2024 Medicare Employe Group Training
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2024 Medicare Employe Group Training
- 1. ©2023 MVP Health Care Medicare & Gov’t Programs Product Strategy Team 2024 Plan Year Medicare Employer Group
- 2. ©2023 MVP Health Care Product Design Process PROPRIETARY & CONFIDENTIAL
- 3. ©2023 MVP Health Care Product Design Methodology PROPRIETARY & CONFIDENTIAL • EBI Data quantitative analysis • Grievances/ appeals qualitative analysis • Customer surveys • Market research • Product performance • Partnership feedback • Collaborative cross-functional team • Financial analysis • High level resource needs • Alignment with corporate strategy • Bid process • Sales/Marketing/ Operations implementation hand-off Product Discovery Product Solution
- 4. ©2023 MVP Health Care 2024 Product Options & Changes PROPRIETARY & CONFIDENTIAL
- 5. ©2023 MVP Health Care 2024 Employer Group Portfolio PROPRIETARY & CONFIDENTIAL 2024 Plan Name Options HMO-POS (H3305) MVP Preferred Gold with Part D (HMO-POS) Base, Standard, Buy-Up *West Only MVP Preferred Gold without Part D (HMO-POS) Buy-Up PPO Plans (H9615) MVP USACare with Part D (PPO) Base, Standard, Buy-Up, Premier PDP Plan (S0586) MVP RxCare Plan (PDP) N/A
- 6. ©2023 MVP Health Care EGWP Service Area
- 7. ©2023 MVP Health Care 2024 Plan Benefit Package Changes PROPRIETARY & CONFIDENTIAL Plan Benefit Package Benefit Description 2023 Benefit 2024 Benefit Preferred Gold Base Skilled Nursing $196 per day (21-100) $203 per day (21-100) Preferred Gold Standard No Changes N/A N/A Preferred Gold Buy-Up No Changes N/A N/A Preferred Gold HMO-POS USACare PPO Plan Benefit Package Benefit Description 2023 Benefit 2024 Benefit USACare Base Skilled Nursing $196 per day (21-100) $203 per day (21-100) USACare Standard No Change N/A N/A USACare Buy-Up No Change N/A N/A USACare Premier No Change N/A N/A
- 8. ©2023 MVP Health Care 2024 Part D Benefits PROPRIETARY & CONFIDENTIAL Tier Comments Tier 1 Preferred Generics Tier 2 Non-Preferred Generics Tier 3 Preferred Brands/Non-Preferred Generics Tier 4 Non-Preferred Drugs Tier 5 Specialty medications >$670 per month Part D Standard Benefit $545 - Deductible $5,030 – Initial Coverage Limit (ICL) $8,000 – TrOOP $0 – Catastrophic Coverage
- 9. ©2023 MVP Health Care 2024 Benefit Review PROPRIETARY & CONFIDENTIAL
- 10. ©2023 MVP Health Care Vision $100 Eyewear Allowance • Once every 24 months • Use any provider • Can be used towards frames, lenses, & contacts PROPRIETARY & CONFIDENTIAL
- 11. ©2023 MVP Health Care Preventive Dental Rider Preventive dental services of 2 x-ray, 2 oral exams, and 2 cleanings per calendar year – max $240 per calendar year Preventive & Comprehensive Dental Rider • $300 per calendar year – Preventive – Emergency – Routine & Restorative • fillings and diagnostic oral exams – Oral Surgery • simple and bony extractions – Endodontics • root canal – Periodontics • scaling and root planing – Prosthodontics • crowns and dentures Dental Rider Options PROPRIETARY & CONFIDENTIAL
- 12. ©2023 MVP Health Care Hearing Services Customer Choice: Structured Co-pay of $699 / $999 or $600 per ear/per aid Allowance • TruHearing Network • Every 3 calendar years • 32 aids priced at or below $1,000 • Extensive Styles available including digital • Batteries or Rechargeability Included • Free Replacement • Free Follow-up Fitting Appointments PROPRIETARY & CONFIDENTIAL $0 Routine & Diagnostic Hearing Exam
- 13. ©2023 MVP Health Care • 14 meals delivered post-discharge from an Inpatient Admission • $0 cost to the member • Fits Multiple Dietary Needs Meal Delivery Service PROPRIETARY & CONFIDENTIAL
- 14. ©2023 MVP Health Care Get Rewarded for completing an Annual Wellness Visit in 2024! • Online Platform with American Specialty Health (ASH) • Choose a $100 a gift card from available options Be Well Rewards Program
- 15. ©2023 MVP Health Care Access to 15,000 gyms across the United States at no-cost! • From national gyms to local community centers, there are more participating fitness locations available in the U.S. to SilverSneakers members than there are Starbucks. • Get moving with thousands of other customers with the LIVE online classes and workshops • Log-in to the on-demand video library of classes, workouts, and how-to videos. • Access fitness programs on the go, track and schedule activities, find locations, and access the member ID with SilverSneakers GO. • SilverSneakers members can now access thousands of online classes created for a wide range of interests and abilities, plus a supportive community, and personalized guidance through “Burnalong” Fitness Programming PROPRIETARY & CONFIDENTIAL
- 16. ©2023 MVP Health Care Contact: Thank You! Tim Sadue – tsadue@mvphealthcare.com Andrew Hart – ahart@mvphealthcare.com Nikki Hungate – nhungate@mvphealthcare.com PROPRIETARY & CONFIDENTIAL
Notas del editor
- Introduction of Name and Title to the audience
- The Product Strategy team has revolutionized the Product Design process at MVP Health Care to better meet the needs of our customers. We as a team like to share what that process is to provide a better understanding of how we develop these highly rated products.
- There are two core phases each year that cover the product development cycle at MVP Health Care. Each of these phases lasts approximately six months. The first of these is the Product Discovery phase. The first step we take is to look to our EBI data which is comprised of quantitative datasets that identify the specific needs of Medicare beneficiaries in our service area. Other datasets that are explored are grievances and appeals, MVP customer surveys, market research, individual product performance, as well as feedback from our partners. Once this data is compiled, we are able to develop a product that meets the needs of our customers. The second phase is comprised of a cross-functional team from across the MVP organization that reviews all of the Product Strategy team recommendations to prioritize any changes to ensure a successful launch. Some of the things this team uses to determine priorities are through a thorough financial analysis, assessing resource capabilities, and confirmation of alignment with corporate strategies. Once approved through the annual Bid submission to the Center for Medicare and Medicaid Services (CMS) the Growth, Operations, Customer Experience teams successfully continue the Product launch process.
- As you will see on the following slides, the Medicare Advantage Employer Group Product Portfolio is remaining stable.
- In plan year 2024 MVP Health Care will continue to offer a mixture of plans to meet the needs of our employer groups and their Medicare eligible retirees. This includes the MVP Preferred Gold HMO-POS plan, the MVP USACare PPO plan, and the MVP RxCars prescription drug plan. Each of the Part C Medicare Advantage plans comes with multiple variations of coverage.Additionally there are multiple riders that can be attached to the plan to enhance coverage with options such as Dental, Vision, and Prescription Drug coverage
- For the 2024 plan year the Employer Group Service area is not changing. We offer plans to employers within the entire state of new York as well as the state of Vermont
- As reflected on this slide, there are no cost share (copay / coinsurance) changes all plans MVP offers with the exception of the Preferred Gold and USACare Base plans. This increase is to the Skilled Nursing Facility benefit. Most of you are familiar with this as the CMS standard benefit increase is absorbed annually into these packages.
- There are no tier changes for our 2024 formulary. The change you should note is the annual increases to the Initial Coverage limits, and true out of pocket maximum, and the catastrophic coverage cost shares.
- Read the Vision benefit slide
- Read the Dental Rider Options slide
- We introduced this new hybrid benefit allowing for customer choice in the 2023 plan year. Thus far we have seen an increase of utilization. At MVP we know that our customers being able to hear leads to better health outcomes. Hearing health addresses social isolation and fall risks for example.
- MVP will continue to offer 1 week of meals post inpatient hospital discharge. This benefit aids in the transition to home when our customers are at their most vulnerable. Our meals can also be customized to meet various dietary and cultural needs.
- MVP is excited to introduce our new Be Well Rewards program. Designed to be simple and easy to achieve. Utilizing the online platform which is accessible through our Gia application a customer who completes their Annual Wellness visit with a provider will receive a $100 gift card from available options presented to them at time of redemption. The gift cards will be store-directed and cannot be used to purchase alcohol, tobacco, and firearms. Additionally, they cannot be used for gambling purchases such as lotto or be used to lower prescription drug copays.
- Our fitness programming is so much more than giving our customers access to fitness centers. Fun Fact - With more than 15,000 participating fitness locations there are more fitness locations for our customers than there are Starbucks! There are online classes and workshops available LIVE online as well as a full on-demand library of workouts and how-to videos for total health. And do not forget about the Silver Sneakers GO App so for our active, on the go customers. Additionally, the Go App provides immediate access to the Silver Sneakers ID card.