There’s a lot of speculation about what the coronavirus will mean for the Medicare Advantage industry, especially as it relates to home-based care. 

Some believe it could mean more MA opportunities for at-home care providers in 2021 — or even sooner, as CMS recently announced that plans can provide mid-year benefit enhancements in response to the COVID-19 outbreak. Meanwhile, others worry it could hinder home care opportunities in the space.

One thing’s for sure: The coronavirus has the potential to change the way that seniors shop for Medicare Advantage plans, according to Cavulus CEO Patrick Phillips. That could mean more disenrollment down the line, potentially slowing MA’s popularity.

“Seniors’ ability to enroll through the avenues that they’re historically been accustomed to [has been interrupted],” Phillips said. “That’s primarily through sitting down with a field agent at the kitchen table, which is likely not going to happen, or enrolling telephonically in a call center.”

Hilton Head, South Carolina-based Cavulus is a technology firm that caters specifically to the Medicare Advantage industry, providing plans solutions for marketing, sales, compliance and more. Phillips says, as of late, he’s seen increased inbound call activity, leading to much longer wait times for seniors reaching out with coverage and plan questions. 

When it comes time for seniors to enroll in Medicare Advantage plans, that combination could leave beneficiaries to their own devices, causing them to do their own research and enroll through unassisted channels.

“Historically, you see an increase in rapid disenrollment rates when you have unassisted enrollments,” Phillips said.

Rapid disenrollment occurs when a beneficiary decides to disenroll from their new plan within three months of enrollment or before their enrollment is final. On a wide scale, such a process could slow the growth of Medicare Advantage.

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In recent years, MA’s popularity has boomed, with more seniors than ever opting to choose an MA plan as their form of health insurance. In fact, more than 24 million Americans enrolled in MA in 2020, double the number enrolled in 2010, according to statistics from the Kaiser Family Foundation. 

In an attempt to help avoid long call center wait times, unassisted enrollment and the rapid disenrollment that comes with it, Cavulus has introduced a new technology to help plans.

“We have somewhere on the order of 30,000 licensed Medicare Advantage insurance agents that are on our technology platform, and it just didn’t make any sense to have all this expertise sitting there [unable to do home visits] when seniors were inquiring about coverage options and formularies and provider networks,” Phillips said.

The technology helps route calls to field agents who are working from home.

“So we’re kind of solving that particular dilemma right now,” Phillips said. “We’re forecasting this model to really hit a much larger bottleneck.”

Another thing Phillips and his colleagues predict: for COVID-19 to highlight the importance of telehealth and home-based care in Medicare Advantage and otherwise.

“It’s solving a lot of problems right now,” he said. “[COVID-19] is really just shining the light on something that was kind of creeping forward over time and just really accelerated the adoption rate of a lot of these things.”



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