2020 Operational Readiness Prep – Ensure Comprehensive Processes in the New Year

I was recently flying to a client site. The Southwest plane was just boarding, and I had a seat at the window in front of the engine. I was watching out the window and noticed a person from the ground crew leaning in looking at the engine. She then went and spoke to a colleague who came over and looked in the engine. They then stepped back and spoke into their headphones. A minute or so later, the pilot came, and the first ground crew and the pilot both looked into the engine. The pilot appeared to commend the ground crew and apparently called maintenance, as a minute or two later maintenance came over as well. After about 25 minutes of review and the pilot walking to maintenance, the pilot came back on the plane and addressed us passengers. He advised a small anomaly had been identified by ground crew, and the pilot worked with maintenance to ensure it had been addressed. He apologized for the delay but said, as the pilot, he needed to make sure things were all in good order before we took off. The plane full of people clapped, and the person behind me yelled out “worth it”.

There were so many things right about this incident. It wasn’t the ground crew’s job to check the engine, but they did. The pilot could have ignored the ground crew, instead he thanked them. The pilot could have let maintenance handle it, but he stayed with them and even walked to maintenance to validate the information. The plane could have taken off with no explanation, but instead the pilot communicated to us what occurred, what was done to fix the issue, and took responsibility for the subsequent delay.

This is what we all strive for in operational readiness: engaged staff, knowledgeable leadership, good communication, and a team who owns what they do.

Now that our benefits are filed for 2020, we need to be in the midst of our operational readiness preparation for the new year. Here are some suggestions to ensure a comprehensive process.

  1. Establish a process for knowledgeable, engaged staff. Each person needs to know not only how to complete his or her job but why it is important and how it impacts downstream activity. They are part of a big picture to provide care to your Medicare Advantage and Prescription Drug Plan members. They make a difference to your plan and your members and need to know that. Without that knowledge, it’s just production and repetitive actions when, in reality, it is people’s lives.
  2. Foster an environment that welcomes feedback. There is a common quote, “Don’t shoot the messenger.” Frequently when an issue is reported, it brings extra work and possibly unwanted scrutiny, but often that is what it takes to fix problems. If we create a negative environment that doesn’t reward self-reporting, we eliminate a key method to be a high-quality, high-performing team.
  3. Prepare for the unexpected. We often prepare for open enrollment, high volumes of calls, high volumes of enrollments, and membership changes. We don’t often prepare as well for the beginning of the benefit year. That is when all the issues rise to the top. What process is in place to address those issues quickly? Forethought and effort should be invested to consider potential concerns and put plans in place to deal with them on an expedited basis. “Prepare for early calls to Customer Service to serve as ‘the canary in the coal mine’,” says Melissa Smith, our Senior Vice President of Stars and Strategy, “then launch, as quickly as possible, ‘rapid improvement projects’ to resolve all that are controllable.” Plan on the unexpected so you can resolve issues quickly.
  4. Create a communication plan. What are your trouble spots today? What changes are being implemented for 2020? How will this impact providers and members? How will you communicate this information to your staff? How do you want them to communicate these issues to your members? What upfront education can occur to minimize negative impact? All of these questions need to be addressed and formalized. It can’t be a one-way communication plan. Solicit information from those on the front line. They hear from your members and providers and, when appropriately informed, give feedback on how to design messages in ways members and providers can best understand.

I fly a lot and am typically not bothered by turbulence or concerns with the flight. Initially, I was worried when I saw the ground crew leaning into the engine. By the time we took off, I wasn’t worried any longer. The whole team at Southwest took their job seriously. That is what we want for our teams. Let’s set up the foundation to ensure operational readiness. It’s not only the best way to take care of our members, but it improves employee morale and job satisfaction. A true opportunity for our organizations to soar.

Gorman Health Group has a full spectrum of subject matter experts for Medicare Advantage and Prescription Drug Plans. We work with health plans on a daily basis—on everything from operational readiness to program assessments, member experience, audit support, and remediation. This keeps us current and relevant. Our experienced Operations team can work with you to set up strategic, efficient, and knowledgeable operations as you implement or grow your Medicare line of business. To help you create your winning strategy, contact us via this link to our website, or you can email me at jbillman@gormanhealthgroup.com.

Julie Billman
Julie Billman

Julie Billman is Senior Vice President of Operational Performance & Provider Strategies at Gorman Health Group (GHG). In this role, health plans look to her to improve operational functions, maximize plan revenue, and educate plan staff to understand and own the Medicare requirements that govern their functions. Read more

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