The state's long-coming transition to what's called Medicaid managed care takes a big step Wednesday, when most of the state’s 130,000 Medicaid recipients enter into an open enrollment period.
They have just about two months to choose which of three out-of-state organizations—Well Sense, Centene or Meridian—they want to effectively take over administration and management of their health coverage starting December 1st.
And with tens of millions of dollars on the line, these companies would love their business.
“The number of members that select them is directly linked to their compensation,” says Lisabritt Solsky, Deputy Medicaid Director for New Hampshire.
“They get paid what we call a PMPM, a per-member, per month rate. So, they really want as many members as they can get.”
Solsky says the three Managed Care Organizations (MCOs) make money by signing up as many people as they can, and then ideally keeping their customers healthy to keep expenses low.
But to get people to sign up, the MCOs can’t exactly compete on price, since Medicaid recipients don’t pay for their care. It’s sort of like airlines before deregulation, when wide seats and attractive stewardesses wooed customers in the 60s.
The managed care world has its own history of marketing strategy.
Anyone Want A Bird?
“The most colorful one was one that gave away turkeys,” says Gordon Bonnyman, Executive Director of the Tennessee Justice Center, a public interest law firm.
His state transitioned to Managed care back in the mid-90s. Six companies did all they could, including door-to-door marketing, branded oven mitts and the aforementioned turkeys to sign up members. It was a loosely regulated transition, and Bonnyman says a lot of vulnerable people were pressured into plans without understanding the stakes.
“Consumers need to understand that, okay, this is what I’m buying into. I’m buying into a plan in which I will not have freedom to choose which doctor I can go to or which pharmacy. I’m going to be locked into a provider network.”
But by being the 48th state to take on managed care, New Hampshire is learning from these past mistakes. The state included strict language in the contracts to prevent marketing abuses.
“We are not permitted to do cold calling or to give a hard sell, in any way,” says Kevin Klein of Well Sense, one of the three MCOs preparing to launch.
“All the communication we have with Medicaid recipients in the state have to be approved through the state.”
The MCOs will be able to compete through incentives, a common strategy nationally. Nothing is guaranteed, but each of the companies has a list of perks members could get if they sign up.
“We offer bike helmets, Weight Watchers and fitness reimbursements, as well as infant car seats,” says Klein.
Marketing To The Masses
Since the state isn’t giving out recipients’ names or addresses, the three MCOs will have to use broad marketing techniques to advertise these incentives.
Think billboards, social media, booths at the mall or maybe radio or TV spots.
But it may not be jingles or gym memberships that get people to pick a plan.
Lisabritt Solsky with DHHS says for Medicaid recipients, what may matter most is which plan will allow them access to their current doctor.
“First you want to figure out, who are my providers, and what plans do they participate in. And if you’ve got a provider that is only participating in one, that is probably the plan you should pick,” says Solsky.
She says you can contact the state to get that information. Medicaid recipients will also receive an information packet in the mail with side-by-side comparisons of the plans.
