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Top 5 Tips to Compete & Grow in the Medicare Advantage Space

Medicare Advantage brings affordable, comprehensive healthcare coverage to nearly 30 million Americans. This program serves diverse American communities, including 3.7 million rural Americans. 40% of Americans making less $25K per year choose Medicare Advantage, and 32% of Medicare Advantage members are racial/ethnic minorities.

Medicare Advantage has had 8-10.5% YOY growth, and 60% of all Medicare beneficiaries will be in Medicare Advantage by 2030. The growth of Medicare Advantage brings opportunity for health plans to expand their member base. However, the diversity of the communities served by Medicare Advantage presents significant challenges for health plans. Furthermore, competition is rapidly growing for health plans in the Medicare Advantage space.

HealthEdge customer SummaCare is a local, self-funded, provider-owned health plan with 62,000 covered lives. Operating in Summit County, OH, SummaCare is part of one of the most competitive Medicare Advantage markets. In 2023, they are expecting members to have over 90 plans to choose from.

How does SummaCare stay competitive in the Medicare Advantage space, especially against national competitors?

We recently sat down with SummaCare’s VP of Operations, Melissa Rusk, to learn how health plans can compete and grow in the increasingly competitive Medicare Advantage space. Her five top tips for health plans are:

  1. Understand your customer needs: Listen to the voice of the customer and take action on it. 
  2. Meet your customer where they are: Be available to your customers when and where they need you. Don’t make them call if they’d prefer to use an app. 
  3. Improve workflow automation: Leverage technology to optimize and automate your workflows to increase efficiency.
  4. Regulatory compliance: Partner with experts that understand regulatory requirements to ensure compliance.
  5. Real-time, accurate data: Leveraging technology platforms and partnerships that make access to real-time, accurate data possible. 

SummaCare has achieved success by leaning into becoming a digital payer to meet the growing consumerism demands in healthcare. Learn more about becoming a digital payer here.