Low-Income Subsidy (LIS) Enrollment Help
- Medicare Advantage (MA) plans are gearing up for the 2027 launch of the Health Equity Index (HEI), placing increased emphasis on addressing social risk factors (SRFs).
- The LIS program provides crucial financial assistance for Medicare recipients, covering Part D drug costs.
- Wiht the HEI replacing the reward factor in Star Ratings, the stakes are higher.
Boost your Medicare Advantage plan’s performance by focusing on Low-Income Subsidy (LIS) enrollment. The countdown to the Health Equity Index (HEI) in 2027 is on, making LIS enrollment more critical than ever. This guide details how Medicare Advantage plans can proactively identify and engage eligible members, ensuring thay benefit from crucial financial assistance for prescription drugs. Discover how targeted outreach programs, leveraging claims data, socioeconomic insights, and predictive analytics, can significantly increase LIS enrollment.Successful strategies include multichannel campaigns that boost LIS reapplication completion rates. news Directory 3 can provide additional insights to help you learn how some plans are seeing remarkable results from these initiatives. Find out about the latest strategies and learn how you can ensure your plan is ready for the HEI.Discover what’s next …
Medicare Advantage plans Focus on Low-income Subsidy Enrollment
Updated June 12, 2025
Medicare Advantage (MA) plans are gearing up for the 2027 launch of the Health Equity Index (HEI), placing increased emphasis on addressing social risk factors (SRFs). Key among these is boosting enrollment in the Low-Income Subsidy (LIS) program, which helps beneficiaries afford prescription drugs.
The LIS program provides crucial financial assistance for Medicare recipients, covering Part D drug costs. Though, the Centers for Medicare & Medicaid Services (CMS) estimates that as many as 3 million eligible beneficiaries remain unenrolled. By increasing enrollment,MA plans can lower out-of-pocket expenses for members,improve medication adherence,and positively influence their Star Ratings.
Wiht the HEI replacing the reward factor in Star Ratings, the stakes are higher. MA plans must proactively identify and enroll eligible members to maintain high performance and qualify for quality bonus payments.
identifying potential LIS recipients requires a multi-faceted approach.While claims data offers a starting point, plans are encouraged to incorporate socioeconomic data, geospatial details, and insights from health screenings to gain a complete understanding of member eligibility. Predictive analytics can then be used to target outreach efforts.
One large payer partnered with Cotiviti to implement a multichannel outreach campaign, using interactive voice response (IVR), text messaging, direct mail, and live agents to engage members nearing their LIS reapplication deadline. This support included warm transfers to the Social Security administration to facilitate seamless reapplication.
in 2023, the outreach program saw significant success. Eighty-one percent of the 27,000 targeted members were reachable via IVR, and 93% through text. Live agents connected with 25% of members, assisting 56% of them in completing their applications. This resulted in a notable increase in the number of members receiving no-cost prescription drug benefits.
What’s next
As the HEI rollout approaches, the LIS program’s importance will continue to grow. MA plans that prioritize engaging vulnerable populations and facilitating access to critical benefits will not only improve individual health outcomes but also enhance their Star Ratings performance.