Navigating existing strategies in the new year

There’s something refreshing and exciting about ushering in a new year. Perhaps it’s the feeling that a new year means a new beginning. After giving pause to reflect on our progress the past 12 months, we feel inspired and optimistic as we envision what lies ahead. But what is often overlooked in the infancy of a new year is that the same challenges, particularly from a business perspective, are still there. The date may change, but the expectations and goals do not.

As a health plan, you have no doubt found this to be true if you are undertaking substantial business transformations to combat a shifting market environment, such as designing a consumer-centric front office, reducing medical expenses through population health management, enhancing engagement with providers or strengthening payer-provider convergence. While the path to rethinking business models and adopting new approaches can take different turns, the expectations and goals are the same:

  • Increase market share
  • Cut costs
  • Improve member and provider relationships

If you’re undertaking any of these strategies, it’s important to realize that you can’t bite off everything at once. Logical progression, in the end, will determine how successful you’ll be at harnessing resources, improving care and managing medical costs. Part of this progression is getting a clear picture of where you are today, and looking ahead to where you want to be:

  • Assessing infrastructure and technologies. Real change happens when the infrastructure exists to support it. Technology plays a critical role in helping payers and providers collaborate to share information, enable higher quality care and lower costs.
  • Leverage your data. Use the information you have at your disposal to understand your performance landscape and prioritize opportunities for improvement.
  • Engage those on the frontlines critical to your success. Providers are the linchpin in improving plan performance. Look to implementing or improving physician engagement tools and services, as well as establishing an overall performance management infrastructure.

For further discussion of benchmarking, provider engagement, value-based reimbursement and consumer-centric front office strategies, along with an examination of proven best practices, please download our Fall 2014 Perspectives.

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