Technology and Vendor Implementations

As with all program and technology initiatives, the short- and long-term successes realized as a result of the investments made rely on the critical stages of vendor transitions, data and system readiness, and project management – A well-oiled Vendor and Program Implementation Initiative. Quite often, our health plan and provider clients have multiple projects running in parallel, making for an environment of competing priorities and scarce resources.

In order to optimize the investments made in technology, as well as the supporting member and provider interventions, the organization will need to commit and align subject matter experts (SMEs) in the areas of Risk Adjustment and Quality with SMEs in Information Technology (IT). Given the financial brevity of Risk Adjustment and Quality bonus programs, Gorman Health Group (GHG) encourages our clients to invest in program management and implementation staff. This staff must be solely dedicated to achieving both a seamless transition from legacy vendors to the new vendor partners. Additionally, the implementation team must be committed to ensuring the implementation of the solutions is on time, within budget, and managed to the highest degree of quality assurance.

If the implementation is delayed, the downstream impact on these critical programs could set the stage for years of inaccurate payments and missed opportunities.

GHG understands the challenges of implementing Risk Adjustment and Quality modules on an accelerated timeline in order to meet financial goals. Applicably, our team of industry experts has each been involved in over 40 unique vendor implementations during our tenure as health plan executives and GHG consultants.

Timing is critical. GHG’s implementation team employs the Agile project management methodology, working with clients and vendor partners to run initiatives in parallel rather than sequentially, creating efficiencies, ensuring alignment of tasks, and coordinating an environment driven by thoughtful multi-tasking to help meet the deadlines for implementation.

Whether you are off-boarding or on-boarding vendors to support your Risk Adjustment and Quality programs, our experienced team of consultants can provide a wide range of support to your company. For more information on our process and our team, please contact me at dweinrieb@ghgadvisors.com.

 

Resources

The much-anticipated “Summary Report on Transitional Reinsurance Payments and Permanent Risk Adjustment Transfers for the 2015 Benefit Year” has been released by the Centers for Medicare & Medicaid Services (CMS). Read the full article >>

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