fewer than 9 of Medicare Advantage plan members say theyrsquove experienced good information and communication from their plans11
At Icario our own research from working with nearly 15 million members is that they are often unhappy with how their plan communicates with them They are inundated with materials some of which can be difficult to understand and when they call their plan they report that they often feel ldquotalked down tordquo and that their concerns ldquowerenrsquot heardrdquo Forresterrsquos 2018 survey of health plan consumers found that only half rated their planrsquos communication skills as high15
icariohealthcom | 12Connecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
5 Steps Plans Should Take to Improve Member ExperienceWith nearly a decade of experience working with health plans to improve the experience of their members (and impact their CAHPS scores) we identified 5 key steps to any successful effort
Offer Convenience Make sure you offer your members the same level of service and convenience they have come to expect from other companies including online access to forms short phone wait times and a live agent during regular working hours
Communicate ClearlyExplain complex medical terms in plain language avoid clicheacutes idioms and slang and use design to help readability Above all donrsquot just tell members what to domdashtell them why it matters
Educate Your Members Provide accurate information and access to resources that your members may not even be aware of such as those you offer through community partnerships This also means anticipating potential member dissatisfaction and informing them what to do if they have a bad experience
Take Action to Address Their Concerns Mock surveys to identify unhappy members are helpful but are a waste of time and money if you donrsquot follow up and address the issues they raise Taking action based on the results of mock surveys helps you be proactive before the member receives that CAHPS survey to complete
Make the Experience PersonalYour members arent one-size-fits-all Your member engagement strategy shouldnt be either Amazon knows what kind of books they like you should you know what kind of messaging and which communication channels they prefer So be sure yoursquore using a multi-channel approach that includes email SMS phone calls IVR mail social media and in-person interactions This also means offering services that meet members individual needs
1
3 4 5
2
icariohealthcom | 13Connecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
Icarios Proactive Approach to CAHPS and SatisfactionTo stay competitive in the marketplace today health plans must make CAHPS and member satisfaction a priority
Icariorsquos Member Satisfaction Solution is designed to help health plans proactively address the most common sources of member dissatisfactionmdashand the Part C measures plans can address directly We begin by applying proprietary predictive analytics to identify the members who are unhappy or unengaged Then we proactively connect with them to keep them informed and engaged We remind them about the valuable benefits their plan offers We connect them with vital community resources And we let them know their plan cares about them
THE RESULT An improved member experience enhanced member satisfaction and a positive impact on CAHPS measures
icariohealthcom | 14Connecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health
1 Harris Insights amp Analytics L Harris Poll Only Nine Percent of US Consumers Believe Pharma and Biotechnology Put Patients over Profits Only 16 Percent Believe Health Insurers Do 2016 httpstheharrispollcomonly-nine-percent-of-u-s-consumers-believe-pharmaceutical-and-biotechnology-companies-put-patients-over-profits-while-only-16-percent-believe-health-insurance-companies-do-according-to-a-harris-pol
2 Kuhn B Zanotti A Why Improving Customer Experience Is So Hard In Healthcare mdash Merchant Medicine 2019 httpswwwmerchant medicinecommarketreport2019715why-improving-customer-experience-is-so-hard-in-healthcare Accessed March 10 2020
3 Lied TR Sheingold SH Landon BE et al Beneficiary reported experience and voluntary disenrollment in Medicare managed care Health Care Financ Rev 200325(1)55-66
4 DuGoff E Chao S Whats Driving High Disenrollment in Medicare Advantage Inquiry 20195646958019841506
5 Welltok Health for the New Senior Generation 2019Available at httpscdn2hubspotnethubfs415877Assetswelltok_medicare_survey_121818pdf
6 Jacobson G Freed M Damico A et al Medicare Advantage 2020 Spotlight First Look Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefmedicare-advantage-2020-spotlight-first-look
7 McDonald I 7 lessons learned from the 2019 Medicare OEP August 6 2019 httpswwwrisehealthorginsights-articles7-lessons-learned-from-the-2019-medicare-oep
8 Jacobson G Freed M Damico A et al A Dozen Facts About Medicare
Advantage in 2019 Kaiser Family Foundation2019Available at httpswwwkfforgmedicareissue-briefa-dozen-facts-about-medicare-advantage-in-2019
9 Schneider EC Zaslavsky AM Landon BE et al National quality monitoring of Medicare health plans the relationship between enrollees reports and the quality of clinical care Med Care 200139(12)1313-1325
10 Landon BE Zaslavsky AM Beaulieu ND et al Health plan characteristics and consumers assessments of quality Health Aff (Millwood) 200120(2)274-286
11 Power J Health Plans Have a Customer Engagement Problem JD Power Finds May 14 2020 httpswwwjdpowercombusinesspress-releases2020-us-commercial-member-health-plan-study
12 Monet V How health plan and provider interaction affect customer satisfaction for plans Beckerrsquos Hospital Review January 30 2017 httpswwwbeckershospitalreviewcompatient-experiencehow-health-plan-and-provider-interaction-affect-customer-satisfaction-for-planshtml Accessed March 10 2020
13 Merkle Merkle Releases Customer Experience Impact Report July 1 2019 httpswwwmerkleinccomnews-and-eventspress-releases2019merkle-releases-customer-experience-impact-report Accessed March 9 2019
14 Adams F The US Health Insurers Customer Experience Index 2019 ForresterSeptember 17 2019
15 Beaton T Customer Service is Primary Driver of Health Plan Satisfaction Health Payer Intelligence June 20 2018 httpshealthpayerintelligencecomnewscustomer-service-is-primary-driver-of-health-plan-
satisfaction Accessed March 11 2020
16 Elliott C h These Companies Have The Best Customer Service Fortune July 11 2018 httpswwwforbescomsiteschristopherelliott20180711these-companies-have-the-best-customer-service-heres-whya21b490b80a7
17 Merkle Merkle Releases 2020 Loyalty Barometer Report Reveals Need to Create Human Connections is Top Priority March 3 2020 httpswwwmerkleinccomnews-and-eventspress-releases2020merkle-releases-2020-loyalty-barometer-report-reveals-need Accessed March 10 2020
18 Humana Humanarsquos Go365reg Wellness and Rewards Program Announces Five-Year Impact Study Results August 6 2019 httpspresshumanacompress-releasehumanas-go365-wellness-and-rewards-program-announces-five-year-impact-study-results Accessed March 11 2020
With over 100 million+ member connections Icario is a health action platform that unites pioneering technology data science and behavioral insights to connect everyone to better health
Our mission is to make the world a healthier place one person at a time
icariohealthcom | goicariohealthcomConnecting people to health