How to Convert Marketing Calls to Leads and Sales

The marketing pieces for your sales campaign have been delivered and the response has been tremendous. Your call center partner must now convert those inbound marketing calls to leads or sales.  What should you expect?

You should expect an inbound call process that is CMS-compliant.  Callers should be fully qualified for eligibility by the call agent. Phone agents should patiently educate all callers on available plans and provide excellent customer service.

There are 2 ways most call centers begin the lead generation process and/or proceed to the telesales process. A select few call centers offer a third option:

  • Agents can set personal appointments for field agents Call center agents can schedule appointments for field agents as they do when scheduling a seminar reservation The call center can relay the appointment to a field office manager or, with proper protocols, directly to the agents via mobile device or smart phone.
  • Prospects can talk with a licensed and plan-accredited phone agent During a sales call the  agent should: 1) Review all appropriate plan details, read the required disclaimers and obtain the prospect's confirmation if they choose to enroll; 2) Minimize data entry errors by using an electronic application that integrates seamlessly with the data captured during the sales presentation; 3) Submit the application via secure protocols and provide the customer a confirmation number; 4) Review the CMS-required information and set expectations for the OEV call and delivery of material.
  • Warm lead delivery Select call centers may offer a lead delivery system that utilizes technology advancements. "Agent Connect" is such a tool and is powered through a mobile platform on Ascend.  This lead delivery system allows phone agents to warm transfer callers to field agents at the moment the caller is ready to set an appointment. The field agent can then schedule an appointment in real-time, complete a scope of appointment on the same call, and immediately begin building rapport with the caller.

Every inbound call that fails to yield a sales appointment or enrollment is a wasted opportunity. Protect your marketing campaign with careful selection of a call center that will best meet your needs.

 

Resources:

The Bloom Call Center is licensed in 48 contiguous states and offers marketing, call center and technology solutions to the health care industry.  Since 2007, Bloom has participated in over 55 million conversations about insurance products, submitted over 200,000 applications for insurance, and set over 150,000 appointments for seniors to meet with Licensed Agents.  Bloom is a proud partner of Gorman Health Group.  Click here to learn more.


Health Plan's Role in Provider Alignment

Long gone are the days when the provider contracting functions, the medical economics function and the health services/medical management functions within a Health plan could operate in their own separate environment with limited interaction. Health plans today are pressured to provide improved member access to health services at reduced cost while striving for improved treatment outcomes for their members. Consequently, health plans are being asked to motivate their providers to adjust practice patterns in ways that support performance based outcomes and shifts emphasis from procedure based reimbursement to value based reimbursement. That can only be accomplished successfully if the dynamics between providers and Health Plans evolve from adversarial to one of shared interest, collaboration and shared decision making.

Give health plans and the provider community credit for recognizing such and having made significant strides in aligning their own interests, as well as their memberships interests, with those of the provider community. Witness collaborate efforts such as ACOs, patient centered medical homes, bundled payment initiatives and other innovative payment programs. Just today United announced an ambitious five year initiative to contract 50 billion dollars of commercial health insurance contracts with ACOs nationwide. Similarly, CMS is committed to publishing on an annual basis Hospital charges to demonstrate the huge disparities in hospital pricing for the same procedures across the country with the hope of eventually motivating hospitals to bring rationality to inpatient services pricing.

Resources:

At GHG we have a history of helping all stakeholder organizations engaged in providing better health outcomes efficiently and in the best possible setting. Come join us.

A rapidly growing number of provider organizations, especially those involved in accountable care organization (ACO)-type arrangements, are deciding to get into Medicare Advantage. Join us for a webinar on August 8 to get practical advice on the best ways of getting into the MA market.

Read more on ACO opportunities in our white paper on the topic.

 


Tip of the Iceberg

Most Americans get their health insurance from employer sponsored coverage. But this coverage has been eroding over the last twenty years.  The Clinton health reform discussions realized that it was impractical and fiscally impossible to remove employer contributions from the financing of American health care coverage.  And in subsequent health reform efforts, there have been a number of programs to shore up employer coverage including the Retiree Drug Subsidy and the Early Retiree Reinsurance programs which subsidized employers who continued to offer retiree medical and drug coverage. These subsidies didn't stop the troubled auto industry from shifting retirees from defined benefit plans to defined contribution plans and sending their retirees to an early version of a private exchange where they could choose among a number of insurance products.  Now with the Affordable Care Act (ACA) health insurance Marketplaces coming on line this October, we are seeing a number of troubled public sector employers seeing an opportunity to unload their retiree health burden.  Detroit and Chicago have announced plans to end employer coverage and send their under age 65 retirees to the new Marketplaces to buy health coverage. The savings are substantial, e.g. Detroit could reduce its health care expenditures from $185 million to under $40 million. The new Marketplaces not only provide an opportunity for retirees to easily find replacement coverage, but also avoid a penalty under the individual mandate since they would no longer have employer coverage that qualified as minimal essential coverage.  These cities would not face a penalty under the ACA's employer mandate since the penalty applies to employee coverage and not retiree coverage. Other troubled municipalities and state and local governments are expected to follow suit since they would not only realize huge annual savings but also have an opportunity to offload GASB liabilities and improve bond ratings.

It is hard to predict the impact on the Marketplace risk pools.  These retirees are older and may have more health problems on one hand, but on the other hand they have had excellent health care coverage throughout their public sector careers.  In addition, the plans offered in the Marketplaces are age rated.  But it is one more reason why the young invincibles need to be encouraged to sign up for Marketplace coverage.

 

Resources

Read Gorman Health Group's recap of the 2013 GHG Forum, which includes details regarding preparing for the health insurance exchanges.  This free download is available on the Point.

Jean LeMasurier provides an overview of key takeaways from CMS' proposed rule CMS-9957- P-Patient Protection and Affordable Care Act; Program Integrity; Exchange, SHOP, Premium Stabilization Programs, and Market Standards.

The Exchanges will create a large risk pool that will allow risk to be managed more effectively with reduced administrative costs.  The final regulation discussed in this white paper references estimates from the Congressional Budget Office (CBO) and more.


Now the Blood is in the Water

Last week, the Obama Administration issued a notice that the Affordable Care Act's (ACA) "pay or play" employer mandate and reporting requirements, which were set to take effect on January 1, 2014, are being postponed until 2015. Now the blood is in the water with all of Washington asking "what's next to be delayed?" It's not even clear the Administration had the legal authority to delay a provision of the law.  While not a big deal for most employers or payers -- most employers already offer comparable coverage to full-time workers -- the political ramifications are huge.

This postponement means that an employer won't be penalized if it does not offer its full-time employees affordable health insurance in 2014 that's comparable to what will be offered in the exchanges -- with a penalty of $2,000 per full-time employee. The ACA also requires health plans and employers to report certain information on health insurance coverage to the IRS in 2014. The Administration also postponed this reporting requirement until 2015, though it still encourages these entities to voluntarily report coverage information in 2014.  Like that'll happen.

Predictably the business interests that fought for the delay had nice things to say for the Administration's decision.  "I think this is less about readiness and more about the fact that they're trying to be flexible in their implementation," said Rhett Buttle, Vice President of the Small Business Majority, which supports the ACA. "It does seem like an olive branch."  But less charitable business interests will see this victory and will start lining up for additional concessions.

The implementation of the rest of the Act, including the health insurance exchanges, individual mandate and other reporting requirements, are unaffected by the announcement and, at least for the moment, are proceeding on schedule -- until they're not.

The event seems to be bolstering the arguments of both sides of the health reform chasm.  The ACA's opponents just got their sneering "I told you so". They say the delay is Obama's admission of the law's failures, and once again the "repeal and replace" chorus just warmed up for another show.  White House Senior Adviser, Valerie Jarrett, defended the delay as listening to employer concerns.

We can't lose sight of the fact that this is the second major delay in the implementation of ObamaCare, and it's playing right into the Congressional Republican narrative that the Administration can't get its act together and that this is going to be one hot mess starting in October.  HHS Secretary Sebelius better have her own Capitol Hill parking spot lined up.

 

Resources

Read Gorman Health Group's recap of the 2013 GHG Forum, which includes details regarding preparing for the health insurance exchanges.  This free download is available on the Point.


The Seismic Impact of the Baucus Retirement on Health Policy

Senate Finance Committee Chairman Max Baucus (D-MT) stunned Washington recently with his announcement that he was retiring and would not seek reelection in 2014.  Next to the Majority Leader, he's probably the most powerful guy in the Senate -- and definitely so on health policy.  Attention turned to who's next and what it means for Medicare, Medicaid and health reform.

The second in line on the Finance Committee now is Jay Rockefeller, but the towering liberal West Virginian has already announced that he too plans to retire next year.  If Finance goes in order of seniority, as is customary, lefty firebrand and former Gray Panthers leader Ron Wyden (D-OR) would be in line to succeed Baucus as Chairman in 2014 if the Democrats hold the Senate -- the first year the Affordable Care Act's major health reforms like health insurance exchanges take effect.

It's a critical transition as Wyden was the only Democrat to work on a Medicare premium support plan with House Budget Chairman Paul Ryan (R-WI). They later diverged and Wyden didn't support the bill Ryan took to the House floor — but Wyden had already irked fellow Democrats both because they didn't like the policy and because he gave Ryan some bipartisan cover in an election season.  Although Wyden did support President Obama's health care effort in 2009-10, he had spent many months trying to put together an alternative approach with then-Utah Sen. Robert Bennett, a Republican. That plan would have moved the country away from the employer-sponsored health insurance system to a market for individuals to buy their own insurance, with subsidies for low-income people.

So liberal lion as he is, Wyden remains the rare member of our upper chamber who's still willing to reach out to the other side to get things done, and that bodes well for the critical business of Finance, which will include a rewrite of the tax code, continuing Medicare reforms, and the inevitable tweaks to ObamaCare to come.  You''ll be hearing much more from the senior senator from Oregon in 2014 and beyond.

Resources

Read Gorman Health Group's recap of the 2013 GHG Forum, which includes details regarding preparing for the health insurance exchanges.  This free download is available on the Point.

GHG policy expert Jean LeMasurier provides an overview of key takeaways from CMS' proposed rule CMS-9957- P-Patient Protection and Affordable Care Act; Program Integrity; Exchange, SHOP, Premium Stabilization Programs, and Market Standards.

 

 


The ObamaCare Enrollment Push Begins

So we're less than 100 days away from the official launch of outreach and marketing for the new Health Insurance Exchanges, and the enrollment push began in earnest this weekend.  It's happening in the face of some tremendous headwinds unlike anything seen since the launch of Medicare Part D in 2006, maybe ever.  The Medicare drug benefit' s takeoff didn't have to contend with furious political opposition at both state and Federal levels, a horribly misinformed public, and the demographic challenges of ObamaCare.

Enroll America, the Obama-driven leftie coalition that's tasked with pushing enrollment in the exchanges, kicked off its boots-on-the-ground effort last week. Enroll America President Anne Filipic told POLITICO today that the first week went well as the group tried to change the conversation from politics to benefits. They had 1,000 volunteers out, 1,000 on a strategy call, 78 events in 25 states (they expected to do 50 in week one), and knocked on 3,200 doors. Not a bad start for a group that sprung from Obama's legendary campaign ground operation.

Changing the debate from politics to benefits is no small task for the pro-ObamaCare forces in the field.  Health and Human Services Secretary Kathleen Sebelius has been getting slammed for her fundraising calls on behalf of Enroll America to industry stakeholders like insurance companies.  Last week 28 GOP senators sent a letter to HHS Secretary Kathleen Sebelius asking her to "immediately stop" fundraising for Enroll America until she has answered more questions about it.

Then Sebelius called all the professional sports leagues last week to seek their help in outreach to potential ObamaCare beneficiaries this fall -- and Congressional Republicans wailed again.  Senator Minority Leader Mitch McConnell (R-KY) and Senator John Cornyn (R-TX) wrote "Given the divisiveness and persistent unpopularity of the health care [law], it is difficult to understand why an organization like yours would risk damaging its inclusive and apolitical brand by lending its name to its promotion," in letters sent to the commissioners of the NFL, MLB, NBA, NHL, PGA and NASCAR.  It appears most if not all of professional sports will not participate.  It's too bad -- I loved the speculation of what the ads might look like.

All of this is of course happening against a backdrop of a terribly misinformed public, especially among uninsured prospective ObamaCare beneficiaries.  An April Kaiser health tracking poll found 42% of Americans are unaware that the Affordable Care Act (ACA) is still the law of the land, including 12% who believe the law has been repealed by Congress, 7% who believe it has been overturned by the Supreme Court, and 23% who don't know whether or not the ACA remains law. And about half the public says they do not have enough information about the health reform law to understand how it will impact their own family, a share that rises among the uninsured and low-income households.

The biggest problem the ObamaCare rollout faces, though, is demographic.  First, many ObamaCare eligibles are low-income, and not necessarily English-speaking. They may not see or understand ads on English TV channels this fall, and they'll need different messaging, outreach and hand-on counseling at the kitchen table. And with Congress literally appropriating 10% of what the Administration requested for insurance Navigators to help the uninsured through the enrollment process, and literally dozens of Red State governors in opposition and of no help on the ground, that's a tall order for Year One.  CuidadoDeSalud.gov is getting a makeover this summer, and HHS announced it has opened its 24/7 call center, which is supposed to be able to handle millions of consumers' questions in 150 languages.

Second, the viability of the exchanges rests on risk selection, and that means if we don't get the "young invincibles" and the "bro's" to sign up to offset the risk of the sick uninsured we know will flock to the program, we'll fall into a rate-setting death spiral.  The Administration is looking for 7 million enrollees in Year One, including 2.7 million young adults.  And there's actually some encouraging news here: Kaiser's poll found more than 70% of those under 30 said that having health insurance is "very important," something they need, and that it's worth the money. Overall, just a quarter of those ages 18-30 feel they are healthy enough to go without insurance.  Doesn't necessarily mean assured enrollment, but it is a ray of hope through all the white noise.

Things are sure to get Presidential campaign-level crazy right after Labor Day, when the Administration is convinced folks will start paying attention.  Expect a blizzard of pro and con communications across every medium imaginable, and millions of confused uninsured consumers in between.

Resources

Read Gorman Health Group's recap of the 2013 GHG Forum, which includes details regarding preparing for the health insurance exchanges.  This free download is available on the Point.

Listen to a GHG podcast from GHG's Executive Vice President Steve Balcerzak regarding the unbanked and the uninsured, and the implications this population will have on ACA enrollment.  This podcast is freely available on the Point.

GHG policy expert Jean LeMasurier provides an overview of key takeaways from CMS' proposed rule that establishes financial integrity and oversight standards for Health Insurance Marketplaces, QHPs in FFMs, and states that operate risk adjustment and reinsurance programs.  This regulatory summary is available to members of the Point.


Agent Oversight Improves Quality and Customer Experience

If you're like most health plans, you rely on key "glue folks" to keep operations running smoothly.  You know the ones: staff members that embrace their role, mind the details and ensure behind-the-scene efforts improve outcomes.  They may or may not communicate one-on-one with customers, but their efforts contribute in a positive way to the overall customer experience.

For many, the partners and team members that manage the oversight of field and call center agents are the very glue of the sales and marketing activities inside a plan.

Consider agent oversight in three parts: ComplianceOperations and Quality. They're three distinct functions of equal importance.  When synchronized, Agent Oversight aids in seamless performance of an organization's sales and marketing efforts.

What do we mean by three distinct functions?  Consider the three-legged stool:

Compliance is more than a disciplinary function. The compliance department should work directly with Operations to ensure open channels of communication exist with all sales agents.  Effective communication of regulatory requirements through training can mean prevention of compliance missteps and disciplinary actions.

Operations should be proactive regarding agent oversight functions.  With careful monitoring of agents and frequent status reports, agent issues can be addressed promptly and directly. Simplify the process with technology to monitor sales meetings anywhere and anytime and assess agent performance in real time. Oversight recommendations may include additional training, corrective action or require immediate termination. Regardless the action, the result must be swift.

Quality programs should offer metrics on evaluating agent performance.  There are a number of ways to rate agent performance in the development and implementation of Quality programs:  grading, coaching or performance reporting.  At Bloom, we use all of those tools — as well as call review, call scoring and calibration for each call center agent.  Plans should work closely with their call center partner to develop, implement and assess a customized Quality program that best meets their needs. A strong partner can work with a plan to implement an existing program or to craft a new one.

Resources

The Bloom Call Center is licensed in 48 contiguous states and offers marketing, call center and technology solutions to the health care industry.  Since 2007, Bloom has participated in over 55 million conversations about insurance products, submitted over 200,000 applications for insurance, and set over 150,000 appointments for seniors to meet with Licensed Agents.  Bloom is a proud partner of Gorman Health Group.  Click here to learn more.


Lessons from Part D for ACA Implementation

It was interesting to hear Mike Leavitt and Mark McClellan compare their experiences in launching the Medicare Part D program in 2005 and 2006 to the challenges facing HHS and CMS in launching the new Health Insurance Marketplaces at a recent Brookings Institution forum. There are so many parallels and yet important differences. The lessons from Part D are also discussed in a new report from Georgetown's Center on Health Insurance Reform funded by the Robert Wood Johnson Foundation.

Several of the parallels include:

  • Outreach and Education Challenges — HHS began a public education campaign 15 months in advance of the Part D program including over 500,000 events and a bus tour by the Secretary and HHS officials. However at the start of enrollment 80 percent of beneficiaries reported they would not enroll or were uncertain about enrolling. 100 days before the Marketplace open enrollment period, HHS is just beginning its outreach program and they are using successful techniques from the Part D program, e.g. extensive use of partnerships and local events conducted by Regional Offices. However, funding for the ACA educational efforts is limited, timing is shorter, and HHS does not have a list of the target population for the individual marketplaces since they do not currently have insurance. Social media offers a shortcut to reaching a key target audience, the 18 — 35 year olds, who are essential to keep premiums affordable. However the challenge will be the messaging. HHS is hopeful that they will be able to build a culture of coverage with the offer of access to an insurance card for the first time and the encouragement from Mom.
  • Public Skepticism — The lack of public support for health care reform has been consistently documented by the Kaiser Family Foundation surveys. However the recent discussions remind us that public opinion was actually less favorable for Part D where only 21 percent of beneficiaries had a favorable opinion in April 2005 compared to 35 percent with a favorable opinion of the ACA in April 2013. Mike Leavitt observed that now the sides supporting the change have reversed. A big difference in Part D was that the penalties for not enrolling carried on forever, thus spurring last minute enrollment. The ACA penalties are comparatively smaller and will not provide the same incentive. That will mean that we will need a longer window to assess ACA performance as enrollment continues to grow over a multiple year period.
  • Plan Participation and Costs — CMS officials worried that stand alone drug plans that did not exist in the private markets in 2005 would not sign up to participate in Part D. There was also controversy about the cost and affordability of the premiums. It turned out that there probably too many choices under Part D and costs came in below projections. There are similar worries about plan participation in the Marketplaces. CMS reports that 120 plans applied to the Federal Marketplace, however participation in the state marketplaces is more uneven and particularly low in the SHOPs with no plans in the Mississippi SHOP and only 1 plan in the North Carolina SHOP. Most of the plan premiums have not been released, however early reports suggest that there will be variation by marketplace and the number of competitors. A study of 9 states by Avalere shows rates lower than CBO predicted. However, we have also read about an average 25 percent increase for plans in Maryland. HHS will post final rates in the FFM in September, although some states may release final rates in late summer.
  • Market Readiness — Despite short timeframes, CMS was ready for enrollment in November of 2005, but we all remember the anecdotal stories of beneficiaries who showed up at pharmacies on January 1 unable to get their drugs. Fortunately, the states came to the rescue and the glitches were ironed out over time. The same concerns about operational readiness face the implementation of the ACA where the number of potential enrollees is higher, the systems more complicated and the subsidies more complex. The longer enrollment period will provide more time to iron out any problems. However, most states will not be willing or able to jump in if the federal roll-out stumbles.

Resources

Listen as Whitney St. Jean, Chief Administration Officer of Gorman Health Group, outlines the components of a successful go-to-market strategy for MA plan sponsors and their partners.

The rapid changes to Part D regulations make the tracking and implementation of these CMS requirements exceptionally difficult — to say nothing of actually managing to them, find out how GHG can help.

Gorman health group can help position you for the challenges—and opportunities—posed by health reform, designing a strategy that takes into account your service area, market environment, core competencies, and vision of the future, click here to find out how.


Sea Change at CMS

Administrator Marilyn Tavenner officially named Paul Spitalnic as the CMS chief actuary. I worked with Paul when he first came to CMS to implement the Part D program. He then served as the Director of the Part C and D actuarial group. Paul is very smart and will ably fill the shoes of other distinguished CMS chief actuaries that I have worked with including Guy King and Rick Foster.  Both Guy and Rick were outstanding public officials who came to CMS from the Social Security Administration and from a tradition of government run social insurance programs. I guess experience with the managed care side of Medicare is no longer considered a handicap.  To me this shows how much has changed at CMS. Part C is almost 30 percent of the Medicare program and Part D is administered through contracts with private plans.  These programs are no longer step children.  Congratulations Paul.


Humana's CEO on Implementing ObamaCare

Reuters got a nice scoop with Humana CEO Bruce Broussard, who took over from the legendary Mike McAllister in January, with an interview on their approach to implementation of ObamaCare in less than 100 days.  It was good enough to reprint in full below.  A couple impressions:

  • Broussard points out how much the industry wants the launch of ObamaCare to NOT fail.  Congressional Republicans could take a lesson: the time for foaming-at-the-mouth opposition is over -- it's time to roll up our sleeves and make this thing work for the good of the country.
  • The comparisons to the launch of Medicare Part D, which Humana dominated with United, are appropos.  There will be mass confusion and disruption in the system as outreach and marketing begin in October.  There will be horror stories of administrative meltdowns keeping sick people from benefits.  But it will work itself out in the latter half of 2014 and will become immensely popular.  Let's just hope an eligibility screwup doesn't kill someone next year -- the media frenzy will be fueled by the reporters' credo  to "afflict the comfortable and comfort the afflicted," and there's nothing more afflicted than a sick American thwarted by governmental or corporate ineptitude.
  • Humana was brilliant is deploying its veterans of the Medicare Advantage and Part D wars earlier this decade to the front lines of ObamaCare.  The similarities between the programs are stunning and the company is way ahead of most of its competitors by leveraging their own vast experience.  Most plans made the mistake of thinking "individual = commercial" when it came to product strategy; the reality is that the exchanges will much more closely resemble government business, with much sicker enrollees and more administratively complex systems to reconcile. 
  • Note Humana's retail strategy at the conclusion of the interview.  That's the same playbook that won the day on Part D: "wallpaper" presence in places like WalMart.  It'll have the same result in the 14 states they're chasing exchange business in.

Humana's CEO on the massive undertaking of health reform

10:28pm IST

By Caroline Humer

(Reuters) - Bruce Broussard took over as chief executive of Humana Inc in January, just in time to steer the health insurer's entry onto the health insurance exchanges created by President Barack Obama's reform law.

Humana plans to sell subsidized insurance plans in 14 states, including Arizona, Colorado, Florida and Kentucky, where it is based, about the same number of states as rivals like WellPoint Inc and Aetna Inc.

The exchanges are expected to bring in 7 million people in 2014. Insurers must offer plans to any individual who applies, regardless of prior health problems. The government will provide subsidies to people who earn up to 400 percent of the federal poverty level, or $94,200 for a family of four.

Humana already has experience with government healthcare programs - it has more than 2.5 million members in privately administered Medicare Advantage plans for the elderly. It also manages Medicare pharmacy benefits for more than 3 million people.

Here is a discussion that Reuters had with Broussard this week on the effort to roll out "Obamacare":

Q: What has proven harder than you thought about the development of the exchanges?

A: This is a massive project. A number of months ago the industry met with the president and he made the comment this is probably the largest healthcare project since the Truman-Kennedy era, and he is right. We are taking on a very, very large project and so there are a lot of details that the states and the federal government are working on. It's keeping up with those and being able to implement them where they are already behind schedule, and trying to keep up so that we do fulfill the needs of the public promise that has been made.

Our challenge right now is it is moving so quickly, keeping up with it and being able to assist the state and federal governments for it to be successful because I think the last thing we want is for it not to be successful. So we are dedicated to helping it. But the details are coming out and they are coming out as quickly as the federal government can get them out.

Q: What did you think about the recent U.S. Government Accountability Office report that said some states are behind?

A: I'm not going to take a different stance than the GAO. I'll just say in general there are a lot of details and everyone is working hard to get this done. The industry is working hard, the states are working hard, the federal government is working hard, but this is a big task that's been taken on and I'm sure details will be get lost in the process just because of the size and the enormous effort that is required here.

Q: When consumers decide on which plan to purchase, would you expect that access to certain doctors and hospitals will play a large role?

A: It's going to be interesting. This is where price and choice are going to come at a crossroads here. I think a more cost-effective product is going to have less choice. It is a test. Most of our products are going to be narrow networks and limited providers because we feel that is the best way we can offer a product that is going to be cost-effective.

Q: How else can consumers judge the value of these products?

A: This isn't much different from (Medicare) Part D and Medicare Advantage when it came out in 2005. There was a lot of confusion around what it meant and there was a lot of time being spent on educating both around choices and options and subsidies to the type of plan.

As we look over the coming number of months, we look at that as a responsibility that we have in educating in the 14 states we will be in. We are going to take our market point sales group that today also handles the Medicare Advantage program, we are going to expand that and they will be an active part of the individual exchange. So we are going to have people on the ground helping people.

We also believe in having relationships where people are in their normal course of life, so retail chains are an important part of that. So not only are we going to have people go to their homes, but in addition we are working with partners with retail outlets so we can staff individuals where it is convenient to a potential member to incorporate in their life.

Q: Do you mean grocery stores and pharmacies?

A: Yes, that's right.

(Reporting by Caroline Humer; Editing by Michele Gershberg and Douglas Royalty)

 

Resources

Gorman health group can help position you for the challenges--and opportunities--posed by health reform, designing a strategy that takes into account your service area, market environment, core competencies, and vision of the future, click here to find out how.

Listen to a three-part podcast series where GHG Executive Chairman, John Gorman discusses the Importance of a Readiness Checklist for the Exchanges for Sales Marketing Enrollment and Risk Adjustment.

Visit our website to learn more about how Gorman Health Group can help support your Medicare Advantage goals.

The rapid changes to Part D regulations make the tracking and implementation of these CMS requirements exceptionally difficult -- to say nothing of actually managing to them, find out how GHG can help.