It’s Time to Stop Operating in Silos

National Thought-Leader MCUSA Calls for “New Era of Collaboration” to Successfully Address the Needs of Consumers and Providers in 2024

BELLINGHAM, Wash.--(BUSINESS WIRE)--
A new era of strategic collaboration between local hospitals, physicians and pharmacies, together with a more consumer-focused distribution system, will be the keys to patients getting the healthcare they want and need in 2024 and beyond.

“Medicare beneficiaries typically have a healthcare team comprised of multiple physicians, a preferred pharmacy and a hospital of choice, yet these providers continue to operate in silos by separately promoting which Medicare insurance they accept,” said MCUSA Consulting’s CEO Kerri Lenderman. “Complicating matters are the vast resources that insurers, brokers, retailers, grocery stores and financial service providers expend promoting Medicare plans for their own financial interests. This adds confusion to the very purpose of health insurance which is to cover the cost of health care services rendered by a patient’s care team.

“CMS is done stimulating growth in Medicare Advantage and making changes that will impact everyone far and wide,” continues Lenderman. “It’s time for healthcare providers to come together at the local level, shepherd the needs of their shared patients and the community and identify where they align to provide a united voice that will ensure continuity of care for patients and patient retention for providers. The delivery system has made huge investments and strides in value based care but everyone is continuing to operate in a vacuum and that adds administrative costs, time to coordinate access and/or plan of care and medication adherence issues for patients. We need to put an end to all of that inefficiency which doesn’t benefit anyone.”

For more than a decade, MCUSA Consulting has been on the forefront of innovation in protecting continuity of care for seniors while serving as a valuable ally to hospitals and medical groups to retain patient relationships they’ve often spent years to cultivate. In 2023 the company began working more actively with independent physicians, community pharmacies and retail chains to better understand their unique challenges.

“We learned independent physicians have common pain points with community pharmacists and we have an opportunity to facilitate better collaboration,” says MCUSA Chief Communications Officer Chuck Chaput. “The local pharmacy is often a community’s most familiar and frequented access point, playing an important role in monitoring patients’ daily health, medication adherence or complications and thus have become a crucial intermediary between doctors and their patients.”

Lenderman says that MCUSA has long recognized that Medicare distributors falsely believe the only stakeholders in the sales process is the insurer, a broker, and policyholder. “They frequently reference this three-legged stool as their recipe for success,” she says, “but we’ve worked hard to challenge that rhetoric, noting there is no stronger bond than that between a patient and their provider. Adding the delivery system as the fourth leg creates stability, a common complaint CMS strongly desires to improve." Lenderman projects that by 2025, 40% of pharmacies nationally – including both independent community pharmacies as well as those affiliated with large retailers -- will be engaging patients through MCUSA’s MedicareOnDemand (MOD) to coordinate insurance coverage while, at the same time, strengthening their own relationships with local physicians, community pharmacies and hospitals.

MOD is an online platform that makes it easy for seniors to match Medicare insurance options with plans accepted by their physicians, preferred pharmacy and hospital. Through MOD consumers can easily compare Medicare Advantage, Medicare Supplement and Medicare Prescription Drug plans online, create a customized shopping experience and/or talk with a telesales or local broker.

Given that many health care providers have existing relationships with local brokers, MCUSA has forged B2B relationships with major distributers to easily bring MOD referrals to existing brokers, improve referral operations and assure accurate client reporting. These brokers represent plans accepted by the referring organization(s), stay abreast of contract changes and abide by quality standards often set by the client. And in serving their clients, the brokers will not only help with Medicare questions and enrollment but will serve patient needs for all future Medicare support throughout the year.

“We have a unique opportunity to usher in a new era of coordination with hospitals, physicians, pharmacies, patients, retailers, distribution partners and insurance carriers all coming together for a common good,” said Lenderman. “MCUSA and MedicareOnDemand are heavily invested in this new model of collaboration and are prepared to provide whatever support a community needs to eradicate the unnecessary fragmentation that currently exists in healthcare and distribution. In doing so, we can put an end to the message confusion and create a patient centric system that unifies communities with all stakeholders to improves access, lessen insurance administrative burdens and make healthcare coordination work better for everyone.”

About MedicareCompareUSA

As the nation’s leader in its space, MedicareCompareUSA currently supports more than 650 hospitals, health systems, physician groups and pharmacies from coast to coast who collectively care for more than 10% of the nation’s Medicare population. With its strong foundation and impressive track record, an increasing number of hospitals and doctors are looking to MedicareCompareUSA and its sister company, MCUSA Consulting, as an indispensable part of a proactive patient-communication and population-management strategy. Visit https://medicareondemand.com and https://medicarecompareusa.com.

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Ross Goldberg
818-597-8453

[email protected]

Source: MedicareCompareUSA