Medicare Advantage Growth Analytics

Shifting consumer behavior, evolving regulations and nuanced market dynamics raise the stakes for sales and marketing teams to innovate. MA plans also must win broker mind share and differentiate themselves in a commoditized market.

Many MA plans use more art than science to make critical growth decisions such as market expansion, benefit design updates and marketing budget allocation. Plans need to learn from other industries and use data and analytics to make key growth decisions.

The competitive MA market has eroded distinctiveness among health plans. Many now offer features and benefits that often are differentiated only by pricing and network options. MA plans must cut costs while adding attractive supplemental benefits.

Regulatory changes related to the Star Ratings program, including an increased emphasis on member experience measures, and continuously increasing benchmarks present significant challenges for MA plans to maintain and improve their quality scores.

Determine which geographies to enter and simulate enrollments based on predictive modeling. Identify emergent trends in those geographies and model how expansion will perform against the expected competition.

Design a differentiated benefits package by understanding its competitiveness, alignment with market trends and customer needs. Using ML-based models, simulate plan performance for different benefit design scenarios.

Maximize broker engagement with advanced modeling with different data types, including agent, enrollment, benefits and social drivers of health data.

Simulate budget scenarios and estimate marketing impact to make objective spending decisions and optimize multichannel budget allocations.

Use data and analytics to maximize Star Ratings by prioritizing underperforming measures and analyzing performance drivers for individual measures. Run a successful program with targeted interventions and real-time performance monitoring.

Overhaul AEP dashboards to reduce the time to insights, provide a next-best-action recommendation with each insight and formulate a clear structure for your teams to follow through. Estimate the impact of actions via what-if scenario modeling.