Top Five Operational Resolutions for 2016

Did you know only 8% of people who make New Year’s Resolutions achieve them? There are many reasons why resolutions are not accomplished. They may have been too aggressive or priorities changed. Sometimes it’s because the goal is too vague or there are far too many and a person is unable to focus on them all.

When it comes to achieving resolutions, there are two keys to success: be specific and stay positive.

Here are our top five operational resolutions to consider for 2016:

1. Re-evaluate your controls against current guidance. Are the standards still the same? Is your evaluation process adequate to ensure compliance?
2. Fix your highest volume workaround. Every department has them. Some prevent rework, some are due to obsolete systems, some were set up for ease of users, but workarounds are hard to monitor, hard to explain in an audit, and are a risk with staff turnover. Fix it so you have one less thing to sidetrack processes.
3. Set up redundancy in processes. We have all been in a place where a single individual knows a process. Your single source of success can easily turn into a single source of failure if that staff person wins the lottery and decides to travel the world.
4. Evaluate and improve the highest priority item requiring rework. One client had a high volume of Medicare Secondary Payer (MSP) records which would be closed and then show up again every few months. The rework and premium loss and recovery were a continuous cycle. After evaluating the records, a root cause was identified, which was within the plan’s control, and resulted in less MSP churn.
5. Celebrate more successes. Does your staff know their compliance rates? Do they know if they are improving month over month? Do they know the compliance issue they reported resulted in better ongoing compliance and prevented harm to members? Celebrating successes not only ensures staff sees the part they play in the big picture but reinforces the requirements.

Gorman Health Group has experienced consultants who can assess and review the operational areas of your organization. We can review current processes and look for efficiencies to improve outcomes and better compliance. Make a resolution to improve your organization’s operational areas — we can help make it happen in 2016.

For more information, please contact me directly at jbillman@ghgadvisors.com.

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