On August 14th, 2024, EnlivenHealth hosted a webinar titled, “Don’t Wait, Migrate: Mitigating 2025 Medicare Changes During Open Enrollment.” During the webinar, Marvin Guardado, Senior Manager of Customer Enablement at EnlivenHealth, and Whit Moose, RPh, owner and pharmacist at Moose Pharmacy, dissected the evolving landscape of Medicare, paying special attention to plan comparisons, upcoming changes, and the importance of patient engagement in pharmacies.
Medicare Plan Comparisons and Patient Retention
Whit and Marvin spearheaded the webinar by discussing the significance of offering Medicare plan comparisons for patients. They emphasized that pharmacies have a pivotal role in helping patients navigate the complexities of choosing an optimal plan. Whit pointed out that it’s not solely about helping patients find the plan aligned with their medications, but striking a balance between a plan that benefits both the patient and the pharmacy. Their discussion further highlighted the positive impacts of plan comparisons on patient retention, revealing a striking 97% retention rate among patients who received a plan comparison. According to Guardado, an additional upside of such comparisons is that Medicare patients form the bedrock for offering clinical services in pharmacies.
Upcoming Changes to Medicare
As part of their conversation about the soon-to-be-implemented changes to Medicare stemming from 2022’s Inflation Reduction Act, Whit and Marvin mentioned significant disruptions. One major adjustment is the $2,000 cap on prescription costs starting in 2025. The webinar also shed light on the prescription payment plan, an opt-in program enabling patients to finance their medications through their carriers. This program has potential benefits but also concerns for pharmacies.
Patient Communication and the Annual Enrollment Period (AEP)
The duo took a detailed look at the challenges pharmacies are likely to encounter during the Annual Enrollment Period (AEP). Whit highlighted the need for pharmacies to prepare for patient conversations and to provide them with accurate information considering the upcoming changes. Marvin joined in on the idea, emphasizing that pharmacies must be proactive in helping patients understand their available options during the enrollment period.
Rescaling Pharmacy Strategies Amid Medicare Disruptions
As Whit explained, an increased number of patients are expected to seek plan comparisons, following the wider awareness of the forthcoming changes. This number is predicted to grow based on the rise in patients making changes or signing up for new plans in the previous year. Marvin seconded Whit’s statement, emphasizing the need for pharmacies to reach out to patients during the open enrollment period. He added that if pharmacies fail to engage with patients about plan changes, it could result in patients switching pharmacies or signing up for out-of-network plans.
Efficient and Effective Patient Outreach
In their discussion about the outreach strategies during the open enrollment period, Marvin and Whit mentioned various methods, including personalized calls, emails, text messages, and even traditional mail. They stressed the significance of using a database to organize patient information and the importance of a scheduling tool to streamline plan review appointments. Responding to a question from the audience, Whit clarified that their service doesn’t financially burden the client: “We do not charge for the service,” he said.
Medicare Plan Comparison for Long-Term Care
Marvin and Whit touched upon the algorithm developed for EnlivenHealth’s Medicare Match that makes it the most accurate plan finder for long-term care pharmacies. Most plan comparison tools don’t account for long-term care contracting data, which causes a large percentage of Medicare plans to show up as out of network or with inaccurate costs.
Conclusion
The in-depth dialogue between Marvin Guardado and Whit Moose yielded thought-provoking insights and valuable strategies for understanding the contours of Medicare plans, their upcoming changes, and the absolute necessity of patient retention. This information is especially invaluable for pharmacies looking to sustain and scale their services in an ever-evolving healthcare landscape. In conclusion, this webinar made it abundantly clear that putting patients at the forefront of their strategies enables pharmacies to not only endure but also thrive amid the uncertainties of the sector.
To learn more about EnlivenHealth Medicare Match, schedule a consultation with a member of our team today!