MedicareCompareUSA Warns Hospitals and Physicians to
Plan Now for “Painful Payer Disruptions”

(BELLINGHAM, Wash. – March 10, 2020) — One of the healthcare industry’s leading authorities on securing and protecting the patient-provider relationship is warning America’s hospitals and physicians to have a plan and strategy in place to combat “painful market disruptions” when payer contracts change.

“Over the past few years, we’ve seen a tremendous uptick in mergers and acquisitions, narrowing of health plan provider networks, plans vacating markets that aren’t profitable, and plan terminations when contract negotiations collapse,” said Kerri Lenderman, CEO of MedicareCompareUSA. “While such changes are troubling to the patient and threaten their continuity of care, they cause significant organizational disruption and distress to the affected hospital or medical group as well. The very real possibility of losing patients and important revenue to an insurer that has provided necessary coverage and developed member trust is painful for providers. Hospitals and medical groups need to prepare for these compelling events by having a strategy in place that allows them to protect and retain patients during marketplace upheavals.”

Lenderman says that this is especially true when it comes to the Medicare population, an audience to whom Medicare Advantage plans aggressively and continuously market. “Health plans have honed their marketing tactics in their attempt to retain membership during contract terminations,” said Lenderman. “It’s time for hospitals and physicians to level the playing field by deploying effective communications and insurance counseling support as a way to protect patient relationships.”

As the nation’s leader in its space, MedicareCompareUSA currently supports more than 600 hospitals and health systems nationwide who collectively care for more than 10% of the nation’s Medicare population. Its sister company, MCUSA Consulting, assists major hospitals and health systems with Medicare Advantage contract terminations by supporting communications and coordinating agency support for patients affected by Medicare Advantage contract terminations. Based on this road-tested experience, Lenderman offers eight tips to providers committed to retaining Medicare patients when health plan disruptions occur.

  1. Engage in regular communication with patients, especially those aging into Medicare, so patients get accustomed to receiving important health insurance information from their provider, not just from their health plan. Waiting until a contract termination occurs is too late to begin positioning as a trusted advisor.
  2. Establish a Medicare insurance helpline so patients have a trusted go-to resource throughout the year—and especially at times of contract termination—that can provide critical information and support for coverage and continued access.
  3. Once it is clear that a contract termination is imminent, launch an aggressive communication campaign that clearly explains where and how to get insurance help rather than letting the health plan reassign the patient to an alternate network provider.
  4. Make sure that all 65+ patients understand that most hospitals and physicians do not contract and accept all insurance options. If a patient enrolls with a health plan that their providers do not accept, their care and provider relationships will be in jeopardy.
  5. Develop a referral relationship with a Medicare brokerage organization that represents the health plans you accept and has a demonstrated track record of supporting hospitals and physicians. Some patients have a Medicare broker, but the vast majority of patients do not have an unbiased resource to compare your accepted Medicare plans. Having this resource in place will be critical when a contract termination occurs, and patients need to switch health plans.
  6. Deploy a digital communication strategy, including updating your website, to engage and inform patients.
  7. Develop an internal employee communications program to ensure that hospital and physician staff know where and how to direct patients seeking assistance.
  8. Partner with an outside resource experienced in developing and implementing these important regulatory-compliant communication strategies.

“Through foresight, planning and implementing a smart strategy with the right business partner, hospitals and physicians are finding a successful formula to protect and retain market share even under the most trying of circumstances when health plan relationships crumble,” said Lenderman.

With its strong foundation and impressive track record, an increasing number of hospitals and doctors are looking to MedicareCompareUSA and its sister company, MCUSA Consulting, as an indispensable part of a proactive patient-communication and population-management strategy.

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