How to Prepare for Medicare Advantage Open Enrollment to Capture More Members and Revenue

This article was updated on 9/22/2023.

The Medicare Advantage open enrollment period is fast approaching. Let’s take a look at where America stands with the plan and how its growth is shaping the future for health plans.

Recently, a report on Health Affairs states that Medicare Advantage, which is responsible for Part A (hospital insurance) and Part B (medical insurance), is on course to cover 69% of the federally-administered Medicare population by 2030. Furthermore, Medicare Advantage enrollment has tripled since 2009 and doubled since 2014, with approximately 31 million Americans now enrolled.

This substantial portion of the population will need help navigating the coverage options that plans offer. Meanwhile, healthcare providers will need help joining a Medicare Advantage network and understanding its various regulations. For health plans or insurance companies, it’s important to take two specific actions as Medicare Advantage Plans begin to dominate and reshape the future of healthcare.

1. Appeal to new Medicare Advantage customers.

Health plans will need to shift their focus to administering Medicare Advantage Plans, which will include helping individuals sign up for coverage during their open enrollment periods. People seeking Medicare coverage options will want to know what exactly plans offer and the out-of-pocket costs they’ll have to pay. By putting a plan in place for administering Medicare Advantage, health plans can be ready to meet more of their members’ needs in a timely and efficient manner.

Part of the plan should include acquiring new members. Because people can choose to switch plans during open enrollment, health plans may experience dips and peaks in their customer base during this period. Having a plan to gain new Medicare Advantage members (and their associated revenue) can help streamline the process so customers transition into the program smoothly, also eliminating some of the aforementioned dips. Staff must obviously have a solid grasp of what a plan offers and its key benefits, but they must also have the skills to enroll new customers, and provide them with positive experiences.

Health plans offering Medicare Advantage Plans can also bundle the customers they cover to provide additional coverage features such as dental, vision, and wellness. Innovating and making the plan’s extra coverage features more appealing than those of competitors can help attract new members. Many seniors, for instance, are looking for customizable plans they can adapt to fit their needs, but plans must be enticing due to the crowded marketplace where once-novel features are now commonplace. Learning where coverage is needed and shaping health plans to fit that need is critical.

2. Find new staff who understand Medicare.

Because Medicare Advantage Plans are overtaking other plans in popularity, it’s important for companies that offer health plans to Medicare recipients to have experienced talent who understand how Medicare works and what plans cover. The right individuals can help organizations acquire more plan members and effectively manage their current customer base.

In general, individuals working for health plans must be motivated and high-energy to handle the fast-paced environment that accompanies many medical roles. Talent must also be compassionate and caring, as the customers needing help may be struggling. While some of the hard skills necessary are obvious, including having basic knowledge of the space, analytical skills, and technical skills, some of the soft skills or traits hiring managers might look for in a team member include:

  • Communication skills
  • Organizational skills
  • Time management skills
  • Attention to detail
  • Flexibility and stability

Partner with a specialized staffing company.

Many organizations can benefit from working with a staffing partner who has a pre-vetted talent pool of experienced and skilled candidates, including licensed sales agents who know the space. The staffing firm could also provide the company with access to administrative and clerical personnel who are familiar with the nuances of Medicare and Advantage Plans. For example, due to the recent Centers for Medicare & Medicaid Services decision on overpayment, some health plans may need staff who can ensure that billing is correct, and overpayment fees are handled promptly so that they don’t interfere with bookkeeping and accounting. The right staffing partner can help you find the talent you need to successfully plan for and navigate the Medicare Advantage boom, particularly during the upcoming open enrollment season.

In healthcare, we’re accustomed to constant changes, whether it’s new regulations, talent shortages, or technological advancements. Medicare Advantage is yet another impetus for change, and it’s one that directly affects your members. It has caused health plans to pause, pivot, and steer in different directions. One thing is certain: The better you understand the types of plans which appeal to members and the better your team is prepared to sell them and enroll them, the more likely you are to create a win-win. With open enrollment looming, the time is now.

Read more in our guide here: How Health Plans Can Prepare for a Rise in Medicare Advantage Enrollment.

Or, contact us today to prepare for the rapidly-approaching open enrollment period, which can have a major impact on your members and revenue.

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