The new healthcare landscape, set forth by the Affordable Care Act and creation of the Marketplace Exchange, has brought new customers with unique purchase drivers and high digital expectations to the market. In taking a look at the demographics of these new individual health coverage policyholders, most of them are prone to higher digital expectations […]
As part of their Distribution and Agency Management Survey, Accenture polled more than 400 senior executives at large and medium-sized insurance carriers in 20 countries from July to October of 2015, all responsible for or involved in their companies distribution and agency management function. While the majority of those surveyed were from life and property […]
CMS’s 2017 Annual Notice of Change/Evidence of Coverage (ANOC/EOC) standardized model materials include an instructional PDF to be used as an implementation guide to managing necessary document alterations, HPMS submissions and mailing processes. Within this year’s instructions notice, under the section “Mailing the Documents” (pg. 5), it details: “MAOs, PDPs and Cost Plans may include an […]
A few months ago, we came across research done by Demand Metric in conjunction with Seismic, concerning the reasons that companies do not do more personalization of content in their customer communications. The top 5 reasons??? Well, they are pretty easy to guess since they have not changed for nearly a decade: 1. Don’t have […]
Member communications are evolving. The traditional default of black & white printing of member materials is increasingly migrating to full color. Mass print production business models are swiftly shifting to print on-demand. Static content and imagery is becoming customer-personalized. So how can you ensure your communications are appropriately evolving to these many changes? Step 1: […]
Millennials, age 21-32, are the new consumer group driving the shift towards patient-centered care. In order to meet their demands for a more personal healthcare experience, health insurers must first understand some of the unique behaviors of self-empowered millennials. Millennials research their symptoms online before visiting a doctor and turn to their social communities for […]
Finalized on November 22, 2015 after 18 months of discussion, the National Association of Insurance Commissioners (NAIC) approved an updated version of its Managed Care Plan Network Adequacy Model Act. Renamed the Network Adequacy Model Act, the name has been intentionally broadened to expand the applicability and scope of the Act to all network plans […]
Pre-2016 Medicare Advantage network adequacy guidance simply states that plans must maintain a network of providers “sufficient to provide adequate access to covered services to meet the needs of the population served” and establish written rules on timeliness of access to care in accordance with CMS standards. Of course, this ambiguity has led to numerous […]
The 2017 Final Call Letter to Medicare Advantage Organizations (MAOs) continued to emphasize the importance of provider directory accuracy and the increased monitoring and enforcement actions to commence due to preliminary data collected via the PNA Pilot Program that found severe violations with the Part D and Part C requirements. CMS stated, however, that they […]
Consumers are demanding more frequent, personalized, meaningful communications from their health insurance providers, similar to the variety of touches they are accustom to receiving from retailers and other companies they purchase services and goods from. While many plans want to deliver more consistent and dynamic engagement, at the same time they must balance this initative […]