On October 9th, 2024, EnlivenHealth hosted the third webinar in its popular Medicare Annual Enrollment Period series, titled “Make the Perfect Match: How to Support Your Medicare AEP Strategy Using Automation.” The webinar was hosted by EnlivenHealth’s Senior Manager of Customer Enablement Marvin Guardado, who was joined by David Scott, PharmD, MBA, the co-owner and clinical staff pharmacist for Scott Pharmacy in Fayette, Iowa.
Reviewing 2025’s Medicare Changes
To kick off the webinar, Marvin shed light on the changing landscape of Medicare plans, where the number of standalone PDPs offered per state is wavering. With Medicare plan comparisons, pharmacies have the chance to help their patients save on premiums. In addition, Marvin emphasized the need to start the appointment process early for Medicare Advantage Open Enrollment in the first quarter of 2025, as well as the advantage of text reminders for patient appointments.
Also, due to the impact of Medicare market changes on commission structures, brokers might hesitate to help patients who have received an ANOC (Annual Notice of Change) letter about their premium changes. When that happens, pharmacists can step up and provide the help their patients need.
A Pharmacist’s Perspective
David Scott shared his hands-on experience with plan comparisons over the years. His pharmacy has used EnlivenHealth’s Medicare Match since 2013, back when the plan comparison tool was known as iMedicare. He emphasized the importance of the availability of Advantage plans given the reduction in Iowa’s Medicare plans to an expected 14 from 70 in previous years. As the plans offer cost benefits and expand clinical interventions, Scott Pharmacy now initiates MA plan conversations with patients. They also dedicate two technicians to aid patients with plan comparisons during the Annual Enrollment Period.
On top of Medicare Part D plan reviews, David brought into focus the need for ensuring accurate medication lists, cautioned against bait-and-switch scenarios, and reminded viewers of retiree benefits and employer group plans.
Additionally, David raised concerns over the impact of increasing pharmacy deserts and many health plans making it easier for patients to not support local pharmacies. He endorsed working with patients to realize the importance of local resource availability and the consequences of focusing mainly on cost.
Kicking Off Open Enrollment without a Hitch
In the run-up to AEP, David proposed that automation would — and should — play a significant role for pharmacies. Using a plan comparison solution like Medicare Match, pharmacy staff can compile a list of patients that are ideal candidates for plan comparisons, due to factors like age, increases in their current premiums, and more.
A focused approach is also invaluable. Pharmacists should look at the factors that might make switching plans more necessary for a patient — e.g. premium increases, drug formulary changes, etc.
Once candidates are identified, outreach is key. Some patient outreach methods — like phone calls, text messages, and emails — can be automated to reach multiple people more efficiently. But the old-fashioned methods like face-to-face conversations and in-bag leaflets can also be effective.
An Alternative to Medicare.gov
Marvin and David both discussed the problems around using Medicare.gov to compare plans for patients. In addition to the unpredictability and occasional inaccuracy of the website, Medicare.gov requires a lot of time-consuming manual entry, limiting the number of patients a pharmacist can assist each day.
Medicare Match by EnlivenHealth integrates with the pharmacy’s existing software and patient records, allowing pharmacists to match the patient to the best plan for their needs without manually entering in drug information. Using EnlivenHealth’s software, plan comparisons can be performed in 10-15 minutes, either in person or over the phone.
Conclusion
A pharmacy’s ability to leverage automation to foster efficient Medicare plan comparisons is now more significant than ever. As the Medicare landscape continues to evolve, pharmacies need to adopt a forward-thinking, adaptive approach to ensure they don’t lose their Medicare patients.
To watch the webinar, click the button below:
To learn more about EnlivenHealth Medicare Match, schedule a consultation with a member of our team today!