Timing is Everything

We chatted with several health plans during the GHG August 11, 2011 webinar. 

The purpose was to highlight that the earlier you begin your risk adjustment the better because you have more chances to:

• Get the data
• Interact with the member
• Impact the member’s satisfaction
• Link the findings to care
• Impact the premium sooner

We found that most of the health plans listening:

• Start their retrospective program in April
• Start their prospective program in March
• Have 50% of the prospective evaluations completed by June
• Evaluate 51-75% of their membership each year via member evaluation

Really?  These answers bring a tear to our eyes.  Be proud if this is your program.

Our tip: Shoot a little higher in your evaluation program next year; a better target is 85%.

Again, shifting your start dates to earlier in the year will help you get to know your member and increase the closure rates or acceptance rates of your evaluations.  Plus getting that premium bump in January of the 2012 will answer questions about expansion plans, bid application, and benefit design.

P.S.  Join us for the next flash webinar in our series: Your Vendor Security Checklist, August 18 at 3:00 pm EST