Medicare Advantage Program Relaunch Case Study

This case study details the relaunch of a Medicare Advantage program by a non-profit health plan after an eight-year hiatus. The organization, leveraging over 25 years of experience in Medicaid and special needs, recognized the potential for growth in the Medicare Advantage market, which had evolved significantly during their absence. The study outlines the challenges faced in entering this complex market, particularly regarding compliance and the need for robust internal systems. It describes the decision to partner with MHK MarketProminence to facilitate member enrollment, premium billing, and financial reconciliation. The case study highlights the successful implementation of MarketProminence, which led to rapid growth, with the plan adding nearly 10,000 members in its first year and reaching a total of 14,000 members. Key factors contributing to this success included simplified enrollment processes, customization, and intelligent automation, which allowed the health plan to efficiently manage its operations and maintain compliance with regulatory requirements.