UnitedHealth Makes Big Move to Help Seniors Navigate MA

As competition increases among payers to sign up and retain seniors in Medicare Advantage plans, UnitedHealth has added 800 nurses and customer-service advocates to its concierge-services team to help seniors with complex conditions navigate their care. The move greatly expands UnitedHealth’s Navigate4me program, which launched in 2017.

Early results from the program have been positive, with a 14 percent reduction in hospitalizations, a 9 percent reduction in emergency department visits for congestive heart-failure patients and a 95 percent satisfaction rate among those who received navigator support.

By expanding its concierge services team from just a dozen associates to more than 800, UnitedHealth should be better positioned to serve its rapidly expanding customer base in its MA plan. The payer plans to double enrollment in the Navigate4me program to 1 million in 2019 by expanding patient groups eligible for the services, including:

• Those who are younger than 65 with a disability and who qualify for Medicare.
• Post-acute care patients following a hospitalization who meet eligibility requirements.
• Those newly diagnosed with Alzheimer’s disease.
• Those who are at risk for social isolation.

MA enrollment nationally is projected to rise to 38 million, or 50 percent of market penetration, by the end of 2025, according to a report last year from L.E.K. Consulting. Forbes reports that currently just under 35 percent of Medicare beneficiaries, or about 20 million Americans, are enrolled in MA plans and that the Centers for Medicare & Medicaid Services projects this number will rise to more than 22 million for 2019. Large insurers such as Aetna, Cigna, Humana and Anthem are in fierce competition with UnitedHealth to expand their Medicare Advantage program offerings.