CodySoft® has added a Markup Tool feature to its Collateral Management Module®, making it easier for users to make, review and accept edits to health plan member marketing materials, such as Annual Notice of Changes (ANOC), Evidence of Coverage (EOC) and Summary of Benefits (SB) documents.
“In a typical scenario, health plans may pass one document around to 30 different people for review via email, and then have to make sense of the edits made to 30 different files,” said Brian Yavorsky, vice president of technology at Cody. “Our Markup Tool lets all users make their suggested edits in one document that’s kept in the Collateral Management Module, eliminating all that legwork and decreasing the chance of errors.”
What Health Plan Marketing Pros Don’t Know About Working with Vendors Can Hurt them
As health plans race to create and distribute Calendar Year 2018 Annual Notice of Changes (ANOC) Packages, most member marketing teams know time is of the essence. But, many aren’t aware of a few particular areas that could potentially hang them up, which is the last thing they want to happen when they’re under the gun.
Even if the health plan has ironclad policies and streamlined procedures, working with multiple outside vendors can pose risks. Each vendor operates according to its own procedures and its own timeline, and vendors caution that meeting plan deadlines is dependent on other vendors’ timely and accurate deliverables. Like a relay race, every time materials change hands, there’s a chance the baton will be fumbled or dropped. And, the more vendors that are involved in the materials creation and fulfillment process, the more the risk of delays and errors increases.
Industry Alert: Iowa Senator Calls for Greater Scrutiny of MA Plans
Kaiser Health News recently published an article about Senator Chuck Grassley (R-Iowa) asking federal health officials to tighten scrutiny of private Medicare Advantage (MA) health plans. His request comes amid ongoing concern that insurers over-bill the government by billions of dollars every year.
In mid-April, Grassley wrote a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, citing an article that alleged billing discrepancies. He has asked CMS officials to explain why they failed to collect nearly $125 million in potential overcharges identified at five Medicare Advantage plans audited in a single year.
The Pros and Cons of Updating Last Year’s AEP Materials vs. Using CMS’s Model Docs
The Centers for Medicare & Medicaid Services (CMS) will release its 2018 Model Documents for Annual Enrollment Period (AEP) materials any day. When it does, health plans will face the same question they face year after year – do we start fresh using this year’s Model Documents or update last year’s materials?
With Annual Notice of Changes (ANOC) averaging around 25 pages and Evidence of Coverage (EOC) documents averaging around 250-300 pages, getting AEP materials into members’ hands by September 30 means there is no time to waste. Generally speaking, using CMS’s Model Docs carries less risk; however, having to construct new documents from the CMS model every year is extremely labor-intensive.
The past several years, CMS’s Model Documents have been composed of roughly 90% boilerplate text that has varied little each year. With the exception of insurers that are consolidating plans or creating new ones, most annual changes to benefits, copays and other aspects of coverage are relatively minor. This may make updating last year’s materials an attractive approach when compared to the thought of using CMS’s model. On the flip side, there also are significant reasons using previous years’ documents might not be the best method.
It’s critically important to understand the following pros and cons when considering whether to update last year’s AEP materials or use CMS’s model docs.
Best Practices for Language beyond the CMS Model Language
The Centers for Medicare and Medicaid Services (CMS) templates for the Annual Notice of Changes (ANOC) and Evidence of Coverage (EOC) contain extensive model language that is required and must be used by every insurer. However, there are also numerous places in these documents where health plans have latitude and flexibility to use their own language to describe benefits, cost-sharing, coverage limits and so forth. These areas provide significant opportunities for health plans to better communicate with their members, and thereby positively impact the member’s experience.
The Secret to Simplifying Health Plans’ Member Marketing Material Translations: A Parallel Project Path
We’ve seen first-hand the frustrations health plan project managers experience in translating their member marketing materials – including Annual Notice of Coverage (ANOC), Evidence of Coverage (EOC), Drug Formulary and Summary of Benefits (SB) – to additional languages.
The question for our CodyPrint® team became: What would give project managers visibility to the translation process, minimize the production timeline, and eliminate the iterative processes that increase the opportunity for errors in these materials?
The answer was a parallel project path for creating both the English and Spanish versions of these materials in lockstep. Rather than the conventional model where the health plan gives a translation company an English document to translate, the translation company does its work and then sends the translated document back, we developed a different methodology to create and revise English and Spanish documents in parallel.
Industry Alert: Is Your Health Plan the Target of CMS’s New Audit Focus?
Vikki Ahern, CMS Director for Medicare Part C/D Oversight and Enforcement Group (MOEG), spoke at this week’s 2017 HCCA Managed Care Compliance Conference. It served as a wake-up call for compliance professionals in attendance.
Although an explanation of CMS’s reasoning was not provided, Vicki Ahern stated that CMS will specifically target small parent plans for 2017 program audits. CMS will begin sending plan sponsor program audit notices on February 21, with audit start dates in April.
3 Reasons the Conventional Method of Translating Member Materials Makes Project Managers Nervous
Project managers are highly organized, detail-oriented people. Some may admit to being control freaks, but that’s what makes them good at their jobs. This is especially the case for project managers responsible for coordinating a health plans’ member marketing communications, given the level of complexity, time-sensitivity and risk involved in creating and distributing these materials.
Producing and distributing accurate, on-time Annual Notice of Coverage (ANOC), Evidence of Coverage (EOC), Drug Formulary, and Summary of Benefits (SB) documents in English is a feat worthy of celebration. But health plans required to deliver member materials in additional languages must deal with another set of issues before the party can begin.
How a Medicare Advantage Voucher Program could be the Next Medicare Part D
With 10,000 Americans entering Medicare every day, the health plan industry continues to expand. In 2015, 55.5 million people were enrolled in Medicare. By 2020, that number is expected to increase to 64.4 million, and to balloon to 81.8 million by 2030.
Yet, of the current 55.5 million Medicare beneficiaries, only a third are enrolled in Medicare Advantage (MA) plans. There is plenty of opportunity for MA plans to grow – and it could happen sooner than most people think, especially if certain factors come into play.
3 Ways Growing Health Plans can Avoid Adding FTEs
Health plans today are feeling more pressure than ever before to do more with less. This is especially true now that health plans have to operate within the federal minimum medical-loss ratio (MLR) requirement. The minimum MLR requirements leaves health plans with only 15 percent of their Medical revenue to spend on administration, marketing, and, often the most expensive line item, employee salaries.
For health plans looking to bring on more resources to handle growth – for instance, moving from a small health plan to a medium-to-large health plan – the obvious course of action may be to hire more full-time equivalent employees (FTEs). However, adding FTEs comes with great expense. Salaries, benefits, workstations, equipment and other expenditures associated with FTEs add up quickly. In short, hiring more FTEs is not necessarily the most efficient or cost-effective next step for a growing health plan looking for scalable solutions.