The Medicare Advantage Onboarding Process

TL;DR:

• McKinsey survey data shows MA enrollees are not getting a great onboarding experience
• Devoted Health provides an example of what good can look like in the process
• There’s probably a gap between what enrollees think they’re getting and what payors think they’re providing

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McKinsey shared a new report last week surveying 600+ Medicare Advantage beneficiaries about their enrollment experience that is worth perusing. The most striking data from our perspective came in the paragraphs below (and associated chart in the article) on how few MA beneficiaries receive basic onboarding components:

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According to our survey, many Medicare beneficiaries found the onboarding process lacked many elements that could augment their experience. Sixty-six percent received details on their plan, care, and coverage in the mail; smaller percentages received this information through other means. Fifteen percent reported not receiving it at all.

Beyond basic plan information, only 19 percent said they were asked to complete a health assessment, and just 5 percent reported that they were asked about their social needs. Less than 10 percent of members noted that their plan helped them enroll in additional benefits or arranged an in-home provider visit. These results suggest that payers, brokers, and others in the Medicare ecosystem have an opportunity to design and implement a more thorough onboarding process and to improve the member onboarding experience.

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The McKinsey report does a nice job highlighting the opportunity to leverage the onboarding process for MA plans, particularly around the opportunity to drive people to annual wellness visits as well as improved STARS scores (member experience metrics matter more in STARS moving forward).

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But what’s interesting in this is: what kind of plans are people signing up for that don’t do any of these things? It seems like a pretty basic operational process to implement to hit on a number of these elements.

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Let’s take a look at Devoted Health’s onboarding process to give some insights here on what good can look like from an onboarding perspective. We picked Devoted as they do a nice job outlining their onboarding experience in broker materials. Here’s their onboarding flow as outlined in broker materials this year: 

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For a plan like Devoted, it appears they’re attempting to provide most, if not all, of the activities outlined above in the McKinsey study. Members get:

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• A welcome text 
• Receive a Welcome Kit (see below for a screenshot of the kit) 
• A follow-up text asking if they have any care needs like DME
• A Welcome phone call

Additionally, in its broker materials, Devoted tells brokers that it will pay them $50 for a Health Risk Assessment that is completed within 5 days, which Devoted uses to: “match members with Devoted Health services like managing medications, controlling chronic conditions like diabetes, or getting settled at home after a hospital stay.”

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That actually seems like a quite reasonable onboarding flow that Devoted is implementing, and one that should cover off on the elements that McKinsey surveyed above. This leads me to believe one of two things are happening in the space (presuming that McKinsey’s survey sample is representative of the general MA population):

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• Most plans aren’t as sophisticated as Devoted in their onboarding process
• Patients don’t realize all of the things their MA plans are trying to do during onboarding

I imagine both of these things are actually true - Devoted is a particularly competent plan, and there are a number who aren’t nearly as competent. But you can also see how Devoted might have members saying they didn’t complete an HRA, because Devoted is paying brokers to complete those HRAs on a member’s behalf. Couple that with other less competent plans, and it's not hard to imagine that there are a number of plans trying to reach out to members during onboarding but doing so unsuccessfully. 

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