The work of creating member documents for Medicare Advantage (MA) members is a highly seasonal endeavor. Typically, MA staff begin work on these documents in mid-April. Per Centers for Medicare and Medicaid Services (CMS), the Annual Notice of Change (ANOC) must be in members’ homes by September 30, and Evidence of Coverage (EOC) documents are due by October 15.
After that date, the intensity of the work effort on MA documents is considerably reduced and employees turn to other assignments. During this period, it’s a challenge to keep employees’ skill sets sharp and up-to-date.
Below are a few ways to ensure that employees who work on MA projects maintain their skills and knowledge year-round:
1. Create quizzes to test staff knowledge
A quiz is a great way to provide a refresher on materials such as the Medicare Communications and Marketing Guidelines (MCMG) document or the Plan Benefit Package (PBP) reports that form the basis of a plan’s benefit offering for the next year. Sample questions could include:
For the MCMG:
- True or False? Plans/Part D Sponsors can use the social security number as the enrollee identification number on the ID card.
- What three components must ID cards include?
- Fill in the blank: PPO and PFFS health plan ID cards must also include the phrase “_______.”
For the PBP Reports:
- What is the definition of the Medicare-defined Part D Standard Initial Coverage Limit (ICL) amount?
- True or False? The Maximum Out of Pocket amount (MOOP) must be the same for in-network and out-of-network benefits.
- True or False? Medicare Part B drugs must have the same cost share as chemotherapy drugs.
- Create exercises to brush up on specific areas of concern
If your employees had difficulty with any specific areas of MA work, test their knowledge by creating specific exercises. For example, if your staff had challenges around Pharmacy benefits, you could develop a simple exercise that reminds them about drug tiers, preferred pharmacies, optional supplemental benefits, and so forth.
2. Offer self-assessment forms
A self-assessment is a great low-pressure way for employees to gauge their own proficiency and progress in MA expertise. You can tailor the self-assessment to specific areas of skill and knowledge and ask staff to self-evaluate by accomplishing specific tasks. For example, a couple of rows in a self-assessment might look like this:
3. Conduct retraining as necessary
With the busy season over, now is a great time to provide your staff with training refreshers, as needed. These can include general trainings, as well as specific areas of concern that were identified during the Annual Enrollment Period (AEP) season. Bringing in a vendor for trainings on third-party software is also a best practice.
4. Start working on next year’s templates now
There’s no better way to keep your employees engaged than to start work on next year’s document templates in advance. Working ahead will also distribute the workload more evenly and avoid summertime peaks the following year. While the CMS model documents do not come out until mid-May, there are other ways to begin work on these templates. For example, if you know you are going to have a new legal section in Chapter 11 of the EOC, you can write that section, and have it prepared to drop into the template. This is just one way to prepare for next year’s AEP season.
5. Make sure staff reads all relevant CMS memos as they come out
It’s important that staff stay current on the latest communications and changes coming from CMS. It’s easy to set up an Outlook rule to direct all incoming CMS Health Plan Management System(HPMS) email memos and attachments to a folder where appropriate staff can access them. You may have other ways that you share this information, including meetings to go over the important changes, and other forms of dissemination.
The CodySoft® HPMS Memo Module®also helps to effectively communicate this information throughout your organization.
Our staff have developed many of the materials needed for these refreshers, including these items:
- A quiz on the MCMG
- A quiz on the PBP reports
- A self-assessment form
If you are interested in working with Cody to offer these skill-set sharpeners to your staff, please contact Brad Boyer at bboyer@CodyConsulting.com
These are just a few ways that MA staff can stay sharp during the off-season and prepare for the coming AEP materials creation process. Our Consulting Services and CodySoft® suite of products can also help health plans deliver accurate, compliant member communications. Contact us to learn more.