For years, many successful Medicare agencies built their reputation around a simple promise: We’ll take care of everything.
That is great service—but as an agency grows, it can also become an operational problem.
At Emerald Medicare, we serve thousands of clients, and one lesson has become increasingly clear: we need to teach clients how to participate in their own Medicare review.
Part D is probably the best example.
Every Annual Enrollment Period, clients with stand-alone prescription drug plans need to consider whether their current plan will still work well for the following year. Formularies change. Premiums change. Pharmacy pricing changes. A plan that was excellent this year may not be the best choice next year.
But accurately reviewing a Part D plan starts with something only the client really knows: What medications are you currently taking?
Historically, an agency might spend considerable staff time calling clients, gathering medications and dosages, confirming pharmacies, entering everything into Medicare.gov or another quoting platform, and then reviewing the results.
Multiply that process by 500, 1,000 or several thousand clients and it becomes extremely difficult to scale.
Teach Clients the Process
Our evolving approach is to educate clients on how to do more of the initial work themselves.
We can send them a short instructional video showing how to enter their prescriptions into Medicare.gov. Depending on the technology an agency uses, clients may also be able to update medications, pharmacies and sometimes physicians through a personalized URL—or PURL—connected to the agency’s enrollment platform.
Our team can then spend its time where our expertise creates the most value: interpreting the results, identifying unusual situations, discussing tradeoffs and helping clients make decisions.
The same concept increasingly applies to Medicare Advantage. Instead of having staff members manually collect and enter every physician for every client, teach clients who are able to use the technology to enter their own providers.
This Isn’t Reducing Service
Some agents may worry that asking clients to do more themselves diminishes the value of the agency. I believe the opposite can be true.
Good service isn’t necessarily doing every administrative task for every client. Good service is making sure clients get the help they need when they need it.
If staff members spend hundreds of hours entering information that clients could reasonably enter themselves, they have fewer hours available for the clients with complicated drug issues, provider problems, enrollment questions or situations requiring real Medicare expertise.
Of course, not every client can navigate Medicare.gov or a PURL. Some clients will always need hands-on assistance, and we should provide it.
But we shouldn’t design the entire agency around the assumption that every client requires the highest level of administrative support.
We need to build systems that allow us to serve more clients well.
Sometimes that means teaching clients to do a little more for themselves—so our teams can do more of the work that truly requires us.
Mark Brownstein, CSA, is Director of Medicare at Emerald Medicare and has worked in healthcare since 1986. His education-focused Medicare practice serves thousands of beneficiaries and provides Medicare education through individual consultations, seminars and webinars.
