Marketplace Revenue Enhancement Analysis
In-depth review of health plan sales channels and development of recommendations to enhance your success in the new world of ACA.
The Federal Marketplace and State Exchanges are upon us, and there is still a wide level of unpreparedness for what’s beginning to happen. Just like the early days of Part-D in 2005, payers have entered the Annual Enrollment Period (AEP) with many unanswered questions about the Marketplace sales process in which they find themselves.
Where once you may have had separate sales organizations for Medicare, individual, group, and even self-funded business, those lines are now blurred by the Affordable Care Act (ACA) and the Marketplace dynamic. The rules have all changed. Even as the AEP is underway, payers are asking themselves: What lessons can be learned from this year’s experience that will make 2014 and beyond more successful? What represents the best approach for sales: Agents, telesales, online sales, or something else? How do we manage our agent network? How do we best optimize our participation across the confusing mix of Federal and State marketplaces, while maintaining our own identity?
Down the road, you may be wondering what happens after December 31: How do today’s (and next year’s) sales decisions impact the longer-term impact the longer-terms effects of ACA, from duplicative administrative costs (and Medical Loss Ratio requirements) to Risk Adjustment? How do we deal with different kinds of enrollment, different kinds of prospects and members, and different kinds of risk distribution, on a state-by-state basis?
I have an extensive background in sales channel optimization and regulatory-driven products, as Director of the nation’s first SHOP Exchange, part of the initial leadership of DestinationRx (the company that powered many aspects of medicare.gov and established most online carrier sales portals in the early days of Part-D), and a thirty-year veteran of the payer and vendor space, in a variety of capacities. For Marketplace Revenue Enhancement Analysis I am working with Toby Rogers, co-founder of DestinationRx and a recognized leader in online sales and Exchange dynamics. Together, through NetCare Health, we lead a team who can review your current sales channel approach, and make recommendations for how to optimize your future success, using industry best practices and decades of experience.
A typical project will:
- Review current sales channel strategy, and determine where and how resources are being spent today.
- Analyze the kind of business these channels have been delivering, and how they will affect future positioning in Risk Adjustment.
- Examine lessons learned to make changes for the coming year ahead.
- Develop actionable recommendations that support the projected sales opportunities, such as:
- Changes in resource allocation between channels to improve results;
- Enhancing existing online presence with Marketplace connectivity;
- Where to find the right kinds of new membership.
Projects are tailored for each client situation with the initial analysis performed either after AEP, or during this AEP (to capitalize on real-time phenomena). In either case, we will provide timely and actionable information that you can use to optimize your sales results, and your organization’s ability to succeed in ACA, at greater levels than ever before.
Availability is limited, so contact us as soon as possible for more information.