3 Steps for Success: 2020 Material Creation and Review Season

It’s late Friday afternoon before Memorial Day weekend and the Centers for Medicare & Medicaid Services (CMS) has gifted us with the Contract Year 2020 model materials memo! Although most organizations wait until the bids are in, we are seeing some plans get a head start on their materials this week.

Last year there were multiple iterations of the model documents posted by CMS.  Hopefully, the changes to documents by CMS will be minimal this year – although CMS is considering adding instructions for Medicare Advantage (MA) plans to disclose a complete list of Part B drugs that are subject to step therapy requirements in the Annual Notice of Change (ANOC) and/or Explanation of Coverage (EOC) documents.  CMS is seeking feedback on this issue as well as indication-based information and mid-year changes by June 20, 2019.   So we expect to see at least one round of changes to the impacted models.

Here are 3 tips to help you get ready for 2020:

  1. Evaluate what worked and what didn’t work well in the material review process last year. Did you conduct a lessons learned session at the end of the season? If you did not have a chance to do a lessons learned session, take some time to reflect before you start your material creation with your team.  This way, you can set expectations with your team and colleagues.
  2. Develop tools and checklists. If these are not in place already at your organization, these resources are integral to helping in development of materials and should be developed. Having strong benefit grids, change documents of benefits from 2019 to 2020, and the listing of all current telephone numbers, websites, addresses is really important to make sure your materials are accurate. 
  3. Taking the time to review materials is critical.  These documents are painfully tedious with a high probability for error in creation.  Without proper checks and balances in your review process, your probability of errors increases substantially.  At GHG, we believe a two tier review process across all materials is needed for success. 

Does this quick hit list warrant additional discussion within your team? If you are doing the above already, fantastic! That said, are you inundated with the day-to-day of CMS and/or Annual Election Period (AEP) planning and requests with six+ hours of meetings a day and little time to catch up and actually get your work completed?  Plans today are stretched thin for the development and review of these extremely time consuming, yet critical, materials and CMS has a zero tolerance for errors.

If you need help with either material development, review or both, contact me directly at dhollie@ghgadvisors.com for more information on how we can help.  But please, call quickly so we can get you scheduled.


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