Questions health carriers should ask as they plan for the future

As quick as one year passes and an open enrollment period closes, the next is upon us. Back to planning yearly initiatives. Back to preparing for the next enrollment season. It’s a lot.

However, before jumping back into the grind, it’s worthwhile to reflect on the previous cycle‘s successes and challenges. It can help kick start your planning, and it affords the opportunity to recognize your colleagues’ hard work and the struggles they faced. It also helps everyone feel connected to the strategic plan, which promotes support of new initiatives.

The best way to do this is to ask some basic questions. Not business-as-usual questions. No one wants to “live with” solutions. Rather, questions that drive innovation and fuel change. Here are my top 5.

What challenges did we face — predicted or not predicted?

Developing preventative measures for the unknown is difficult. Explore the whole customer experience, not just business processes. Problems are rarely isolated to one functional area and usually have intertwined causes with minor problems that circle back to create a big challenge. Working with all areas to identify challenges invites a fresh perspective that can break the silo mentality. Getting everyone on board so they feel like a real contributor leads to successful change implementations.

How can we avoid or mitigate these challenges in the future?

Thinking critically about surprise developments and facing challenges from different angles to define it can bring visibility to their causes. Understanding why things went wrong allows us to stay ahead of the bumps in the road.

• Try open innovation! Encourage and leverage ideation from the full team. You never know from where the solution may arise.
• Look for multiple solutions! Prioritize each solution from the simplest to the to most complicated. The most simple, doable solution can be superior to the more complicated one.

Were we transparent with our partners?

The strongest business relationships are built on trust.

• Letting customers know the challenges faced is half the battle.
• The second half is letting them know your plan to resolve them, including when issues will be corrected and when the tools will be put in place to prevent them in the future.

Collaborative partnerships can breed success. Transparency also allows for more effective communications and stronger relationships.

Do any compliance changes impact our business this year?

Regulatory changes for Medicare are always evolving and changing.

• If you do not have the proper monitoring and change management tools in place you will fall behind.
• Falling short in expediting and implement such changes can be costly to your company.

Garnet Care can help assess your current tools and develop a plan that includes tools to ensure you know what is coming and are prepared for what it entails.

Were customer expectations met?

Honest assessments of how yearly projects and open enrollment went allows for improvement and strong strategy going forward.

• Avoid the “blame game.”
• Acknowledging where each area can improve allows for a more unified approach moving forward.
• Making customer needs your priority will determine your goals and shape your strategic plan.

To discuss your CMS Program audit readiness, email Courtney Seypura at cseypura@garnetriver.com or call Courtney at 518-605-0216.