Updated on October 7, 2019
Congratulations! You’ve made it through another benefits planning season and you can finally relax. But not so fast. Focusing on execution during implementation is equally important to minimize hiccups.
Here at Catalyst for Payment Reform (CPR), we’ve summarized a few tips so you can maximize your benefit dollar while enhancing the member experience.
- Demo the member tools
Whether you use your health plan’s transparency tool or a specialty vendor’s, dedicate some time to reviewing it in detail. If you didn’t use our price transparency specifications during your evaluation process, create your Catalyze.org account and login to get free access to our refreshed specifications so you can ask your vendor partner how they measure up.
In addition, request a demo of the provider lookup tool. Is there a prominent reference to higher value services, such as telehealth? How are Accountable Care Organization providers and Centers of Excellence displayed?
Finally, are plan selection tools accurate and intuitive? Is your concierge staff trained to assist an employee with their plan selection?
In general, focus first on getting any big accuracy or member experience issues resolved, then seek opportunities to promote high-value health care.
- Conduct “secret shopper” calls
During implementation, it’s also worth checking under the “member services” hood. Employers who conduct “secret shopper” member services calls benefit by identifying opportunities and training the staff supporting their members. Aside from an improved member experience, these calls can result in improved integration with other benefits (such as telehealth, EAP, etc.) and referrals to higher value providers and services.
- Maximize your benefit design summary
Look for ways to maximize this summary that your members can look to when they want to understand their benefits. Is there an opportunity to prominently display high-value services and features of your benefits design such as telehealth, primary care, urgent care, and medical and pharmacy value-based insurance design? How effectively does your benefit summary capture high-level instructions for members to access your expert medical opinion partner prior to an elective procedure? Does the benefit summary refer to your Centers of Excellence? Or are many of these details buried in your Summary Plan Description? With just a few minor changes, your benefit summary can more effectively communicate the high-value health care options available to your members.
- Meet with your health plan(s)
By the fall, your health plan should be able to report on your health care claims and utilization for the first half of the plan year. Meeting with your health plan will allow you to briefly step away from implementation to understand how the plan is performing, determine if there is “low hanging fruit” that can positively impact your plan and processes in the near-term, and otherwise, inform you prior to post-annual enrollment strategy sessions.
- Start thinking about next year’s strategy
It’s not too early to start! If you’re planning larger initiatives, such as conducting a health plan procurement, implementing a new plan design, or implementing a near-site/on-site clinic or direct provider contract, having planning meetings with partners will keep you on track. Some employers even initiate their communications plan for significant changes a year in advance. Don’t forget to visit our Tool Library, as we continue to update our health care purchaser tools that we offer for free to benefit managers and other professionals who purchase health care on behalf of a population!
With thoughtful planning, you’ll have ample time to enjoy the holidays before your new plan year and strategy season begins!