Annual plan performance review is a key strategic service that we provide to employer groups. We like to think of this as our chance to shine! This meeting is our opportunity to be in front of our clients to provide deep analysis of their plans – and connect on how our services helped their members AND saved money for their company.
We consider our annual review a tactical, strategic, collaborative process to use data and consultative expertise to drive change. Our Medical Director, Dr. Jim Koren, is the key clinical resource at most of these meetings. Annual reviews are important, he says, as they are “the only time that we have undivided attention of a group for many hours to listen to us without interruptions. We get to choose the agenda and data. I have always been a believer in using data strategically to point out opportunities for improvements in population health, cost savings, and network usage. And this meeting is a singular opportunity to do that.”
National Alliance has had a lot of positive feedback over the years with our customized and clinically-focused approach. “There aren't a lot of groups that don't want to have it a second time!” Dr. Koren reports.
A lot of administrators provide annual meetings. But we continue to evolve our approach to provide superior value to groups.
The quarterback.
Our clinical team working with the group drives the preparation and the meeting. Typically this is our Medical Director, but we have other associates that provide the same service. The team’s personal familiarity with complex cases and the unique delivery systems across the country goes a long way. Dr. Koren says, “We often cite examples of our work with a particular member on a case. Since we manage their high-cost claimants all year long, we can say – here’s an example where we did it well.”
The game plan.
We enhance the reporting template each year to account for market trends. Some carriers rely on the same approach every year or simply use a canned report from their system. But our clinical, reporting and account management teams work together to deliver meaningful insights to help our clients understand their population and self-funded plans better. We know the importance of staying current – for example, adding a section to discuss COVID-19 testing and treatment for the group.
We look for particular issues a group may be having and provide recommendations. In our analysis, we consider any pain points for the group – such as low engagement with case management, or over-utilization of high-cost imaging – and suggest solutions. This may be a new outreach strategy, a change to benefit design, or adding a new program. Our account management team helps drive this conversation and provides options for the group’s review – in consideration of the group’s focus and direction for managing the plan.
Post-game analysis.
Follow-ups are common to drill down into more details. Based on the discussion during the annual review, our account management and analytics teams often provide follow-up analysis. For example, it may be a request for a benchmark on a specific benefit, or a closer look at utilization patterns in a particular region.
Team Ownership.
Since our partner Blue Plans own the relationship with the group and are connected to the local market, we look to them for leadership on the on the direction of the annual review. We have the flexibility to accommodate partner Blue Plans’ unique approaches, and the partner drives their own level of involvement in the process. We work as a team to make sure the annual review aligns with the partner’s goals and demonstrates the value of being Blue.
We take pride in going above and beyond the traditional administrator role in plan performance analysis. It’s just another way National Alliance stays on the constant edge.