The Importance of Being More Strategic in Attracting and Retaining Seniors

// By Paul Gauthier //

There are three unmistakable truths.

The first truth is that approximately 10,000 Americans turn 65 every day, making Medicare recipients the fastest-growing segment of the American population. The confluence of aging baby boomers, better lifestyle habits, and incredible advances in pharmaceuticals has resulted in 41.5 million American seniors today. This number is projected to grow to 84 million by 2050.

The second truth is that health plans and insurance companies are obsessed with capturing the turning-65 market. “New seniors” find their mailboxes stuffed with direct mail solicitations from Medicare Advantage and Medicare Supplemental plans, each promising extraordinary benefits and trying to “one-up” each other through price and value-added features. Open enrollment becomes a bonanza for television and radio stations airing commercials, social media advertising sees a dramatic spike in activity, and community forums, breakfasts, and seminars are almost unavoidable.

The third truth is that while all of this commotion takes place, many hospitals are sadly sitting on the sidelines and, in essence, have defaulted to the health plans the marketing to these “new seniors.” This is a strategic error of gargantuan proportions. Left to chance, patients run the risk of choosing a health plan the hospital is not contracted with. Such ill-advised and often ill-informed purchasing decisions can interrupt a patient’s continuum of care while denying the hospital the patient whose loyalty may have taken years to cultivate.

But it doesn’t need to be that way. Nor should it.

Given the marketing savvy and abundant resources of today’s health plans, providers can no longer just assume that patients “will find their way to us.” Today, it is more imperative than ever for providers to “own the relationship” with their patients as never before. But owning the relationship means having a proactive strategy for not just attracting new Medicare patients but—perhaps even more important—retaining current ones.

The idea of marketing to seniors is not new. For years, hospitals have designed clinical programs, educational seminars, and special collateral materials expressly for this targeted demographic. They’ve studied what works and what doesn’t when communicating with seniors relative to language, images, colors, and messaging. And smart hospital marketers have learned to dispel misleading stereotypes such as assuming that all seniors fall into one neatly packaged, homogeneous group, for they do not.

It is now time to put that knowledge and experience to work.

The avalanche of marketing materials new seniors receive from health plans is overwhelming, confusing, and conflicting, leaving many seniors no neutral place to turn for help or unbiased guidance. Such is particularly true for seniors who have existing relationships with doctors and hospitals, and whose number-one concern when turning 65 is making sure they have continued access to these trusted providers once they go on Medicare. For hospitals, that’s the time for action.

Rather than defaulting to the health plans to drive the bus, what hospitals should be doing is aggressively reaching out to these seniors turning 65 and reminding them of four facts crucial to their ongoing health and confidence:

• Every hospital and every doctor does not accept all insurance options or health plans.
• Insurers contract with Medicare annually and network affiliations change (as do benefits and co-pays).
• If a patient enrolls with a health plan directly, Medicare regulations greatly limit the hospital’s ability to communicate with that patient throughout the year regarding changes that may affect their care.
• If patients enroll with a health plan that their existing hospital does not accept, their relationship with their existing doctors will likely be in jeopardy.

Beyond simply providing this caution, hospitals need to furnish these new seniors with a resource that will help them sort through the maze and enroll in a health plan that makes these warnings a non-issue. Medicare.gov and various statewide health insurance benefit advisors (SHIBA) are sadly inadequate in this regard—for while they rate plans and provide information on price, that is where their assistance ends. There is still much left to chance, for both the patient and the provider.

The hurdle that individual hospitals or health systems face in becoming more actively involved in the selection progress is that regulations by the Centers for Medicare & Medicaid Services prohibit providers from steering patients toward a specific plan. But at the same time, HIPAA encourages providers to inform patients of insurance changes through education. What’s more, an increasing number of accepted quality standards outwardly embrace the idea of a provider supplying assistance to patients in securing insurance resources.

The good news is that there are now regulatory-compliant, independent resources—not owned or operated by any specific health plan—that can support hospitals, health systems, medical groups, and clinics in their patient-retention efforts. The competencies, services, and connectivity offered by these resources provide an important and often missing link between health care providers and consumers.

The most effective time to fortify that link is during the open-enrollment selection window when seniors, particularly new seniors, make their health plan decisions. To provide maximum value during that time, an increasing number of successful hospitals are partnering with an outside company to establish a toll-free helpline staffed with agents who can answer consumer questions on coverage options, provide evenhanded information on multiple plans, and assist patients in enrolling in a health plan accepted by their existing hospital and doctors. Doing so helps assure continuity of care, preserves the trusted relationship built up over time, and allows providers to retain market share they likely invested significant resources to cultivate.

Once established, hospitals can proactively promote this service to existing patients and other seniors in the community through any or all of the communication vehicles at their disposal, including:

• Establishing a direct link on their website
• Tapping into social media posts and/or advertising
• Pushing out emails to former patients soon to turn 65
• Sending traditional letters to former patients soon to turn 65
• Running articles in their community newsletter (online or hard copy)
• Having promotional materials describing the helpline available at the hospital (and/or in affiliated physician offices)
• Hosting informative seminars in conjunction with local insurance agents who can not only provide information but who are licensed to help seniors with the enrollment process
• Launching an assortment of creative joint marketing efforts between the hospital and the helpline service

Once these relationships are established between the senior, the hospital, and the helpline’s agent, these independent services can support ongoing patient communication throughout the year. They can, for example, provide an annual review of an enrollee’s Medicare coverage during the annual election period. Doing so assures that beneficiaries have the information they need to intelligently select a plan that best meets their specific needs, preferences, and budget. They can also serve as the “eyes and ears” in the marketplace and by doing so provide real-time advice from the patient’s perspective on what is most important to them regarding value and service.

Perhaps most important, these agents can communicate with the patient on compelling events and issues that may affect their care. For example, if contract termination between the hospital and a given health plan is imminent, the patient can be immediately directed toward another plan the provider is contracted with, rather than allowing the plan to deliberately assign the member someplace else. In this way, the service acts as a kind of safety net for both the hospital and the patient—making sure the provider retains its desirable book of business while, at the same time, assuring that patients make informed decisions on their ongoing health coverage.

Whether a hospital seeks more Medicare Advantage volume or more traditional Medicare/Supplemental market share, developing a solid “turning 65” program should be viewed as an indispensable part of its patient communication and population health management strategy. Doing so will reap enormous benefits both short-term and long-range, while further positioning the hospital as the “go to” health destination for seniors and others in the community.

Paul Gauthier is founder and chief executive officer for MedicareCompareUSA (www.medicarecompareusa.com), the nation’s leading independent resource in helping Medicare beneficiaries select a health plan that is accepted by their existing hospital and doctors.