OEP Winners Credit Year-Round Marketing, Outreach

Medicare Advantage enrollment grew just 1% during the 2021 Open Enrollment Period (OEP) that ran from January to March, compared with growth of 7% during the preceding Annual Election Period (AEP), according to AIS’s Directory of Health Plans (DHP). While the large MA insurers continued to nab the bulk of OEP signups (see infographic, p. 7), an AIS Health analysis finds that of the top 25 OEP performers, regional players followed their AEP successes with OEP gains that were impressive relative to their size.

AIS Health asked some of the top 25 OEP performers what they did differently, if anything, this past year to retain members and attract new enrollees. In addition to enhancing their product portfolios, plans that deployed a year-round multichannel marketing approach and embraced digital capabilities to stay in touch with members during the COVID-19 pandemic appeared to be winners during both the AEP and the OEP.

Alignment Healthcare Founder and CEO John Kao says the Orange, Calif.-based company has focused on “three key growth avenues.” They are: (1) growing membership in existing markets; (2) adding new contiguous markets in existing states; and (3) establishing foothold markets in new states. “These service area expansions were complementary to our strong growth in our existing markets, which was driven by expanding our provider relationships and introducing new, innovative products,” asserts Kao. The insurer this year moved into new markets across California, Nevada and North Carolina and has said it is pursuing a “national expansion strategy” that it will put into action next year.

Kao also attributes innovation to membership growth, drawing on the examples of existing offerings — like the ACCESS On-Demand Concierge black card or Grandkids On-Demand companion care — in addition to the launch of an “ethnically diverse product called Harmony (HMO) to meet the specific needs of the Asian community” and expanded provider partnerships.

AmeriHealth Caritas Family of Companies credits its open enrollment successes to “a broad range of strategic tactics that had not been previously implemented for these plans or that were utilized to a greater degree,” according to a spokesperson. These included a combination of television advertising, direct mail campaigns and digital outreach to reach eligible populations within the plans’ geographic footprint, as well as ongoing sales efforts and broker outreach.

Healthfirst, New York’s largest not-for-profit health insurer, launched a new zero-premium MA plan that offers personalized benefits. Members could choose one of the following: a $35 quarterly over-the-counter (OTC) allowance for covered items including food, a $0 dental deductible, or 12 one-way trips to visit doctors, hospitals or pharmacies. This was also the second year in a row that it was the only Medicare HMO in its market to earn a 4-star rating from CMS.

According to Jen Cohen-Smith, senior vice president for Medicare at Healthfirst, the plan’s open enrollment successes were largely driven by its “hyper-local business model.”

“We were heavily engaged in our communities and have the ability to identify and mobilize towards market disruption,” Cohen-Smith tells AIS Health. “For nearly 30 years, Healthfirst has worked with its network of hospital systems, community providers, and partners to improve health outcomes through better access to care — especially in underserved communities, and this was especially important during the pandemic.”

Where there were winners, there were losers, and DHP identified 10 plans with OEP losses ranging from 450 to 2,067 members. Only three of those plans — Golden State Medicare Health Plan, EmblemHealth and Central Health Plan of California — also lost membership during the AEP. Several plans — including SCAN Health Plan, Highmark Health and Blue Cross Blue Shield of Michigan — made big gains during the AEP and remained in the top 20 insurers overall.

Deft Research’s Executive Vice President George Dippel suggests that for many AEP “non-switchers” who made a move during the OEP, “it had to do with plan changes they never realized.” MA Prescription Drug plan “formulary changes or network changes sometimes aren’t realized via the traditional [annual notice of coverage]; they are realized after a trip to the pharmacy or to the doctor in early January,” he stated in a research brief on Deft’s OEP study.

© 2024 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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