Webinar Summary: The MVP Method: Elevating Patients & Profits Through Expert Medicare Plan Comparisons

On September 16th, 2025, EnlivenHealth hosted a webinar titled, "The MVP Method: Elevating Patients and Profits Through Expert Medicare Plan Comparisons." This webinar brought together industry leaders Marvin Guardado from EnlivenHealth and Whit Moose, RPh from Moose Pharmacy to share actionable strategies for pharmacies navigating Medicare plan comparisons and enrollment. With the Annual Enrollment Period (AEP) just a month away, the session provided key recommendations for optimizing patient care, increasing pharmacy revenue, and scaling operations to handle high patient volumes.

Setting the Stage for Success: Key Themes and Objectives

Marvin Guardado began the session by outlining the rapidly evolving Medicare landscape for 2026, focusing on how pharmacies can stay ahead of upcoming plan changes, market consolidations, and carrier withdrawals. A readthrough of EnlivenHealth’s mission statement captured the essence of the webinar's intent: “It's to put pharmacy teams at the center of care and get them paid. And we do that by building digital tools to improve patient care, strengthen population health, and help pharmacies grow sustainably.”

Whit Moose—a fourth-generation pharmacist actively involved in his community—shared insights from Moose Pharmacy’s experience managing multiple retail pharmacies throughout North Carolina. He underscored the importance of leveraging plan comparisons for patient retention and profitability, noting, “We focus on patients that contribute the most to our bottom line while ensuring everyone continues to receive optimal care.”

Challenges and Opportunities in Medicare Plan Management

The discussion delved into the complexities pharmacies face in navigating Medicare Part D (PDP) and Medicare Advantage (MA) plans. Of particular interest was the role of Special Needs Plans (SNPs) for patients with chronic conditions like diabetes.

Insights on WellCare and Plan Comparisons:

One focal point was the challenges posed by WellCare plans. While some plans boast patient-friendly features like low copays and no premiums, pharmacies often shoulder high reimbursement burdens. Marvin highlighted that pharmacies must be proactive in addressing patients on such plans:

"If you're not accepting WellCare, you need to tell the patient, 'We’re not taking that plan anymore. If you want us to be your pharmacy, we'll have to look at another option.' For expensive drugs like Eliquis, patients may need to use WellCare, but for cheaper medications, pharmacies can explore matching prices or find alternative options."

On the other hand, Medicare Advantage plans were described as increasingly favorable for pharmacies. Almost three-quarters of MA plans offer zero premiums—a feature appealing to patients—while also providing better reimbursement rates for pharmacies, especially for branded medications.

"MA plans offer $0 premiums but pay better for the pharmacy,” said Marvin. “Some rates are as low as AWP minus 23%, while others land closer to AWP minus 19%. These differences, especially on brands, make targeted plan comparisons imperative."

SNP Opportunities for Chronic Conditions:

SNPs for conditions like diabetes stand out as underutilized opportunities for pharmacies. Whit shared his insights:

“As these patients get special needs plans for conditions like diabetes, we can start to look at other opportunities to work with them as far as diabetic shoes or some other kind of area where we may not have a lot of focus right now. But with these folks in this plan, that could be opportunity.”

The benefits extend beyond patient care; SNPs tend to be profitable for carriers, making them a win-win solution.

The Role of Plan Comparisons in Patient Retention

Data presented in the session highlighted the power of plan comparisons in securing patient loyalty. According to Marvin, 97% of patients who received plan comparisons last fall continued filling prescriptions at their existing pharmacy, compared to just 76% of patients who didn’t get comparisons. This gap in retention reflects substantial revenue loss for pharmacies failing to proactively evaluate patient plans.

As Marvin explained:

"Extrapolate that on how much revenue a Medicare patient brings to your pharmacy—about $2,800 per patient annually—and the 21% retention gap represents significant dollars."

Efficient Workflows and Scalable Solutions During AEP

One of the webinar’s standout discussions involved workflow optimization, particularly during AEP when patient volume peaks significantly. Both speakers emphasized the importance of structuring operations to handle increased demand without overburdening pharmacy staff. Key recommendations included:

Designating a point person: “Having one team member manage plan comparisons minimizes confusion and keeps the process streamlined.”

Implementing appointment systems: Structuring patient interactions allows pharmacists to prioritize high-value tasks while scaling personalized service.

Leverage automation tools: Text reminders, digital portals, and virtual consultations via Zoom offer efficient ways to complete enrollments while reducing manual effort.

Accuracy in Data: The Starting Point for Success

Throughout the discussion, Marvin and Whit emphasized the value of precise data collection during patient intake. Accurate eligibility checks require specific information, such as the last four digits of a patient’s Social Security number or their Medicare ID. Knowing the exact plan—including contract ID, benefit ID, and plan ID—is crucial for tailoring comparisons. Taking shortcuts in this initial step results in mismatched recommendations and missed opportunities.

Proactive Engagement Beyond AEP

While AEP was the webinar’s primary focus, Marvin and Whitaker urged participants to consider long-term engagement opportunities with Medicare beneficiaries. Patients turning 65, dual-eligible individuals, and those coming out of healthcare facilities offer prime opportunities for pharmacies to strengthen relationships and drive revenue year-round.

“It's not just an AEP thing,” said Marvin. “This is where you're going to be able to talk to majority of your Medicare patients, but you have opportunities to engage them throughout the year.

Marvin added: "They're turning 65. They're dual eligible. They're coming out of a facility. There's a lot of these life changes that provide you with an opportunity to engage patients throughout the year.”

Closing Remarks and Actionable Next Steps

The webinar wrapped up with an invitation to join a product walkthrough of EnlivenHealth Match—a tool designed to simplify plan comparisons and enhance pharmacy productivity.

With strategies to retain patients, grow revenue, and streamline operations, Marvin and Whit left pharmacies with a clear roadmap for success as AEP approaches.

To watch the webinar in full, click here.

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