Medicare

We use census-tract and county-level analytics and Medicare Advantage–enrollment projections to determine growth opportunities for our clients. Using advanced analytics, we help inform competitive-product portfolios and marketing strategies to support organizations.

We drive end-to-end design (or redesign) of product portfolios using both publicly available Centers for Medicare & Medicaid (CMS) data and client-claims data—our actuaries work hand in hand with client teams to develop actuarially sound product designs. We also help clients refine their portfolios via consumer research and simulations.

We drive growth across enrollment sources by deploying next-generation engagement strategies, including proprietary analytics to prioritize outreach and develop customized journeys based on consumer microsegments and member-level preferences. We also support clients on building commercial-partnership strategies to improve age-in conversion.

We perform rapid diagnostics and benchmarking across marketing and sales to identify opportunities to improve conversion and cost effectiveness, deploy channel-level strategies to segment and prioritize brokers, improve internal-agent performance, optimize digital marketing and engagement, and build capabilities for continuous improvement.

We provide end-to-end support to improve risk-coding accuracy and completeness for Medicare Advantage payers and, ultimately, to improve patient care through better clinical documentation.

Offering seniors ever-improving quality-of-care and health outcomes is an imperative for Medicare Advantage payers. We deploy our proprietary Star-rating-performance diagnostic to identify priority measures and highest return-on-investment (ROI) interventions for near-term impact and resource optimization. We also work in partnership with clients to support the execution of initiatives to improve program governance and interventions using advanced analytics.

A large regional payer had a low age-in-conversion rate. We helped design and implement an age-in-conversion strategy across marketing and sales channels, improving the age-in conversion by three times and driving 20 percent improvement in agent productivity using best-fit product-matching analytics.

A not-for-profit plan across multiple states with a poor Star performance on Medicare Advantage plans sought our help in developing a rapid assessment of the program to improve performance. We worked hand in hand with the central Star organization to implement a defined set of initiatives and helped the client achieve a 6 percent gain in revenue over two years, with a revamped budget and governance model to sustain success year over year.

A large health plan embarking on a huge program to transform its growth sought our support in identifying the biggest value-creation opportunities and strengthening nascent capabilities. We developed an 18-month Medicare-growth transformation and helped the client build a full, end-to-end, digital product-match personalization tool, leading to higher conversion rates and an increase in members.