GUIDE
Health plans put a lot of focus on giving members the assistance they need to reach health goals. The same focus on finding supportive account management can help your plan reach the complex set of goals required for its success. A comprehensive request for proposal (RFP) should identify a dedicated account manager who will provide insights and support that fosters improved operational efficiency for staff.
To help take the guessing out of creating an effective RFP, we’ve identified key areas of focus. In this series, you’ll find insights on overcoming the challenges of selecting a digital health partner with an RFP and finding a partner with member-centric solutions that can enhance quality and performance reporting.
Here, we look at how your RFP can identify the partner that will rise above competitors to manage your account at a level that relieves staff from manual processes allowing them to focus on their areas of expertise.
Support at Every Step
There are so many aspects of a successful health plan, it can feel overwhelming to keep everything moving in the right direction. Take the stress off your team bringing a plan partner on board that’s your single point of contact to oversee program operations and has the experienced people in place to provide support.
Look for a digital health partner with an in-depth understanding of the regulatory environment, performance strategies including success in Star Ratings and quality measures, and how to meet emerging health equity requirements – all necessities to help your plan rapidly adapt to the evolving industry. Can the vendor provide guidance to hardwire best practices into your routine operations and infrastructure for continuous, long-lasting success?
Dedicated Account Manager
A strong partnership is defined by the ability to effectively communicate project needs with vendors. Establishing a clear line of communication with a dedicated account manager ensures a smooth transition from solution implementation to execution.
Your account manager should provide the insights you need to monitor product implementation and coordinate technical resources for ongoing support. If a project encounters a delay, can the team react to develop a quick resolution that fits within your plans resources and budget.
The training for new or existing platforms should not fall you or your team. Expect your account manager to coordinate the training the team needs to execute a successful program.
Monitors Program Performance
It common for plans to launch programs or strategies that are directionally aligned with Star needs but stop short of tackling the last steps. A dedicated account manager needs the resources to bring your plan across the finish line by regularly reviewing campaign metrics and providing member support and outreach to help them reach their health goals. Work with a vendor who will deploy plan-specific strategies to get higher-member engagement, which produces more valuable member interactions, improved quality and volume of data points.
Ensure your partner can access expert recommendations for how to best deploy your engagement solutions. The Centers for Medicare and Medicaid Services (CMS) outlined a Framework for Health Equity to help health plans develop strategies that ensure all individuals have equitable access to healthcare services.
Aligning plan performance efforts with these new regulatory standards sets the stage for more effective quality improvement initiatives. Your plan partner should manage your refined member engagement strategies with more personalized and meaningful interventions to drive stronger and sustainable quality scores.
Partner in Product Strategy
In the final weeks of 2022, CMS released proposed regulation and data to support the sweeping changes for Medicare Advantage plans. CMS actions are a reminder that the way plans operated yesterday will not be a winning strategy in the future.
As your plan moves ahead to provide safer, coordinated and equitable care, the need for a vendor with proven knowledge of Star Ratings can’t be underestimated. Check to determine if the team has weathered seasons of significant change and has established strategies for 4+ Star success during the difficult periods. The account manager must be backed by a team that can guide Medicare Advantage plans short- and long-term strategies for sustainable Stars success.
Keeping up with ever-changing Medicare and Medicaid regulations requires support from a team with expertise in this area to ensure your plan remains compliant. They should be proactive to interpret regulatory changes and define what affects your operation. You also want a reactive product development team that’s ready with solutions to address the changes.
It’s also important to find a plan partner that can remain nimble by being open to processing ad hoc requests and program updates.
Supports What’s Already in Place
Organizations put a lot of resources into creating a brand to affect member perception and how members interact with them. Your plan partner needs to assist with outreach and promotion while enforcing the brand guidelines you’ve developed within white-labeled member-facing web portals, applications and marketing materials.
Learn More and Prepare
In the next week you can learn more about how to write an RFP to get the level of service your health plan deserves. In the final section, we’ll share information about the importance of finding a vendor ready to deliver in the following area:
- Technical infrastructure and security. A digital-first mentality needs a strong base of data security practices and impeccable privacy protocols.
If you want to get started now, download the Healthmine RFP guide and checklist to learn how to prepare a request more efficiently for proposal and avoid common pitfalls with finding the right partner.
At Healthmine, everything we do builds an improved relationship between members and their health plan. We pride ourselves on providing exceptional account management and support to our clients as they become familiar with Healthmine, as needs change and as the plan grows.
