Healthier Members, Stronger Plans: The Economic Benefits of GetSetUp for Medicare Advantage

In today’s healthcare environment, Medicare Advantage (MA) plans are under growing pressure to balance high-quality service delivery with cost management amidst tight budgets and regulatory demands. As these plans search for innovative ways to engage, educate, and support their aging members, the need for solutions that are both effective and efficient becomes increasingly apparent.

GetSetUp offers a comprehensive, scalable solution tailored for Medicare Advantage plans. Covering critical areas such as digital literacy, health equity, financial literacy, fall prevention, member benefit education, and digital activation, GetSetUp consolidates multiple services into one cohesive platform. This not only enhances the overall member experience but also improves health outcomes—allowing Medicare Advantage plans to “do more with less.”

Why Partnering with GetSetUp is a Strategic and Cost-effective Solution 

1. Consolidating Multiple Services into One Comprehensive Platform

Medicare Advantage plans often engage with multiple vendors to provide various member services, from digital literacy training to health education and financial wellness programs. However, managing multiple contracts, vendors, and performance reports adds to the administrative burden and costs. GetSetUp offers a single, integrated platform that covers all of these critical areas, streamlining operations and improving member satisfaction.

Cost Efficiency:

• Streamlined Vendor Management: By partnering with GetSetUp, plans can reduce the complexities and expenses associated with managing multiple service providers. This consolidation simplifies oversight, performance tracking, and contract management.
• Lower Operational Costs: By offering diverse member services through one platform, plans can eliminate redundant programs and optimize resources. GetSetUp’s high engagement rates and broad appeal ensure that members’ diverse needs are met efficiently, reducing the need for multiple overlapping services.

2. High-impact programming with Proven Outcomes

GetSetUp’s platform is designed specifically for older adults, offering engaging, interactive programming that caters to this demographic's unique needs. The platform provides both live, instructor-led classes and hybrid on-demand content, giving members the flexibility to choose the learning format that suits their preferences and schedules. This ensures higher levels of participation, which directly correlates with improved health outcomes.

Economic Benefits:

• Reduced Healthcare Costs: GetSetUp’s focus on preventive health education and wellness can help reduce costly healthcare interventions, such as hospitalizations due to falls, unmanaged chronic conditions, or emergency department visits. 

For example, research by UnitedHealth Group showed that improving health literacy could prevent nearly 1 million hospital visits each year, including:

• 93,000 (6%) fewer avoidable hospitalizations.
• 80,000 (5%) fewer hospital readmissions.
• 820,000 (4%) fewer emergency department visits annually.

• Increased Retention: Satisfied and engaged members are more likely to stay with their current Medicare Advantage plan. This reduces the costs associated with member churn, such as marketing and recruitment of new members.

3. Supporting Regulatory Compliance and Member Satisfaction

As Centers for Medicare & Medicaid Services (CMS) guidelines place increasing emphasis on digital health education and member engagement, Medicare Advantage plans must demonstrate their commitment to these areas to maintain compliance and secure higher star ratings. GetSetUp’s programming not only meets CMS requirements but also fosters higher member satisfaction, which can have a direct impact on a plan’s financial performance.

Regulatory Alignment:

• CMS Compliance: GetSetUp’s educational programs align with CMS’s focus on member engagement, digital health, and preventive care. By integrating these offerings into a Medicare Advantage plan’s quality improvement initiatives, plans can show commitment to meeting regulatory requirements.
• Higher Star Ratings: Improved member engagement and satisfaction contribute to higher CMS star ratings. These ratings are critical for plans, as they influence reimbursement rates and bonuses. 

One UnitedHealth Group report showed that in counties with the highest health literacy levels, Medicare beneficiaries experience:

• 31% more flu vaccinations.
• 26% fewer avoidable hospitalizations.
• 18% fewer emergency department visits.
• 13% lower healthcare costs per beneficiary.
• 9% fewer hospital readmissions.

Cost Savings and Efficiencies Associated with Health Literacy for Older Adults

Health literacy is a crucial factor in improving both health outcomes and financial performance. Low health literacy is associated with poor health outcomes and higher healthcare costs. By improving health literacy, Medicare Advantage plans can achieve substantial savings and reduce preventable health incidents.

Key Statistics on Health Literacy and Cost Savings:

• Financial Savings: Enhancing health literacy could save the Medicare program over $25.4 billion annually.
• Medicare Beneficiary Health Costs: On average, spending per Medicare beneficiary is $700 less in counties with the highest health literacy levels compared to counties with lower literacy levels.
• Preventable Hospital Visits: Improving health literacy could prevent nearly 1 million hospital visits annually, contributing to significant cost savings for Medicare Advantage plans.

Partnering with GetSetUp offers Medicare Advantage plans a powerful, cost-effective solution to meet the needs of their aging populations. By consolidating multiple services into one comprehensive platform, MA plans can streamline operations, reduce costs, and improve member engagement. GetSetUp’s proven results in health literacy and wellness education further contribute to better health outcomes, fewer costly hospitalizations, and higher member retention.

In an economic climate where Medicare Advantage plans must “do more with less,” GetSetUp provides the perfect solution—delivering high-value services that enhance both member satisfaction and plan performance.

Additional Data Sources

Data points illustrating the benefits of digital engagement among older adults and how it impacts health plans:

1. Improved Health Outcomes Through Digital Engagement

• Empowerment in Healthcare Decisions: A study published in JAMA Network Open found that 81% of older adults (aged 50 to 80) use digital health technologies, such as patient portals and mobile health apps, to manage their health. This engagement is associated with improved health literacy and proactive health management. 
• Reduction in Emergency Room Visits: Research indicates that older adults who actively use telemedicine services have more frequent interactions with their healthcare providers and a lower utilization of low-value clinical tests, potentially leading to reduced emergency room visits and healthcare costs. 

2. Cognitive and Emotional Benefits

• Decreased Depression and Increased Social Satisfaction: Regular internet use among individuals over 50 is linked to increased life satisfaction and lower levels of depression, as it enhances social connectivity and reduces feelings of loneliness. 
• Reduced Risk of Cognitive Decline: Engagement in online group exercises has been shown to improve physical, psychological, and social well-being in older adults, which are factors associated with a lower risk of cognitive decline. 

3. Cost Savings and Lower Healthcare Utilization

• Fewer Hospital Readmissions and Cost Savings: A study highlighted that older adults account for a significant portion of healthcare expenditures. Digital health interventions, such as personalized digital coaching, have the potential to reduce hospital readmissions and associated costs by promoting better health management among older adults. 
• Increased Member Satisfaction and Loyalty: Health plans that incorporate digital health technologies and provide support through education for their use may experience increased member satisfaction and loyalty, as older adults become more confident in navigating health services. 

4. Higher Rates of Preventative Care and Screening

• Increased Participation in Preventative Care: Older adults who engage with digital health technologies are more likely to participate in preventive care measures, such as regular health screenings and vaccinations, due to improved access to health information and services. 
• Reduction in Late-Stage Diagnoses: Access to online health education and resources enables older adults to seek timely medical advice, potentially leading to earlier diagnoses and reducing the incidence of late-stage disease presentations. 

These data points underscore the significant benefits of digital engagement for older adults, including improved health outcomes, enhanced cognitive and emotional well-being, cost savings, and increased participation in preventive care.