Getting Ready for the Bid Season
Since the CMS Medicare Advantage January enrollment numbers did not include the last three days of the Annual Election Period (AEP), it is important to utilize the February enrollment file to get the full picture of AEP results. At GHG, we like to develop the reporting in January for directional results and get an idea of where the landscape may be heading for the year ahead. Plus, looking at your marketplace at the beginning of each year is very important to the product/plan/benefit process that is now upon us.
Last week, my colleague, Diane Hollie, and I spoke at a conference solely geared toward the upcoming bid process. We spoke about the types of analyses an organization should be looking at and we had great discussions about the data and types of data to be viewed/analyzed. One thing was very evident – Marketing, Sales, and Product Development staff that have the data of the marketplace need to be a part of the bid process.
The bid process needs to be a team approach, with one clear leader, and include representatives that are accountable for profits and losses (P&Ls). For example, some of the team members that should be included are Sales/Marketing, Finance/Actuary, Network, Pharmacy, Medical and Health Management, and Compliance.
At the beginning of the bid process, it is important to level-set the team on the marketplace. Some of the analyses we typically present include:
- Service area demographics
- Medicare penetration
- Current membership analysis
- Enrollment trend analysis
- Results of the last AEP — who are/were the winners and losers this AEP and why?
- Product analysis
- Benefit analysis
It is important to dig into the data to understand the story being told. Remember to ask – what part in the story do you play? Are you a protagonist with a diminishing role, are you the antagonist shaking up the market, or are you just happy to stay alive in the story? Whatever role you play, it is important to understand the part, own it, and have your plot development for the next AEP and beyond.
Check back next month as we look at the AEP results and see what’s happening in the marketplace on a national level.
Resources
GHG will provide a complete benefit design and strategy analysis that will take into account organizational strengths in operations and medical management that includes a thorough examination of your intended market and a feasibility analysis. Visit our website to learn more >>
Smart benefit design is a dynamic process that begins with an examination of intended markets with consideration given to strengths in member retention and medical management, and is executed with specific enrollment and financial targets in mind. Visit our website to learn how GHG can help >>
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