Topic: Strategy

The True Path to Improving the Medicare Member Experience

John Gorman

I’ve been struck lately by two new research reports that demonstrate improving the member experience is the top challenge facing Medicare Advantage plans. First, JD Power is out with its 2017 Medicare Advantage Satisfaction Rankings. Among the results: Read more

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Evolve from Restrictive to Supportive Medical Management, or Die

John Gorman

I am continually amazed by how many health plans in Medicare Advantage (MA) and Medicaid still cling to restrictive, “Dr. No”’90’s-style managed care practices like pre-authorizations, referrals, and concurrent review. With massive policy changes looming in Medicaid, and the influence of Star Ratings in MA greater than ever, health plans may soon have a gun to their heads: evolve medical management from restrictive to supportive, or die.

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Preserving Your Investment Through the Member Experience

Nilsa Lennig

I was on a client call last week with a few of our Gorman Health Group Sales, Marketing & Strategy subject matter experts presenting a sales and marketing budget the team created to help illustrate pre-operational investments in sales distribution and marketing strategies to a potential “new market” entrant. These budgets are two pieces of a much larger “Go, No Go” analysis we performed for this client, however, the discussion around these budgets led to a question from our client’s CEO that could, in essence, define the future success of this health plan in Medicare Advantage: “Does this budget account for initiatives that will enhance the members’ experience?”

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Still Mean: Senate GOP Releases ACA Repeal Bill That’s Worse Than House

John Gorman

After six weeks of intensely secret negotiations, the “Better Care Reconciliation Act of 2017” (BCRA) is out, and it’s much worse than the House’s AHCA. The story remains the same: worsening benefit cuts for the poor to provide a tax cut for the rich. After Trump called it “mean,” and literally every healthcare organization has rallied against it, the hoped-for moderating influence of the august upper body of the U.S. Congress is gone. TrumpCare is still mean.

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Three Reasons Why Pre-AEP Marketing Is Critical

Diane Hollie

One of the reasons healthcare marketing is so interesting is that it’s never static for long. Once you think you have it figured out, something changes in the mix. Pre-Annual Election Period (AEP) marketing is one of those phenomena that changes the mix in AEP marketing. If a pre-AEP marketing strategy is not in your marketing plan this year, here are three reasons why you may want to reconsider: Read more

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Go-to-Market Strategy: Bringing It All Together

Nilsa Lennig

Go-to-market strategy is truly fantastic as it is literally aligning the entire organization to drive profitable growth supported by a governance structure that helps more effectively manage.

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Final Benefit Submission Is Done. Top 5 Items To Focus on Now!

Diane Hollie

Benefits were submitted on June 5, 2017. Too many times we see health plans wait until the last minute to complete important information. This tends to lead to incorrect mailings and advertising getting into the marketplace with costly errata mailings occurring. Gorman Health Group recommends you start with a strong work plan in place to get the following documents completed, starting now:

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