How to Score a Win-Win for Medicare Advantage Plans
Improving member satisfaction and reducing costs with full-service benefits
High member satisfaction is a key indicator of a quality Medicare Advantage plan.1 When reflected in CMS Star Ratings, high member satisfaction, often translates into: 2
1. Higher member retention
2. Improved health care outcomes
3. Quality bonus payments for Managed Care Organizations
“Many Medicare Advantage plan members have fixed incomes. By minimizing their out-of-pocket (OOP) obligations, along with combining excellent provider network access, we contribute to an integral part of increasing member satisfaction,” said Susan Taylor, Area Vice President for the Government Market Solutions team at VSP® Vision Care.
Taylor, working in collaboration with Strategic Retention Manager Kim Thomas, offers this solution for increasing member satisfaction for Medicare Advantage plans.
VSP routinely reduces members’ OOP expenses and increases member satisfaction with full-service benefit options for Medicare Advantage plans. A full-service model is a comprehensive vision plan where basic lenses (single vision, bifocal, trifocal) are covered-in-full, and the allowance is designated for frames and/or contact lenses. Cost of services, including lab fees, are held at a contracted rate, which is lower than usual and customary fees. This results in members having a lower OOP experience and higher member satisfaction ratings for Medicare Advantage plans.
Of equal importance is the fact that the lower contracted rates for exams and material lab charges, that come with the full-service benefit plan design, also help reduce costs for Medicare Advantage plan clients.
Reduced costs without compromising member health and satisfaction? Sounds too good to be true.
Yet it is true. The VSP Government Market Solutions team routinely collaborates across the business to analyze benefits utilization and claims experience to help Medicare Advantage plan customers understand the costs of an exam plus allowance benefit design versus a full-service plan design. Nearly always, the per-member per-month costs of a full-service plan costs less than the exam plus plan. One health plan customer that recently made the shift to a full-service plan design saved more than one million dollars in claims costs in the first year.
Increasingly, health plan customers that choose VSP as their vision care partner are electing the full-service vision benefit design. This is better for the member and better for the plan. That’s a win-win.
Contact us to schedule a free consultation with VSP
1 The Centers for Medicare & Medicaid Services (CMS) Fact Sheet.
2 Meyers DJ, Trivedi AN, Wilson IB, Mor V, Rahman M. Higher Medicare Advantage Star Ratings Are Associated With Improvements In Patient Outcomes. Health Aff (Millwood). 2021 Feb;40(2):243-250.