“Thirty days hath September,” goes the old rhyme (so old, in fact, its origins can be traced back to the 13th century). Written to help us remember the number of days in any given month on the Gregorian calendar, the lines roll easily off the tongue. Everyone knows the cadence and the words. The rhyme is easier to remember than actually remembering the calendar itself. For Medicare plan administrators the old rhyme isn’t a helpful life hack – it’s a stark reminder of a serious deadline.
On September 30, ANOCs (the Annual Notice of Change for Medicare plans) and EOC (Evidence of Coverage) are due in members’ hands. In most industries, a notice of change would require only a well-designed postcard reading something like “Hey – we’re moving!” accompanied by a cartoon graphic of a moving van. But healthcare isn’t most industries. It’s heavily regulated by CMS – an agency not exactly known for its brevity.
In an effort to aid Medicare plan providers with compliance, CMS publishes a model member kit document for reference. It’s currently 170 pages long – and that’s not counting the multi-language insert that Medicare plans must send to members (more on this soon). Adding insult to injury each member kit must include:
- Welcome letters
- Multi-language insert
- Provider directories
- Formulary listings
Each element on that list represents a headache for Medicare plans. That is a lot of fulfillment when you’re talking about thousands of members. At first glance, furnishing these member kits might seem relatively simple. After all, it’s just inserting the newest information into last year’s member kit framework, right? Wrong. These member packets pack a big punch in terms of preparatory and administrative resources.
The rules around healthcare communication are constantly evolving. The latest compliance issue comes from Section 1557 of the ACA. It requires Medicare Plans and Part D sponsors to post a Nondiscrimination Notice that must be printed in English as well as the top 15 non-English languages spoken by individuals with limited English proficiency for the relevant state. ANOCs/EOCs are included in the scope of this policy. This new reality throws a wrench into the old practice of rebooting last year’s kit. Member kits are no longer “one-size-fits-all.” Customization is now the name of the game. As the clock ominously ticks away each September, many Medicare plans rush to fulfill member kits. Now forced to customize these kits, there is a real danger that the clock will run out, resulting in significant fines, member dissatisfaction – and loss of profit.
What Lurks Below
Member kit fulfillment is a handful. There’s a ton of information to juggle, yes. But it’s the process itself, lurking under the surface, that can cause the most trouble. Cross communication between internal teams, as well as vendors, can spell trouble for version control – especially in customized kits. With multiple levels of project management and different channels of communication, something is bound to get lost – or changed, or entered incorrectly. And one mistake can unravel an entire process.
Last minute changes are inevitable, and sometimes the last minute is too late. Once thousands of kits have been printed, they can’t be unprinted. Executing these processes can be incredibly difficult, and drain valuable resources in time and manpower – not to mention potentially drawing fines from CMS. Hefty fines. The agency is taking an increasingly tough stance against what it considers unclear or inaccurate benefit information furnished to enrollees. Last year, fines ranging from around $35k – $350k each were imposed on Medicare plans. Needless to say, Plans need to change the way they approach member communication – or they are going to have a bad day.
Very Bad Day – That’s You
Successful member communications in the modern healthcare environment require effective, transparent workflows. Different aspects of member kit design and production are normally managed by different stakeholders – be they internal or outside vendors. All too often, efforts are duplicated, communication is jumbled and changes are missed.
When there are multiple chefs in multiple kitchens, there must be a common system that keeps everyone in line and production on point. Member communication software platforms eliminate the confusion from the member communications process. Communication platforms should provide Medicare plans with simple and efficient ways to request, view, approve and file kit components in a centralized location. This eradicates inevitable duplication of efforts and gets version control under control.
A centralized system for communication management also clarifies the roles of the stakeholders involved and integrates true project management functionality into the process. When time is of the essence – and with member kits it always is – efficiency and clear communication are imperative. The distressing part is that many communication platforms provide piecemeal components of the necessary elements to change a bad to a good day instead of a unified front. Platforms like ABG’s BridgeSuite encompasses all the unified elements backed by a second glance service team that keep workflows moving, clarify roles, eliminate costly mistakes and manage the member kit process from conceptualization through printing and delivery.
Stay the same with jumbled processes but when it comes to ANOC, a missed date or a content error is more than a missed opportunity – it’s a disaster reducing competitive edge, profit margins and pathways to success.
The clock is ticking on the ANOC delivery date. Is your plan ready to deliver?