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Medicare Advantage plans have played an increasingly larger role in the Medicare program over the past decade. More than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans in 2018. This collection provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes new analyses of Medicare Advantage plans’ extra benefits, use of prior authorization, and bonus payments paid by Medicare.

1. Enrollment in Medicare Advantage has nearly doubled over the past decade

In 2018, one in three (34%) Medicare beneficiaries – 20.4 million people – is enrolled in a Medicare Advantage plan. Between 2017 and 2018, total Medicare Advantage enrollment grew by about 1.5 million beneficiaries, or 8 percent – a nearly identical rate of growth compared to the prior year. The Congressional Budget Office (CBO) projects that Medicare Advantage enrollment will to continue to grow over the next decade, with plans including about 42 percent of beneficiaries by 2028.

One in five Medicare Advantage enrollees (4.1 million) are in group plans offered by employers and unions for their retirees in 2018. Under these arrangements, employers or unions contract with an insurer and Medicare pays the insurer a fixed amount per enrollee to provide benefits covered by Medicare. The employer or union (and sometimes the retiree) may also pay a premium for additional benefits or lower cost-sharing. The growth in enrollment in Medicare Advantage group plans reflects a larger trend by large employers (including state governments) and unions to adopt strategies to limit their liability for retirees’ health costs. Group enrollees comprise a disproportionately large share of Medicare Advantage enrollees in nine states: Alaska (100%), West Virginia (53%), Michigan (51%), Illinois (42%), Kentucky (39%), Delaware (37%), Maryland (35%), New Jersey (34%), and Wyoming (30%).

3. The share of Medicare beneficiaries in Medicare Advantage plans ranges across states from 1% to over 40%

The share of Medicare beneficiaries in Medicare private health plans, including Medicare Advantage plans and Medicare cost plans, varies across the country. In 25 states, at least 31 percent of Medicare beneficiaries are enrolled in Medicare private health plans, with more than 41 percent of enrollees in four states (FL, HI, MN, and OR). The majority of the Medicare private health plan enrollment in Minnesota is in cost plans, rather than Medicare Advantage plans; cost plans are paid differently and subject to different rules than Medicare Advantage plans. Medicare Advantage enrollment is less than 11 percent of Medicare beneficiaries in three mostly rural states (AK, VT, and WY).

4. The share of Medicare beneficiaries in Medicare Advantage plans varies across counties from less than 1% to more than 60%

Within states, Medicare Advantage penetration varies across counties. For example, in Florida, 66 percent of all beneficiaries living in Miami-Dade County are enrolled in Medicare Advantage plans whereas only 10 percent of beneficiaries living in Monroe County (Key West) do so. In 135 counties, more than half of all Medicare beneficiaries are enrolled in Medicare Advantage plans or cost plans. Many of these counties are centered around large, urban areas. For example, while Miami-Dade County is the urban area with the highest Medicare Advantage penetration rate, 65 percent of beneficiaries in Monroe County, NY (Rochester) and 62 percent of beneficiaries in Allegheny County, PA (Pittsburgh) are enrolled in Medicare Advantage plans. In contrast, in 688 counties (22%), no more than 10 percent of beneficiaries are enrolled in Medicare private plans; many of these low penetration counties are in rural parts of the country but some urban areas, such as the District of Columbia, also have relatively low Medicare Advantage enrollment.

5. Half of Medicare Advantage Prescription Drug Plan enrollees pay no premium (other than the Part B premium)

Most Medicare Advantage enrollees (88%) are in plans that include prescription drug coverage (MA-PDs), and about half of these beneficiaries pay no premium for their plan, other than the Medicare Part B premium. However, one-quarter of beneficiaries in MA-PDs pay at least $50 per month, including 10 percent who pay $100 or more per month, in addition to the Part B premium. Among MA-PD enrollees who pay a premium for their plan, the average premium is $70 per month. On average, beneficiaries in MA-PDs pay $34 per month in 2018.

6. Premiums paid by Medicare Advantage Prescription Drug Plan enrollees have been relatively constant since 2012

Overall, average premiums at the national level have been relatively steady for MA-PD enrollees since 2012, although premiums for regional PPOs have steadily increased while premiums for other types of plans have declined. Average MA-PD premiums range from $26 per month for HMO enrollees to $48 per month for local PPO enrollees and $45 per month for regional PPO enrollees.

7. Medicare Advantage enrollees’ out-of-pocket costs for Part A and B services are capped at $5,187, on average, in 2018

In 2018, the average out-of-pocket limit for in-network services covered under Medicare Part A and B services for Medicare Advantage enrollees is $5,187, similar to 2017 and 2016 levels, but substantially higher than $4,288 in 2011. As in prior years, HMO enrollees generally have lower out-of-pocket limits ($4,908 on average) than enrollees in local PPOs ($5,908 on average) or regional PPOs ($6,519 on average). Since 2011, Medicare Advantage plans have been required to limit enrollees’ out-of-pocket expenditures for services covered under Parts A and B – in contrast with traditional Medicare – and are required to have limits for in-network services that are no more than $6,700 annually. Limits were required for regional PPOs since they were first authorized in 2006.

8. Four out of five Medicare Advantage enrollees are in plans that require prior authorization for some services

Medicare Advantage plans can require enrollees to receive prior authorization before a service will be covered, and most Medicare Advantage enrollees (80%) are in plans that require prior authorization for some services in 2018. Prior authorization is most often required for expensive services, including skilled nursing facility stays, inpatient hospital stays, and Part B drugs, and is infrequently required for preventive services. In contrast to Medicare Advantage plans, traditional Medicare does not generally require prior authorization for services.

9. Most Medicare Advantage enrollees have access to some benefits not covered by traditional Medicare in 2018

Medicare Advantage plans may provide extra benefits that are not offered in traditional Medicare. Medicare Advantage plans can use rebate dollars (including bonus payments) to help cover the cost of extra benefits. Plans can also charge additional premiums for such benefits. Most enrollees are in plans that provide some dental care (62%), a fitness benefit (69%), and/or eye exams or glasses (77%). Since 2010, the share of enrollees in plans that provide fitness benefits or some dental care has increased (from 52% and 48% of enrollees, respectively) while the share with a vision benefit has been relatively steady (77% in 2010).

10.Total bonuses paid by Medicare to Medicare Advantage plans more than doubled over 4 years

Since 2012, Medicare Advantage plans have been receiving bonus payments, as a result of changes made by the Affordable Care Act of 2010 and a CMS demonstration that terminated after 2014. Medicare Advantage plans with quality ratings of 4 or more stars, and plans without ratings are eligible for bonus payments. Between 2015 and 2018, the total annual bonuses to Medicare Advantage plans have more than doubled, from $3.0 billion to $6.3 billion. The rise in bonus payments is due to both an increase in the number of plans receiving bonuses, and an increase in the number of enrollees in these plans.

11. Extra benefits are funded by bonuses and other rebate dollars paid by Medicare

Extra benefits offered by Medicare Advantage plans are funded wholly or in part by bonuses and other rebate dollars. In 2018, Medicare Advantage plans will receive an estimated $6.3 billion in bonuses, averaging $321 per enrollee. Medicare requires plans to use bonus payments to reduce cost-sharing or premiums, or provide extra benefits, while retaining some portion of the bonus payments for administrative expenses. Bonus payments are much higher, on average, for people enrolled in Medicare Advantage plans sponsored by employers or unions ($585 per enrollee) than for people in Medicare Advantage plans open to all beneficiaries ($260 per enrollee). Employer-sponsored group plans account for 20 percent of Medicare Advantage enrollment but 37 percent of bonus payments. Special Needs Plans, which are mostly comprised of people dually eligible for Medicare and Medicaid, account for 13 percent of enrollment but only 9 percent of bonus payments in 2018.

12. Most (74%) enrollees are in Medicare Advantage plans that receive bonuses in 2018 (4 or more stars or not rated)

In 2018, 74 percent of Medicare Advantage enrollees are in plans with quality ratings of 4 or more stars and eligible for bonus payments, an increase from 67 percent in 2017. An additional 1 percent of enrollees are in plans that were not rated because they were part of contracts that had too few enrollees or were too new to receive ratings.

For many years, CMS has posted quality ratings of Medicare Advantage plans to provide beneficiaries with additional information about plans offered in their area. All plans are rated on a 1 to 5-star scale, with 1 star representing poor performance, 3 stars representing average performance, and 5 stars representing excellent performance. CMS assigns quality ratings at the contract level, rather than for each individual plan, meaning that each plan covered under the same contract receives the same quality rating (and most contracts cover multiple plans).

https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage/

1. "Boiler Room": To get you hungry for success

A young Ben Affleck nails it with this classic "Boiler Room" speech. Fifteen years later and this interview scene still racks up thousands of hits on YouTube. Why? He's not joking.

Inspiring Line:

"You will make a million dollars within three years of your first day of employment at J.T. Marlin. There is no question as to whether or not you'll become a millionaire working here. The only question is how many times over."

2. Amy Cuddy: To remind you nonverbal cues are crucial to your success

Bow down to the queen of keynotes. Amy Cuddy brought in an impressive seven million views for this TED Talk, placing it among the top 20 TED Talks of all time -- and for good reason.

This video is full of interesting tidbits about the nonverbal cues you're giving every minute, every day. Her advice on "power posing" is invaluable when it comes to sales meetings. Remember: Your prospects are not only evaluating your pitch, but your confidence and how you carry yourself.

Inspiring Line:

"If you feel like you shouldn't be somewhere: Fake it. Do it not until you make it, but until you become it."

3. "Hidden Figures": To highlight the importance of being first

"Hidden Figures" is the true story of Katherine Johnson (Taraji P. Henson), Dorothy Vaughan (Octavia Spencer), and Mary Jackson (Janelle Monáe), three African-American women who serve at NASA as part of astronaut John Glenn's historic launch into orbit.

This clip highlights Jackson's fight to be allowed to attend classes that would further her work as a NASA engineer. Never underestimate the value of a well-worded, thoughtful speech in winning someone over.

Inspiring Line:

"Out of all the cases you're going to hear today, which one is going to matter a hundred years from now? Which one is going to make you the first?"

4. Steve Jobs: To encourage you to love what you do

Steve Jobs. Arguably the best salesperson of our generation explains what really makes us salespeople tick: The love of what we do. Remind yourself of this and you will succeed every time.

Inspiring Line:

"If you look at the ones that ended up being successful in the eyes of society, oftentimes it's the ones that loved what they did, so they could persevere when it got really tough."

5. "Friday Night Lights": To motivate you to work as a team

It has been said that sales is the ultimate contact sport. Football or sales, every day you go out there and hustle your way to the top. Whether you're in the locker room or sitting at your desk, this one pulls on the heartstrings.

Inspiring Line:

"Being perfect is not about that scoreboard out there. It's not about winning. It's about you and your relationship to yourself and your family and your friends. Being perfect is about being able to look your friends in the eye and know that you didn't let them down."

6. Motivational Montage: To give you a quick hit of all the motivational greats

A quick search for "motivational speech" will bring you 2,150,000 YouTube results, but when it comes to quality, Mateusz M is the king of catalyst. Mateusz has created an art of his own. "Dream" is a personal favorite. A montage made from the very best of "Into The Wild," "Rocky 4," "Seven Pounds," "Pursuit of Happyness," and "A Beautiful Mind," completes this piece of gold.

Inspiring Line:

"Greatness is not this wonderful, esoteric, elusive, god-like feature that only the special among us will ever taste. It's something that truly exists -- in all of us."

7. "Wolf of Wall Street": To get you fired up

This entire movie is full of outrageous monologues, but if you don't have hours to spare, here's a three-minute refresher. A quick recap of this blockbuster: Jordan Belfort (the real-life "Wolf of Wall Street") gets out of jail, writes a New York Times bestselling memoir, and sells the film rights to Red Granite Productions. The biopic grosses $392 million worldwide and Leo lands a Golden Globe for Best Actor. Everybody's happy!

The (Only SFW) Inspiring Line:

"So you listen to me and you listen well. Are you behind on your credit card bills? Good -- pick up the phone and start dialing!"

8. The Young Guru: To make you cry a little

The youngest motivator to grace this list, this six-year-old superstar's words of wisdom are so moving they have been made into dozens of autotune remixes. A T-Pain in the making.

Inspiring Line:

"Thumbs up everybody -- for rock and roll!"

9. Shonda Rhimes: To remind you to push past your comfort zone

For one year, Shonda Rhimes said "yes" to everything that scared her and got her out of her comfort zone. She's the powerful mind behind the hit shows Grey's Anatomy, Scandal, and How to Get Away With Murder.

Rhimes is passionate about her work and when she's in the zone, and deep in her work, she calls it a "hum." In her Ted Talk, she tells her story of how she lost her "hum" and what she did to get it back.

Inspiring Line:

"And a crazy thing happened: the very act of doing the thing that scared me undid the fear, made it not scary. My fear of public speaking, my social anxiety, poof, gone. It's amazing, the power of one word. "Yes" changed my life."

10. "Erin Brockovich": To highlight why you should play the long game

Erin Brockovich is a legal clerk and environmental activist who was instrumental in building a case against the Pacific Gas and Electric Company of California in 1993 despite her lack of formal education.

Julia Roberts famously brought Brockovich to life in the eponymous film, showing just what planning, hard work, and grit can do to turn a meeting or a deal your way.

Inspiring Line:

"By the way, we had that water brought in special for you folks."

11. "Glengarry Glen Ross": To make you feel like a closer

I'm just going to say it: This is the most iconic sales monologue of all time. Alec Baldwin completely demolishes this scene from 1992's "Glengarry Glen Ross." In terms of practical advice, you might be better off with Amy Cuddy but Alec instills a bit of good old-fashioned grit. Who's a closer? You're a closer!

Inspiring Line:

"A-B-C. A: always, B: be, C: closing. Always be closing!"

12. Amy Purdy: To challenge you to look at obstacles as opportunities

How do you respond to challenges? Amy Purdy, now a professional snowboarder, lost both her legs below the knee when she was 19 years old. She tells her inspiring story of recovery and how she drew inspiration despite facing a tremendous obstacle.

Inspiring Line:

"So the thought that I would like to challenge you with today is that maybe instead of looking at our challenges and our limitations as something negative or bad, we can begin to look at them as blessings, magnificent gifts that can be used to ignite our imaginations and help us go further than we ever knew we could go. It's not about breaking down borders. It's about pushing off of them and seeing what amazing places they might bring us."

13. "Braveheart": To inspire your courage

Alright, so Mel isn't really talking about sales here but it's too epic to not make the list. Channel your inner William Wallace while you work through those cold calls.

Inspiring Line:

"They may take our lives but they will never take our freedom!"

14. "Joy": To put a smile on your face

"Joy" is the true story of entrepreneur and QVC star Joy Mangano. During a tour of the QVC sound stage, executive Neil Walker (played by Bradley Cooper) explains what makes stars Joan Rivers and her co-host Cindy so great at selling.

He highlights their timing and the warmth they bring to their sales segments. It's more than just who they are and what they're pitching, it's that they're masters of knowing their audience and closing deals.

Inspiring Line:

"The stars, they always make the mistake -- they think it's about the face but it's not. It's really about the hands and the eyes."

15. Eric Thomas: To remind you, you've got to want it

How bad do you want it? Perhaps one of the most underrated speeches on this list comes from Eric Thomas, a motivational speaker, and youth activist. While you're at it, download this as an MP3 and put it on your gym playlist. Get your elliptical on.

Inspiring Line:

"Listen to me -- you will never be successful until I don't have to give you a dime to do what you do."

Bonus Inspiring Line (too great to leave out):

"When you want to succeed as bad as you want to breathe, then you'll be successful."

16. Angela Lee Duckworth: To help you build your grit

It takes grit to succeed in sales. In her TED Talk, Angela Lee Duckworth speaks about the power of passion and perseverance. She also emphasizes the need for a growth mindset to build grit. The growth mindset is the idea that "the ability to learn is not fixed, that it can change with your effort" and it was introduced by psychologist Dr. Carol Dweck.

Bonus material: Here's Dweck's Ted Talk that provides more detail about the growth mindset.

Inspiring Line:

"Grit is passion and perseverance for very long-term goals. Grit is having stamina. Grit is sticking with your future, day in, day out, not just for the week, not just for the month, but for years, and working really hard to make that future a reality. Grit is living life like it's a marathon, not a sprint."

17. "Any Given Sunday": To stress no gain is too small

In this classic clip from "Any Given Sunday", Al Pacino's Coach Tony D'Amato fires up his players before a big game by explaining that life is a game of inches. We fight for what we want, inch by inch, to reach our goals. That's how we become successful. That's how we win.

Inspiring Line:

"Life's this game of inches. In life or football, the margin for error is so small ... the inches we need are everywhere around us ... on this team, we fight for that inch ... That's what living is -- that six inches in front of your face."

18. "The Pursuit of Happyness": To remind you no one can tell you what you can or can't do

In the Pursuit of Happyness, Will Smith's character is a father on the brink of homelessness trying to make a better life for his son. In this scene, he encourages his son to fight for his dreams -- even in the face of being told he "can't" do something.

Inspiring Line:

"Don't ever let someone tell you can't do something. Not even me, alright? You got a dream? You got to protect it."

19. "The Office": To show you the power of passion in creating a compelling message

If you're a fan of the office, you're likely familiar with this inspiring clip. Dwight's prank-prone coworker Jim, coaches a nervous Dwight before a big speech he must give to other paper salespeople at a Northwest conference. What Dwight doesn't know is that Jim has coached him with speech notes from infamous dictators. Dwight delivers the speech and puts so much heart into it, the room is inspired -- a reminder that when you're passionate about something, it's infectious (even if it's a little ridiculous).

Inspiring Line:

"Some people will tell you salesman is a bad word. They'll conjure up images of used-car dealers and door-to-door charlatans. This is our duty to change their perception. I say salesmen and women of the world unite. We must never acquiesce, for it is together, together that we will prevail."

Source

For some older adults, private Medicare Advantage plans next year will include a host of new benefits, such as transportation to medical appointments, home-delivered meals, wheelchair ramps, bathroom grab bars, or air conditioners for asthma sufferers.

But the new benefits will not be widely available, and they won't be easy to find, during this fall's enrollment period.

Of the 3,700 plans across the country next year, only 273 in 21 states will offer at least one. About 7 percent of Advantage members — 1.5 million people — will have access, Medicare officials estimate.

That means even for the savviest shoppers it will be a challenge to figure out which plans offer the new benefits and who qualifies for them.

Medicare officials have touted the expansion as historic and an innovative way to keep seniors healthy and independent.

Despite that enthusiasm, a full listing of the new services are not available on Medicare's web-based "plan finder," the government tool used by beneficiaries, counselors and insurance agents to sort through dozens of plan options.

Medicare officials see the added benefits as a key to helping Advantage members prevent costly hospitalizations. Federal approval of new supplemental benefits is "one of the most significant changes made to the Medicare program," said Seema Verma, the head of the Centers for Medicare & Medicaid Services, at an insurers' meeting last month. She added that she expects plans to expand the number of services in coming years.

Medicare Advantage plans, which are an alternative to traditional Medicare, serve 21 million beneficiaries and limit their out-of-pocket expenses. But they also restrict members to a network of doctors, hospitals and other medical providers. They often offer benefits not available in traditional Medicare, such as dental and vision care, hearing aids and gym memberships. The federal government pays the plans to help cover the cost of each member.

Enrollment is underway now for choosing a Medicare Advantage plan, as well as for people in traditional Medicare who want to buy a policy for drug coverage. The deadline for both plans is Dec. 7.

Among the new benefits that some Medicare Advantage plans said they will offer are:

• Trips to the pharmacy or fitness center in addition to doctor's appointments for plan members, depending on where they live or their health conditions.
• A monthly or quarterly allowance for over-the-counter pharmacy products such as cold and allergy medications, eye drops, vitamins, supplements and compression stockings.
• Doctors or other health care providers who make housecalls, under certain conditions.
• A home health care aide for a limited number of hours to help with dressing, eating and other daily activities, sometimes including household chores and light housekeeping.

Read the full article here

Last month CSG Actuarial reported the 3rd quarter 2018 Medicare Supplement enrollment results for UnitedHealthcare.  They now have updates from other market leaders Aetna, Humana, CNO Financial, and Torchmark, summarized below.

Aetna Reports Results for 3rd Quarter 2018

For 3rd quarter 2018, Aetna reported Medicare Supplement member in-force counts of 775,000, up 18,000 from 2nd quarter 2018 and 42,000 over the past 12 months.  The 18,000 increase in membership during 3rd quarter 2018 was double the membership growth in 3rd quarter 2017.  The table below shows Aetna’s Medicare Supplement enrollment counts by quarter since 4th quarter 2011 and annual increase in Medicare Supplement enrollment counts by quarter since 4th quarter 2012.  CSG Actuarial projects Aetna’s overall Medicare Supplement sales at 4th in the overall market over the past 12 months.

Humana Reports Medicare Supplement Results for 3rd Quarter 2018

Humana reported 3rd quarter 2018 Medicare Supplement lives of 246,600, a 2.1% increase over 2nd quarter 2018 and a 5% increase over 3rd quarter 2017.  The 5,100 increase in membership during 3rd quarter 2018 was 132% higher than the membership growth in 3rd quarter 2017.  The table below shows Humana’s Medicare Supplement enrollment counts by quarter since 1st quarter 2011.  Humana also reported 2nd quarter 2018 Medicare Supplement premiums of $129 million, up 7% from 3rd quarter 2017.  Based on estimates from CSG Actuarial, Humana’s sales ranked 7th in the market over the past 12 months.

CNO Financial Group Reports Medicare Supplement Sales in 3rd Quarter 2018

CNO Financial Group (parent company of Bankers Life & Casualty, Washington National, and Colonial Penn) reported 3rd quarter 2018 Medicare Supplement sales of $13.9 million, down 3% from 2nd quarter 2018.  For the past 12 months CNO Financial Group reported Medicare Supplement sales of $61.1 million, ranking in the top 10 in the Medicare Supplement market.  CNO Financial Group also reported 3rd quarter 2018 Medicare Supplement earned premiums of $204 million, equal to results from 2nd quarter 2018.

Torchmark Reports Medicare Supplement Sales in 3rd Quarter 2018

Torchmark reported 3rd quarter 2018 Medicare Supplement annualized new sales of $13.4 million, up 32% from 3rd quarter 2017.  For the past 12 months, Torchmark reported Medicare Supplement annualized new sales of $72.7 million, ranking in the top 10 in the market.

Source

Benjamin Franklin once said, "Experience keeps a dear school, but fools will learn in no other." In other words, you can rely solely on first-hand experiences to gain sales knowledge -- but it might be painful.

To dramatically cut down on your learning curve, pick up some sales books. A read penned by a selling expert will offer you all the benefits of personal experience without negatively affecting your quota or efficacy.

Picking a book can be tough, as there are thousands to choose from. Enter: This reading list. Hubspot has curated the top-ranked books from Amazon's sales best-sellers. Whether you want to ask better questions, prospect more effectively, lead your sales team, or become an all-around better salesperson, there's a pick here for you.

Here is the list:

1. "The Challenger Sale: Taking Control of the Customer Conversation"

Matthew Dixon and Brent Adamson

According to a study of thousands of sales reps across multiple industries and geographies, the most successful put their energy toward delivering valuable insights -- not becoming their prospect's friend. Join the ranks of the top performers with Adamson and Dixon's signature Teach, Tailor, and Take Control methodology.

Review excerpt: "This is an excellent book, with provocative insights and useful information for salespeople looking for ways to break out of the pack."

2. "The Challenger Customer: Selling to the Hidden Influencer Who Can Multiply Your Results"

Brent Adamson, Matthew Dixon, Pat Spenner, and Nick Toman

CEB's latest research reveals even Challenger salespeople struggle to close without the help of a very specific type of customer stakeholder: The Mobilizer. In this book, you'll learn how to identify Mobilizers, engage them, and work with them to get deals over the finish line.

Review excerpt: "What a great follow-up to the Challenger Sale. (It) provided me with additional insight on how to approach selling to a group of stakeholders. It has real data, real studies and real tactical strategies. If you're in the B2B space, this book is a must!"

3. "New Sales. Simplified.: The Essential Handbook for Prospecting and New Business Development"

Mike Weinberg

Looking for a one-stop guide to bringing on new business? Look no further. In this book, Weinberg lays out a proven formula for finding prospects, developing the relationship, and reaching a mutually beneficial agreement.

Review excerpt: "I loved the stories, the irreverent tone, and the honesty of this book. But what I appreciated most was that it delivered on its title -- this book really does simplify what you have to do successfully acquire new customers."

4. "The Psychology of Selling: Increase Your Sales Faster and Easier Than You Ever Thought Possible"

Brian Tracy

Learn how to harness psychological principles in the sales process while simultaneously getting a dose of personal motivation.

Review excerpt: "‘The Psychology of Selling' is a superb, practical, easy-to-read return to the fundamentals of professional salesmanship for novices, journeymen, and seasoned, top-performing salespeople. More than common sense placed into form, it serves as an instructional blueprint -- or as a road map -- to establish, build, grow, and maintain a successful sales career."

5. "The Science of Selling: Proven Strategies to Make Your Pitch, Influence Decisions, and Close the Deal"

David Hoffeld

Hoffeld's advice is based on the latest research in behavioral economics, social psychology, and neuroscience. You'll learn a science-based approach to asking questions, securing incremental commitments, resolving objections, reducing your competition's influence, and more.

Review excerpt: "‘The Science of Selling' is the ultimate collection of evidence-based practices for sales ever collected in one volume. Until now, most of the studies in ‘The Science of Selling' have been scattered and tucked away in academic journals, (making them) virtually inaccessible to sales leaders. Most readers will find the material new, and I expect, quite surprising."

6. "The Sales Acceleration Formula: Using Data, Technology, and Inbound Selling to go from $0 to $100 Million"

Mark Roberge

Sales leaders aiming to scale their sales team and build a multi-million dollar business should definitely pick up this book, written by former HubSpot CRO Mark Roberge.

Review excerpt: "Every company -- regardless of its business and sales strategy -- will absolutely benefit from reading this book. The stories (Roberge) tells, the way his selling initiatives fit together, the combination of selling and technology he describes … even the use cases he lists make the approach he describes applicable to any sales organization -- however well-entrenched."

7. "Influence: Science and Practice"

Robert B. Cialdini

Cialdini reveals the six psychological principles that cause people to comply. Once you've incorporated these powerful concepts into your messaging, leading your prospects to say "yes" will be less challenging.

Review excerpt: "Whether you are on the selling or buying end of any transaction, knowing what Mr Cialdini discovered through years of research and testing will be to your financial advantage. (But) 'Influence' is not just about money. It is a guide to getting what you want or need in a fair and ethical manner."

8. "To Sell Is Human: The Surprising Truth About Moving Others"

Daniel H. Pink

If you're currently working in sales, you're probably well-aware the old playbook doesn't work. Pink offers fresh yet practical insights to modern selling, including how to move others, make your message clearer and more persuasive, and gain referrals.

Review excerpt: "No, this is not 'another' book about selling. I've read a lot of them, written a few of them, and I can tell you: This book stands alone in a special category."

9. "Secrets of Closing the Sale"

Zig Ziglar

This book includes more than 100 different ways to close depending on the situation and 700 thought-provoking questions to use with prospects. You'll also find suggestions from a hundred of America's most successful salespeople.

Review excerpt: "Ziglar teaches you, from the beginning, that there's no room for success in a salesman's career if he's taking the fast route, making the quick sale, and then locking the door behind him."

10. "The Only Sales Guide You'll Ever Need"

Anthony Iannarino

Iannarino shares his biggest lessons from 25 years of selling, including how to increase your self-discipline, get over your fear of the competition, be more resourceful, discover the buyer's true needs, and more.

Review excerpt: "Anthony Iannarino is my new sales guru. His book shows you exactly how to understand your offer and relate to your customer."

11. "The New Strategic Selling: The Unique Sales System Proven Successful by the World's Best Companies"

Robert B. Miller, Stephen E. Heiman, and Tad Tuleja

Every salesperson will benefit from learning how to reach "win-win" agreements, prevent sabotage by internal blockers, identify the four types of decision makers, engage senior executives, and more.

Review excerpt: "This book, in my opinion, found a perfect balance between theoretical framework and hands-on, immediately applicable knowledge."

12. "Cracking the Sales Management Code: The Secrets to Measuring and Managing Sales Performance"

Jason Jordan and Michelle Vazzana

Jordan dives into the critical activities and metrics sales managers and executives should implement and track to lead their teams to success.

Review excerpt: "I liked the focus on real-world quantitative management via metrics (and) would recommend this book to any sales manager who wants to achieve and measure results."

13. "Words That Sell: More than 6000 Entries to Help You Promote Your Products, Services, and Ideas"

Richard Bayan

Keep this informative manual at your desk so you can quickly find the perfect terms and phrases to grab your prospect's attention, create desire for your product, and ultimately, win their business.

Review excerpt: "After a brief primer on writing in which the author lays down basic writing principles, readers are free to comb through the book to find the words they need to make a big difference in the way they communicate with others."

14. "Book Yourself Solid: The Fastest, Easiest, and Most Reliable System for Getting More Clients Than You Can Handle Even if You Hate Marketing and Selling"

Michael Port

Port's book covers a range of strategies for earning more business, from building a powerful social media presence to developing a personal brand to perfecting your pricing strategy.

Review excerpt: "An excellent and enjoyable read. Michael Port lays out a fresh and honest approach to marketing yourself and your business. 'Be true to yourself' and the people you serve. This takes the pressure off of trying to contrive an image of someone (or something) that is really not you, and makes self-promotion almost natural!"

15. "7L: The Seven Levels of Communication: Go From Relationships to Referrals"

Michael J. Maher

If you're not generating warm introductions to potential customers, you're losing out on a valuable source of business. Discover the concrete steps that will win you referrals. Although "7L" is geared toward real estate professionals, its takeaways are applicable to any sales role.

Review excerpt: "Michael provides an easy-to-follow step-by-step system to create long-lasting relationships with clients and vendors that will result in an endless supply of referrals. This book has completely changed how I do business … I went out and bought 30 [copies to give] to my associates."

16. "Fanatical Prospecting"

Jeb Blount

Successful prospecting incorporates multiple touches across multiple channels. Pick up this book to learn how to text, email, call, and socially engage buyers.

Review excerpt: "Jeb teaches you how to prioritize your prospects and leverage social selling in your overall prospecting efforts. If you are thinking about a career in sales or you want to jump start what you are doing in your present job, then this is the book for you."

17. "Predictably Irrational, Revised and Expanded Edition: The Hidden Forces That Shape Our Decisions"

Dan Ariely

Have you ever been flummoxed by a prospect's irrational decision? Once you read this book, you'll have a new understanding for the assumptions and emotions behind the actions we take. Guiding buyers to the right choices will become far easier.

Review excerpt: "This is a fascinating look into how our brains process information. The author sets up experiments to test his hypotheses about how people respond under a variety of situations."

18. "Go-Giver, Expanded Edition: A Little Story About a Powerful Business Idea"

Bob Burg and John David Mann

This quick read reveals the importance of giving to business success. Not only will you walk away convinced that giving leads to receiving, you'll also know how to give to achieve your desired results.

Review excerpt: "Clear, entertaining, and immediately practical, this book has evolved my approach to business -- and life. When you go through your day focusing on how you can give and being open to receiving, you build stronger relationships and prosper on multiple levels."

19. "DISCOVER Questions Get You Connected"

Deb Calvert and Renee Calvert

Learn how to structure your calls, ask thoughtful, intelligent questions, and help prospects come to their own conclusions about your product's value.

Review excerpt: "'Discover Questions' was excellent -- giving experienced and novice salespeople guidance on how to ask questions, drive the sales conversation, and show you care!"

20. "Little Red Book of Selling: 12.5 Principles of Sales Greatness"

Jeffrey Gitomer

This book is short, sweet, and to the point. Readers will learn to focus on why people buy and why it matters to the sales process. With entertaining illustrations and soundbites in every chapter, this book is easy to return to for specific helpful tips when you need them most.

Review excerpt: "Excellent book that focuses on selling the right way. Highly recommend this for anyone who is involved in sales and wants to expand their techniques so they close more."

21. "Think and Grow Rich"

Napoleon Hill

This book is beloved by many career salespeople. The result of nearly 20 years of research, Hill's book outlines 13 steps to success, including developing a definite purpose, building a positive mental attitude, and channeling the power of the subconscious mind.

Review excerpt: "This book is one that everyone must read. From the very beginning, it began changing my mindset and how I view life. Some books are filled with information on how you should be thinking, but this one shows how to create lasting change."

22. "Spin Selling"

Neil Rackham

"Spin Selling" shares the results of Rackham's 12-year, million-dollar research project examining effective sales performances. In his book, Rackham outlines his findings and shares the principles of SPIN (Situation, Problem, Implication, Need-payoff).

Review excerpt: "If you love sales, read this book and discover how to improve your technique. The research behind this book is exhaustive, and the technique is so organic you may discover you're already using it. In that case, you'll be able to improve your skills."

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In the most recent technical changes made to Part C and Part D plans for 2019, CMS codified the star ratings methodology in regulations. Now, CMS is proposing changes to these regulations, such as new definitions to clarify the meaning of terminology used in describing the star ratings methodology.

In addition, CMS is proposing several changes to improve program quality and accessibility of the Medicare Advantage (MA) and Part D Prescription Drug Program (PDP) Plan Quality Rating for measures other than Consumer Assessment of Healthcare Providers and Systems (CAHPS).

Cut Point Predictability and Stability

CMS proposes two enhancements to the current hierarchical clustering methodology that is used to set “cut points” for non-CAHPS measures. Cut points are used to separate a distribution of measure scores into distinct groups or star categories, such that each grouping accurately reflects true performance. These two enhancements would increase year-over-year stability and predictability for a plan’s cut points, but may also slow the programs’ ability to keep pace with changes in performance across the industry.

First, CMS proposes to modify §§ 422.166(a)(2)(i) and 423.186(a)(2)(i) to add mean resampling to the current clustering algorithm. Mean resampling would reduce the sensitivity of the clustering algorithm to outliers. In short, it would reduce the random variation that contributes to fluctuations in cut points and, therefore, improve the stability of the cut points over time. The second proposed enhancement is a 5% “guardrail” for all measures that have been in the Part C and D Star Ratings program for more than 3 years, whether scored on a 0 to 100 scale or an alternative scale. The guardrail would be a cap that imposes a 5% maximum allowable movement from the previous year’s cut points for each measure threshold. Thus, it would allow a degree of predictability.

Measure Updates and Other Adjustments

CMS also proposes changes to measures in the Star Ratings program for performance periods beginning in 2020 and 2021, including:

• MA plans controlling high blood pressure, to apply new hypertension treatment guidelines from the American College of Cardiology and American Heart Association by moving the blood pressure target to <140/90 mmHg;
• Medicare plan finder (MPF) pricing accuracy for PDP plans, to better measure the reliability of sponsors’ prices advertised on MPF;
• MA plan all-case readmissions, to assess the percentage of hospital discharges resulting in unplanned readmissions within 30 days of discharge; and
• MA and PDP plan improvement measures, to exclude any measure that has a reduction due to data integrity concerns.

Among other things, CMS proposed to add a provision that would assign a 1-star rating to the applicable appeals measure(s) if an MA organization or PDP plan sponsor failed to submit Timeliness Monitoring Project (TMP) data for CMS’s review to ensure the completeness of their independent review entity (IRE) data.

CMS is also adopting detailed modifications for the Star Ratings measures for MA and PDP plans in areas that have “experienced extreme and uncontrollable circumstances” like natural disasters. These modifications would apply at the contract level to mitigate certain negative Star Ratings effects on any contract within an “emergency area” during an “emergency period” as defined by federal law.

In sum, CMS recognizes the public’s “overall support for the use of the hierarchical clustering algorithm,” and now seeks to further refine the Star Ratings program to ensure that the methodology is stable, predictable, and free from undue influence of outliers. This rulemaking presents a significant opportunity for stakeholders to shape the rating methodology for quality and performance of MA and Part D programs. Comments on the proposed rule are due to CMS no later than December 31, 2018.

https://www.cmhealthlaw.com/2018/11/ma-pdp-star-ratings-proposed-technical-changes-for-2020/

Last week, the Medicare Rights Center and the National Council on Aging (NCOA) released a new resource on the expansion Medicaid-to-Medicare transition process. Our Expansion Medicaid Transitions Guide is designed, in part, to help advocates learn about their state’s transition process and better assist clients when they need to switch from expansion Medicaid to Medicare. The guide includes terminology, an overview of select state processes, and some troubleshooting steps advocates can consider when encountering problems.

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