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Latest news and updates about the Medicare and pharmacy industries.

Four Ways to Win with Patients This Medicare Open Enrollment

Posted on October 15, 2020 by Amplicare Team


Medicare Open Enrollment, which runs from October 15 to December 7 yearly, is a time of a significant opportunity for pharmacists and patients alike. On one hand, it provides the opportunity for Medicare beneficiaries to compare their options and potentially switch to a more cost-effective plan. On the other, this period provides an avenue for pharmacists to demonstrate their expertise and care by helping patients navigate the plan selection process.

To make the most of the opportunities Medicare Open Enrollment provides, pharmacists must be proactive in their efforts to engage patients. Here’s a look at four ways pharmacists can help patients during this period and what Amplicare tools are available to create a seamless experience for all parties.

1. Compare Medicare Plans

Consider these statistics: about 90% of Medicare beneficiaries are not enrolled in the most cost-effective plans for their medication regimen. By 2030, there will be more than 80 million Medicare beneficiaries. Add to these numbers the fact that a new study found 47% of Medicare beneficiaries and 57% of those nearing eligibility are overwhelmed by the prospect of finding the right plan. What this data points to is an opportunity for pharmacists to provide the guidance that patients need when it comes to understanding Medicare and their options.

When patients have the opportunity to switch plans during Medicare Open Enrollment, offering plan comparison services at your pharmacy can help satisfy a crucial patient need, potentially increasing patient retention and loyalty.

How Amplicare Helps

Amplicare provides multiple reports that specifically target the opportunities of Medicare Open Enrollment. This includes the Open Enrollment report, which identifies Medicare-eligible patients who have filled a prescription at the pharmacy in the past 12 months. When using the report, you have the option to filter results to prioritize certain segments of your pharmacy’s patients. For instance, say you are interested in launching a communications campaign to patients on plans that will be out-of-network with your pharmacy in the coming year. The report identifies these patients to make communications easy.

2. Check Drug and Doctor Networks

This point goes hand-in-hand with plan comparisons but is worth highlighting on its own as it addresses a potential knowledge gap for patients. Formularies change each year, and while patients may be content with their current plans, they may not realize that a formulary change could affect their out-of-pocket expenses. Therefore, it is important for them to reevaluate their options during Medicare Open Enrollment to account for changing formularies and costs. As a healthcare professional, you are well placed to help educate them on the importance of being aware of formulary changes, check plan restrictions, and potentially find alternative medications that may be more suitable for their budgets.

Similarly, patients may not realize that a plan change could result in their doctors and specialists being out of network. This is particularly true for patients enrolled in Medicare Advantage plans, which have limited doctor networks. Considering the growing popularity of Medicare Advantage plans — the Congressional Budget Office expects 47% of all Medicare beneficiaries to be enrolled in these plans by 2029 — it is increasingly important that patients are aware of potential changes. Educating patients and confirming their doctor networks before they switch plans goes a long way to creating a positive experience for them.

How Amplicare Helps

Amplicare also offers a Formulary Lookup and a Doctor Lookup tool. The Formulary Lookup enables you to easily review plan restrictions for different medications and find alternatives at the click of a button. The Doctor Lookup pulls information from the national doctor database to help identify network restrictions for your patients’ doctors.

3. Increase Patient Communications

During the Open Enrollment period, your Medicare patients will likely be inundated with information from various sources, from brokers to plans. As their trusted healthcare partner, it’s essential to let them know you’re knowledgeable about the Medicare enrollment process and available to help them. This is where automated communications come in. Automating patient communications during this period is a great way to ensure your messages get across to patients without having to take the time to manually place calls to every patient.

How Amplicare Helps

Amplicare’s patient engagement solution makes it easy to automate and schedule phone calls and text messages to patients at any point during Open Enrollment. As an added bonus, pharmacies can also opt in and activate pre-populated text message reminders to patients about their eligibility and plan comparisons. Additionally, with Amplicare, you’ll be able to segment your communications to ensure your messages are targeted to the right people, whether you’re reminding them to come in for a plan comparison, notifying them of their eligibility status, or informing them of their plan’s network status.

4. Empower Patients to Make Decisions

While Medicare Open Enrollment is a time of great opportunity, it is also an incredibly busy time for pharmacies. If your pharmacy serves a high number of Medicare patients, it may be challenging to find times to conduct plan comparisons. Providing information to patients can help empower them to consider their options on their own and reach out to you for assistance if necessary. Plus, with COVID-19 a lingering issue this year, providing an option through which patients can remotely consider their plan options will go the extra mile in improving the patient experience. 

How Amplicare Helps

Navigate, Amplicare’s new CMS-approved patient enrollment portal, provides the opportunity for patients to compare plans from home. Your pharmacy provides access to the portal, which has medications pre-populated to reduce the risk of error from manual entry. Patients see a plan comparison (similar to your pharmacist view in Amplicare but with a few key differences), including plans that are affordable and in-network with your pharmacy. In addition, they’ll be able to access plan comparisons you’ve initiated in the pharmacy as well as educational resources. They will also have the option to contact your pharmacy for a remote consultation, or enroll online with the help of a pharmacy-friendly broker.  

Want to learn more about how Amplicare can help you have a successful Medicare Open Enrollment? Email growth@amplicare.com or schedule a consultation with one of our experts.

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