Medicare Advantage Intake Surveys May Draw Insights, But Not Always

New Medicare Advantage plan members can self-report their health literacy status during the enrollment process, but may not be as responsive in an enrollment survey of perceived healthcare discrimination, a Humana study found.

Using a cross-sectional study design, Humana implemented a live telephonic concierge outreach service to enroll and survey new Medicare Advantage members. Two questions were included in the intake process to assess response rates and the feasibility of collecting self-reported data. The study lasted from December 2021 to March 2022. It covered 406 members.

The service asked enrollees one of two questions to gather self-reported data on perceived healthcare discrimination and health literacy. First, the concierge advocate inquired as to how new members would compare their quality of care in the last year to the care of patients from different races. Second, the advocate asked how often the new members needed help when engaging with health-related materials.

More patients were willing to reply to the health literacy screening than to the perceived healthcare discrimination question. Only 5.4 percent of survey participants refused to engage in the healthcare literacy question, compared to over a fifth (22.8 percent) who declined to comment on the perceived healthcare discrimination query.

These results indicated that health literacy screenings may be more feasible than perceived healthcare discrimination screenings. Both patients and advocates were more comfortable engaging with the health literacy question than its counterpart. In 4.9 percent of the enrollment calls involving a perceived healthcare discrimination screening, advocates skipped the question.

Black enrollees were less likely to be nonresponsive to the perceived healthcare discrimination question, with a 16.1 percent nonresponse rate compared to 23.2 percent nonresponse among other races. Out of the seven respondents who reported experiencing perceived healthcare discrimination, six identified as Black.

For the health literacy question, around 18 percent of the respondents reported low or limited healthcare literacy. These enrollees were more likely to be in the low-income bracket and Black. They also had higher rates of loneliness and social isolation and were more likely to experience food insecurity.

The researchers warned that the sample used in this study was not balanced. The population was primarily low-income and non-White. This dynamic produced a sampling bias, so the results should be considered critically.

One of the key takeaways, according to the researchers and to the payer organization behind this study, was that telephonic, enrollment surveys can effectively contribute to data and insights on certain enrollment populations. However, the approach is not appropriate for all queries. Humana will implement these results in its own business practices.

“Learnings from this pilot have been very informative for our business and have led to a number of programs and interventions across the [Humana] enterprise,” J. Nwando Olayiwola, MD, chief health equity officer and senior vice president at Humana said in a press release. 

“We have expanded screening to digital and live modalities, strengthened our staff capabilities around understanding and responding to low/limited health literacy, and improved engagement with our members. This is the goal of any thoughtful screening programs- leveraging insights for tangible action.”