PremiumAssist Dual Eligible Enrollment & Retention

Centauri's PremiumAssist Dual Eligible Enrollment & Retention solution identifies eligible Medicare Advantage health plan members who qualify for dual eligible status through outreach, enrollment, and redetermination services.

 

CMS has increased their focus on dual eligibility and clinical comorbidities as capitation drive. The new in-year capitation model puts plans at higher risk if members leave the plan, increasing the need for retention efforts. Failure to recertify is most frequent cause for loss of dual enrollment (and dual plan revenue) among Medicare beneficiaries.  PremiumAssist utilizes a proactive engagement strategy with members to promote retention of dual status and reduce traditional fall-off rates by up to 50%.

 

Our services can help the majority of dual eligible members receive $165 a month towards their standard premium. For those on a fixed income, a $1,980 a year savings can make a noticeable difference in their quality of life. And, with the SocialService+ Social Determinants of Health (SDOH) option, members can also receive assistance with non-medical community benefits that they would not have otherwise known existed.

Key Differentiators

  • Industry-leading AI-driven analytics identify, quantify and predict high value members within non-dual and dual eligible populations with 95% accuracy
  • Outreach to members using on-shore advocates without the use of IVR technology for meaningful, human connections
  • Support for Medicaid Deductible and Spend Down qualifications included in core product
  • Superior retention results – clients have reported dual Medicare/Medicaid retention rates up to 5% better
  • Superior re-enrollment results, average length of Medicaid fall off reduced by 30%
  • Compliant, interactive reporting dashboard updated daily
  • Plan referrals support conversion results
  • HITRUST Certified
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