Innovation and Empathy in Medicare: HealthChangers Podcast

October 5, 2017

On any given day, 10,000 people in the U.S. turn 65 years old and become eligible for Medicare. As choosing the right Medicare plan has become more complex, navigating all the options can be overwhelming.

In this episode of HealthChangers, two members of the Medicare team at Cambia discuss today’s seniors, a new tool that can help people sort through options step-by-step and advice for those working in the health care industry – whether a consumer, patient or a member. Paul Lowry and Steve Mendes both participated in Cambia's igniter program to innovate on new ways to help the Medicare population with digital tools

You can listen to this episode with the player above, on iTunes or on Stitcher, or read the full transcript below. 

Links and Resources

Jeremy Solly (JS): Let's start off this podcast with a staggering statistic. On any given day 10,000 people in the U.S. turn 65 years old. You heard me right, 10,000. They're baby boomers reaching retirement all eligible for Medicare. Choosing the right Medicare plan has become increasingly more complex, so helping all these people understand their options is a daunting task. Our two guests today believe they have a way to make this process easier. Paul and Steve work on Cambia's Medicare team.

They sat down with us to talk about Medicare, today's seniors and a new tool to help people sort through Medicare options step-by-step. Welcome Paul, thanks for being here.

Paul Lowry (PL): Thank you and good morning.

JS: Welcome Steve.

Steve Mendes (SM): Hi there. Thank you.

Why Medicare?

I'm always up for a good challenge. If you look at the senior market or the Baby Boomers as you want to call them, it's the largest segment in the county.”

JS: What inspires you around this work?

PL: As far as Medicare goes, I really enjoy helping people. Unlike those that are younger that may not have many medical concerns - again the older you get, the more you are going to use it - and so finding the plan that is right for you, that will fit your needs the best, is kind of what we specialize in.

SM: I'm always up for a good challenge. If you look at the senior market or the Baby Boomers as you want to call them, it's the largest segment in the county. It's also the most diverse segment in the country. If you look at someone who's 64 years old or someone who's 84, there's three different generations between there.

Addressing Senior Stereotypes

“I always find interesting that seniors are online more during the day than millennials...It’s a big myth that the younger folks are online more than some of the older people.”

JS: Are there things that you think people might find surprising about seniors and this Medicare population? Any myths that maybe we have some preconceived notions in our heads that are different from the work you guys do and what you've seen on a day-to-day basis?

SM: Yeah. I think as a country we've kind of created this stereotype of seniors and it's just not true. To give you some context, today's seniors graduated high school in mid early 70s. So you know they were there during the dawn of all computing and grew up on television. It's a different kind of generation that has really redefined aging.

As an example, a vast majority of them are online. A vast majority of them do own cellphones, and over half of them are smartphones. A little more than one out of every four seniors would have a smartphone and if you kind of look at across the generations, that's a lot considering some of them are in their 70s, 80s, and 90s. They are definitely online.

I always find interesting that seniors are online more during the day than millennials because they have so much time on their hands and they're on desktops, on mobiles and on tablets. It’s a big myth that the younger folks are online more than some of the older people.

PL: And I would say we've seen this evolve in the last 10 years, 11 years that I've been doing Medicare. In the beginning, I would say that stereotype probably played out a little more in reality than it does now. When I started, you didn't do as many things online. They wanted to meet face-to-face. And if I was meeting with somebody face-to-face for the first time, there was a pretty good chance that unless we had sent them something by mail, they hadn't done any research for Medicare or the Medicare plans out there.

That has completely changed, to where now, there might be a 70/30 chance that the person I am going to sit down in front of has already been online and done research on our plans or somebody else's plans. So they kind of have a little education going into the meeting because they have gone online and used the different things.

Bridging the Medicare Process

“People have piles and piles from different health insurers of all the information they need to know. That itself is overwhelming and people just come very just kind of - they almost take a step back and disengage...”

JS: Do you see people in the Medicare population asking for these digital tools now, whether they are doing kind of the research, or once they are a member are they looking to find, you know, interact with their health care in a digital way?

PL: Yeah, I would say so. They are utilizing different online tools.

SM: Yeah, I think it's not even a question of are they asking for it. It's just to expect it at this point.

JS: Can you guys describe to us what is it like for someone joining Medicare today from, "Okay, I'm eligible" to "I now have Medicare"? What does that bridge look like?

PL: You know it's hard to draw comparison to anything else in the health care industry, because it's quite a bit different than anything they've experienced in the past. Whether they've been on an individual, under 65 medical plan, or whether they've had medical benefits through their employer group, it interacts completely different.

You know, some people are eligible at different levels. So depending on how long you worked and paid into the system, you may have Part A paid 100 percent and you may have a premium for Part A. If you are retired or you're receiving...I should say you're receiving Social Security at the time you turn age 65, you're automatically enrolled in Medicare A and B. If you're not receiving Social Security, however, you have to manually enroll, whether you do that online, you call Social Security, or you go and meet with somebody face to face at Social Security.

SM: Yeah, if you're a fly on the wall and there's a dinner table and everyone's 64, every person on that table would have a completely different situation. And there's a lot of misinformation going back and forth.

As complex and as important as your health care coverage is through your senior years, people start researching right around 63. Of course, there's a spike right around 64, and as they approach 65, but we have made it - we as a country, and as health plans - a complex topic for a lot of good reasons. Navigating that can be pretty difficult, and so a typical person who's 64 will start to get a drove of direct mail in their inbox. People have piles and piles from different health insurers of all the information they need to know.

That itself is overwhelming and people just become very just...they almost take a step back and disengage. And you know decide "Well I'll think about it later" or "I'll talk to a broker" or "I'll ask my neighbor," but what your neighbor went through could be completely different than what you need to go through. So it's really important you do your homework and that's where some of the online tools that we've been investing come into play.

Medicare 101: Get Your Questions Answered

“Education is probably the number one thing right now”

JS: So I want to get to that. This sounds confusing, and up until this point, what are some of the ways - and Paul, I've heard some stories - what are some of the ways that you guys have helped to educate people that are in that space where it's new, and it's confusing? I have to explore these options and obviously it's different for everybody so somebody has to guide me through. But you've been that guide for people, right? 

PL: Right.

JS: What are some of the things that you have done over the years to help guide people?

PL: You know, we actually have a lot of different programs we do. Education is probably the number one thing right now. We’ve got programs where we may work with some of our employer groups to have special Medicare 101 classes for their employees. It’s usually for their employees that are getting up there in age, getting nearer to being Medicare eligible and even some cases where they may be younger and not quite ready for Medicare, but they have a family member maybe a parent that's getting close to Medicare and they have to help them out.

We hold public Medicare 101 classes as well where you know we send out to our members, and say, "Hey we've got this class that if you're nearing Medicare - you have questions you can come to it," and we try and cover as much on the subject as we can. We break it down into things a little - making it a little simpler for people to understand. And we even do one-on-ones where we actually sit across from somebody and say, "Hey you know what is your situation?" and take that information and give them kind of a personalized recommendation.

Keeping it Personal

“I changed into some scruffy clothes and went back and I actually mowed her lawn for her. You know it’s one of those things that - that's kind of how our Medicare team operates.”

JS: So you've done one-on-ones with people?

PL: Yes.

JS: Do you have any one-on-ones that stood out to you over the years?

PL: I actually have two. Two that I still smile about. One of them I met with a lady and she was turning 65. She was trying to figure out which direction to go so and I showed up at her house and she let me in and right away. I noticed she had her arm in a cast because she had a broken arm. So we sat down, we went over the information, and found the plan that would work best for her and got her enrolled. And when I left - as the same as when I showed up - I noticed that her front yard had grown up quite a bit. The reason it hadn't been mowed lately is because she had a broken arm, so she couldn't operate the lawn mower.

Why some of the neighbors didn't help out, I don't know, but I kind of took it upon myself that when I was done with my work shift for that day, I changed into some scruffy clothes and went back and I actually mowed her lawn for her. You know it’s one of those things that - that's kind of how our Medicare team operates.

I had another one that I showed up and the lady had just recently moved into my service area from another state. She was needing to replace the plan she had in her former residence. I got there and she had a couple little puppies that just were yapping all the time and running around and jumping all over us. She's apologizing and she wanted to put them in a room, but unfortunately these small trailers she lived in didn't have doors on the rooms, so these puppies are just running around.

After a couple minutes, she just looks at me and said, "You know if we could get my kennel put together real quick we could put the dogs away." I spent the next 30 minutes putting her little dog kennel together, so that we could take the puppies put them in the kennel in a different room and kind of go about our business.

JS: That's amazing, Paul. Thank you. 

Communicating Medicare Online

“…There's nothing stopping us from kind of distilling this casual kitchen counter discussion and making it into an online tool – something that people can view whenever they want.”

JS: So this has been an interesting journey of getting people educated around Medicare. It's taken you guys into a project that you have done for our health plans here. Can you tell us about this tool that you've developed - this online tool to help educate people around Medicare?

PL: Sure.

SM: Well, you know, Paul will be telling me about stories where he's sitting at someone's kitchen counter just having a casual conversation, and how helpful that is just to break it down because we have made it so complicated. So we decided you know there's nothing stopping us from kind of distilling this casual kitchen counter discussion and making it into an online tool – something that people can view whenever they want.

We got together and we thought about all the different questions that people had, all the different scenarios, and found a way to break it down into some simple three, four, or five different questions that can help guide you based off when your date of birth is, your employment situation, do you travel, etc.

We created this online tool where in just a few quick questions, and about two or three minutes, you would have a tailored recommendation on your Medicare next steps, which saves so much anxiety. When we poll seniors about “What's your experience as you approach Medicare?” it's a lot of anxious feelings and putting it off to the side or being really uncertain. And we really wanted something to kind of take the veil of uncertainty off, and just show how simple it really is if you break it down.

PL: Because like Steve mentioned earlier in our discussion, more and more seniors are tech savvy and using the web more often. A lot of times they want to have an idea of what is out there before they even sit down with somebody. So our thought was, Why not take that Medicare expert and make it a Medicare expert in a box, by taking some of the things that myself or some of my teammates would ask as far as questions go, and put it into a tool and ask those same questions. We typically find when we're meeting with somebody, you can get a pretty good idea of their situation within just the first few questions you ask.

SM: In the typical education process, as you sift through on your own a myriad of different documents, some of them from CMS, some of them are from health plans, you have to go through a comprehensive list of all the different scenarios to actually find and hope you found the right solution for you and what your next steps are.

So what we did is rather than having to sift through all the information, you answer a few quick questions. We will give you that tailored recommendation and tailored dates – down to the date you need to enroll, the date you should sign up, and what plan might be right for you.

Medicare: Step-by-Step

“Research is a long and arduous process and we've kind of simplified it for you…”

JS: So this is called Medicare: Step-by-Step, right?

SM: Yep.

JS: And have you guys already been using it? It's out in the wild?

SM: Yeah. It's been live for about eight months now and there's different ways we promote it. You can find it through social channels. You can find it on Google.

JS: We'll be sure to include a link to Medicare: Step-by-Step and the show notes for this podcast too so that those of you listening can click on it and check it out for yourselves.

So what are some the things that you've seen people that have used this already? Have you gotten any feedback or noticed anything by the earlier doctors if you will the people that have already used it in the last you know eight months?

SM: Well the idea of saving time is a big hook, and so we've tested different messages to try to promote the product, and the one message that works the most is really you're saving time. Research is a long and arduous process and we've kind of simplified it for you, and so we've seen that message resonate really well. On the website analytics, a lot of people do want to email the results to themselves, so that is something that is popular. People like to keep and hold onto this information to save it for later. So that's a good feature that we're seeing that's working.

PL: Yeah, and I've actually had a couple of people that I was going to meet with that I asked them to go out and use the tool and try it out, and then bring the information in to me when we meet hoping that they would kind of start working their own research. By the time they even got to me, they would kind of have an idea about what path that they wanted to go down.

For the couple of people I asked to do this it actually worked out pretty well, because when they came in although they weren't educated on all things Medicare - which is not the purpose of the tool - they had a foundation that we could start working off of, verses those that have no clue or those maybe sometimes even worse that have talked to a neighbor or a family member and said, "Well here's kind of what I want to do because my Uncle Bob does this," and then you have to almost have to tear that down and start over. So yeah, it's showing that it can definitely help.

Tailoring to Different Levels of Knowledge

“By using the Medicare: Step-by-Step tool they're able to develop some questions that they may not have thought of otherwise.”

JS: This sounds like it can be a really handy tool for people in all different levels of digital savviness that are kind of aging into Medicare right? So whether it's the totally DIY person that wants to do it themselves, go online, go through the Step-by-Step tool, get the recommendation and follow it, you know they could sign up on their own.

But then you're also, Paul, using it as a tool to kind of do pre-interview before you go sit down with somebody and help them complete the process and make sure that they're getting that you know that great valuable help that you and your team provide.

PL: Exactly, and a lot of you know a lot of the confusion stems from people not knowing the information but also not knowing what they don't know. By using the Medicare Step-by-Step tool they're able to develop some questions that they may not have thought of otherwise. Now they're starting to see some things - the juices are flowing and now they're thinking, "Hey this talked about this. This brings up a question I have," so I think it not only helps set that foundation, but I think it can also help them start to think more creatively on their own part.

SM: The most common reaction that I get when watching someone go through the tool is that they had no idea why certain questions would be relevant. For example, Social Security or retirement date, and one neat feature in the tool is if you don't understand why we're asking a question in the first place, you can hover over and it will say why are we are asking you know are we already on Social Security or when do you plan to take it.

Those these little gottcha moments are pitfalls that we try to intercept early on to educate the consumer consider this and think about this and so that at the end of the experience as well we have this section called Avoid Common Pitfalls, because these pitfalls really are what they sound like. You can really get yourself in a pickle if you don't consider certain things as you approach 65.

Advice for Consumers, Patients and Members

“Understand that the topic they are covering with these people is very complex, can be very confusing and is something unlike anything they have had to deal with in the past.”

JS: Before we wrap up first of all thank you guys for sharing about Medicare. Step-by-Step and helping us learn more about Medicare, but before we go I want to hear from each of you what advice do you have to listeners today? Whether they're working in the health care industry or whether they're a consumer right, a patient, or a member - somebody looking to do their research on Medicare? What advice would you have for them?

PL: Actually I would give two pieces then, so for the people that are working in the health care industry that may work with care beneficiaries. I would ask that they remain patient. Understand that the topic they are covering with these people is very complex, can be very confusing and is something unlike anything they have had to deal with in the past.

So it does take a certain kind of person to understand that and be able to work through them. That you're really a teacher and an educator. Even if you are a sales executive or a salesperson the education part needs to come first.

And then for those that are Medicare beneficiaries that are aging in and looking at their Medicare options, I would ask them to do some research on your own so that you can formulate some of those questions and ideas, but also to contact a professional.

Get ahold and have conversations with a Medicare expert, because what your Uncle Bob has may be completely wrong for you. There's so many different situations and each person is special and different, and really a professional can dive into their specific situation, and make sure that what they are enrolling in is the best option for them.

SM: And my advice, this would be in the perspective of if you're in the marketing industry or health care industry or innovation, is when looking at this demographic, thinking and treating them with dignity and respect. Take those stereotypes out of your mind and kind of really understand who these people really are. They are our parents they are our grandparents and you know to have empathy with what they are going through because it's a jarring time. It’s a very complex thing when it comes to this large transition and you know aside from doing the education, consider this group with a lot of respect. I think that goes a long way.

JS: Excellent. And I'm just going add too, try the Medicare: Step-by-Step tool. Check that out and we will have the link in our show notes, so.

SM: Absolutely.

JS: Thank you guys for being here today I appreciate you sharing with us.

SM: No problem.

PL: Thank you.