RELIEVING THE PAIN OF ANOC & EOC STREAMLINING DOCUMENT CREATION AND REDUCING COSTS WITH INTELLIGENT DYNAMIC PUBLISHING TECHNOLOGY

Transcription

1 RELIEVING THE PAIN OF ANOC & EOC STREAMLINING DOCUMENT CREATION AND REDUCING COSTS WITH INTELLIGENT DYNAMIC PUBLISHING TECHNOLOGY

2 RELIEVING THE PAIN OF ANOC & EOC Contents 3 EXECUTIVE SUMMARY 4 RAPIDLY AGING POPULATIONS, GROWING ADMINISTRATIVE CHALLENGES 5 KEY PAIN POINT: ANOC & EOC DOCUMENTS 6 TRADITIONAL DOCUMENT MANAGEMENT SOLUTIONS FALL SHORT 7 AN EMERGING SOLUTION: INTELLIGENT DYNAMIC PUBLISHING 7 KEY ELEMENTS OF AN INTELLIGENT DYNAMIC PUBLISHING SOLUTION 9 DYNAMIC PUBLISHING CASE STUDY 9 POWERFUL BUSINESS IMPACTS OF INTELLIGENT DYNAMIC PUBLISHING 10 DYNAMIC PUBLISHING: A COMPETITIVE ADVANTAGE TODAY AN ESSENTIAL TOOL TOMORROW RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 2

3 EXECUTIVE SUMMARY Challenge: Each year, health insurance plans struggle to produce their CMS-required Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents efficiently and accurately. Failure to meet compliance dates or follow strict regulated guidelines can impact insurer ratings or result in fines. This time-consuming process is a persistent pain point straining internal resources and leading to significant staffing costs. Emerging Solution: Intelligent dynamic publishing platforms leverage forward-thinking technology that empowers health insurers to work smarter, not harder. These platforms connect CMS model document structures with web-based plan data management to automate model document creation, streamline review cycles and help ensure the accuracy of personalized documents. MID-MAY CMS RELEASES DOCUMENTS SEPTEMBER 30 ANOC & EOC DOCUMENTS DUE IN MEMBERS HOMES Key Benefits Mitigate burden of model document creation for internal staff Generate initial ANOC and EOC proofs significantly faster Reduce model document templates and simplify document proofing Simplify year-over-year changes Minimize review cycles Ensure accuracy and mitigate delivery risks Drive operational efficiencies, cost savings and increased ROI RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 3

4 RAPIDLY AGING POPULATIONS GROWING ADMINISTRATIVE CHALLENGES For health insurers, managing the complexities of Medicare health plans is an ongoing challenge that presents significant internal costs. That burden is rapidly intensifying. The U.S. population age 65 and older is expected to grow more than 20 percent 1 over the next 20 years, adding approximately 10,000 new Medicare beneficiaries every day. This demographic trend is also expected to drive a surge in the Medicare population from 54 million in 2014 to a projected 93 million by As this growth accelerates, effectively navigating administrative challenges ensuring compliance with constantly evolving CMS requirements, optimizing reimbursement for care and driving operational efficiencies to minimize costs is increasingly critical to the growth and prosperity of all health insurance organizations. Medicare Population Booming U.S. Medicare Population in 2050: 93 MILLION in 2014: 54 MILLION NEW MEDICARE BENEFICIARIES EVERY DAY Growing Administrative Challenges for Health Insurers Ensure Compliance Optimize Reimbursement Reduce Internal Burden How Do You Drive Efficiency & Minimize Costs? DEDICATED EXPERTISE DATA-DRIVEN TOOLS INTELLIGENT WORKFLOWS RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 4

5 KEY PAIN POINT: ANNUAL NOTICE OF CHANGE AND EVIDENCE OF COVERAGE DOCUMENTS Medicare Advantage plans are familiar with the painful and time-consuming task of compiling, reviewing and distributing the required Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents for every customer on Medicare plans. As CMS releases its model documents each spring, health insurance organizations kick off a hectic season that severely strains internal resources. The painstaking process of reviewing model documents requires the smallest of edits to cycle back through every reviewer from product managers and communications departments to marketing and legal leading to endless revision cycles and an incredible drain on internal resources. This manual editing process is slow and tends to be highly error-prone. Reviewing multiple sometimes dozens of versions of EOC documents, each of which can exceed 200 pages, leaves considerable room for human error. Common edits fail to make it to every version, countless revision cycles lead to version confusion and the tight timelines exacerbate this complex process. The traditional ANOC and EOC process entails a great deal of work (at great cost), presents numerous opportunities for error and threatens a high cost for those errors. With the Medicare population growing, and with intensifying competition driving the need for streamlined bottom lines, today s health insurance organizations need a better solution. They need an approach that reduces review cycles, mitigates the risk of errors, minimizes the burden on staff and reduces the overall cost of the process PAGES X 20+ DOCUMENTS MANY ORGANIZATIONS MANUALLY REVIEW A DOZEN OR MORE EOC DOCUMENTS, WHICH CAN EXCEED 200 PAGES. The traditional process entails a great deal of work (at great cost), presents numerous opportunities for error and threatens a high cost for those errors. RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 5

6 TRADITIONAL ANOC/EOC PRODUCTION PROCESS The traditional process creates burdens, costs and challenges at every step, leaving substantial room for improvements. Slow Model Document Creation Starting Over Every Year Slow review process tightens timelines Excessive review cycles drain resources, increase costs Manual editing increases errors, adds additional costs Painstaking, Linear Document Review Error-Prone Manual Editing TRADITIONAL DOCUMENT MANAGEMENT SOLUTIONS FALL SHORT The most common solution to the ANOC and EOC challenge is outsourcing all or part of the process to a third party. However, this still requires an extensive and resource-draining review of each and every model document at the outset, as well as review of draft documents prior to production to ensure they meet requirements. This tedious review process starts fresh every year. Engaging consultants to help with the front end of this outsourcing process can simplify things to a degree. However, working with consultants yields a different problem: although these experts may have thorough knowledge of CMS regulations, they typically lack familiarity with the complexities of an insurer s many plans. This still leaves internal staff burdened with extensive involvement in the document creation process. Once again, this burden is often annual, as consulting firms typically send a new group of experts each year effectively erasing any advantages gained from the previous year s set-up. RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 6

7 Some basic automation tools use model document structures and variable data inputs to simplify the editing process and reduce the risk of errors. But again, these solutions drain internal resources on the front end. Internal staff must walk through every model document, indicating preferences and starting from scratch every year. None of these existing solutions effectively accomplishes the ultimate goals of reducing review cycles, mitigating errors and removing burdensome workflows from internal staff. AN EMERGING SOLUTION: INTELLIGENT DYNAMIC PUBLISHING A ground-breaking solution is emerging that effectively accomplishes the highly valued goal of reducing review cycles while mitigating the risk of errors. This comprehensive solution, Merrill Connect Dynamic Publishing Platform, leverages forward-thinking technology to enable health insurance organizations to work smarter, not harder. Merrill s intelligent system automates model document creation, streamlines editing and review, and drives significant savings by dramatically reducing internal staffing costs for the annual ANOC and EOC creation process. Dynamic publishing automates model document creation, streamlines review and enables simultaneous editing, and drives cost-savings through dramatic reduction in staffing costs. KEY ELEMENTS OF AN INTELLIGENT DYNAMIC PUBLISHING SOLUTION True partnership with consultative experts To go beyond the shortcomings of existing consultative approaches, Merrill s in-house health insurance experts establish a true, ongoing partnership with our clients. These dedicated consultants work to understand an insurer s plan complexities and preferences, complementing their CMS expertise with client-specific, in-depth knowledge. Rule-based logic for intelligent model document creation Advanced, rule-based logic tools empower consultants to transfer deep CMS expertise and client-specific, in-depth knowledge to an intelligent system that knows an insurer s unique plans and preferences. The system draws on a library of CMS model document structures and stored client data values, incorporating year-over-year changes and enabling quick adaptation to annual CMS changes with minimal client involvement. RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 7

8 Forward-thinking dynamic publishing technology Building on the foundation of a consultative partnership and the simplified model document creation process, forward-thinking dynamic publishing technology combines CMS model language with web-based plan data management to generate real-time ANOC and EOC documents with accuracy and speed. This technology aggregates all data from Plan Benefit Package (PBP), bid submissions, benefit grids, Summary of Benefits documents and other key resources, and uses this data to drive the creation of each personalized document, populating changes accurately in the correct location. The system stores and utilizes all data fields to easily manage changes year after year. AN INTELLIGENT DOCUMENT CREATION PROCESS The Merrill Dynamic Publishing Solution drives efficiency and accuracy at every step of the ANOC and EOC process. Automated Model Document Creation Automated Management of Year-Over-Year Changes Model documents generated faster, with minimal internal staff involvement Fewer review cycles, faster review process resulting in lower staffing costs Data-driven document personalization mitigates errors and associated costs Plan data management yields year-over-year efficiency gains Streamlined, Non-Linear Review Cycle Data-Driven Document Personalization RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 8

9 CASE STUDY Dynamic Publishing A large health insurance organization recently deployed the Merrill Connect Dynamic Publishing solution to manage its ANOC and EOC processes. The organization reports several definitive first-year impacts, including: Model document templates available for review a full month earlier Fewer overall staff involved in document review process Internal review cycles cut in half Document errors effectively eliminated Cost savings over $1 million due to streamlined review and reduced internal staff involvement POWERFUL BUSINESS IMPACTS OF INTELLIGENT DYNAMIC PUBLISHING Model document creation: Internal burden minimized, excessive templates eliminated, first proofs delivered faster A true consultative partnership bridges the gap between specialized CMS and client-specific knowledge. Internal staff no longer have the burden of deciphering subtle annual CMS changes. Just as important, they also no longer spend significant time coaching consultants on the complexities of their plans and preferences. Consultants do the heavy lifting of getting to know a client s plans. Then, with just a few simple questions to internal staff, consultants leverage rule-based logic to create an intelligent system that intuitively maps client plan data onto CMS model documents. Web-based plan data management incorporates year-over-year changes using stored data values. This reduces the total number of templates and delivers first proofs for internal review faster as much as a month earlier easing the time crunch of this hectic season. RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 9

10 Dramatic internal time savings from simplified, non-linear review cycle Our solution enables a non-linear review cycle that significantly speeds the proofing process. Multiple parties can review model documents simultaneously, with edits and comments centrally tracked. A single project manager can aggregate edits for the next round of reviews. Clear reporting of year-over-year changes makes individual review quick and easy, eliminating the need to painstakingly review every word of a largely static document. This simplified, non-linear review can drive significant internal time savings that grow exponentially based on the number of reviewing parties within a health insurance organization. Dynamic publishing empowers a health insurance organization to truly achieve more, in less time, at a lower cost. Ensured document accuracy mitigates costly errors A simplified, centrally managed review process also mitigates the risk of missed edits and version confusion, ensuring accurate creation of model documents. Data-driven dynamic publishing creates each individual plan document with exceptional accuracy, instantly mapping individual plan data into the approved ANOC and EOC model document templates. This eliminates the risk of document errors and their related costs. Drives measurable savings across the organization ROI that grows year-over-year The advantages of dynamic publishing described above deliver significant, measurable time and cost savings throughout the ANOC and EOC creation process. Early adopters of dynamic publishing report savings of more than $1 million in the first year alone, thanks to a shortened review cycle that dramatically reduces internal staffing costs. This innovative solution does not merely divide the workload among already overburdened staff members it leverages forward-thinking technology to replace human-driven workflows with intelligent, data-driven processes. The end result is significant cost savings over traditional approaches. This creates a lasting foundation for ROI that grows yearover-year. Rule-based logic of the intelligent system continually streamlines model document creation and review following year-one consultative set-up. First proofs come sooner. Reviews go faster. Savings increase. $1M+ INITIAL ANNUAL COST SAVINGS REPORTED BY MERRILL CONNECT DYNAMIC PUBLISHING CUSTOMER First proofs come sooner. Reviews go faster. Savings increase. RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 10

11 The impact of these operational efficiencies ripples across an organization. With the typically painful ANOC and EOC process reliably simplified, internal resources can be redeployed. In essence, the solution empowers a health insurance organization to truly achieve more, in less time, at a lower cost. DYNAMIC PUBLISHING: A COMPETITIVE ADVANTAGE TODAY AN ESSENTIAL TOOL TOMORROW Medicare Advantage plans experience the annual pain of ANOC and EOC document publishing. This challenge will only grow more significant and more costly as the overall Medicare population swells dramatically in the coming decades. Leveraging an advanced, dynamic publishing platform can immediately ease this burden, with impacts that will continue to grow year-overyear. Health plans can significantly reduce the internal burden and cost of this process, transforming human-driven workflows into intelligent, data-driven processes, enabling streamlined, non-linear review cycles, and mitigating the risk of costly errors and delivery issues. This forward-thinking technology provides a competitive advantage today empowering a health insurance organization to redeploy staff and funds toward other critical growth initiatives and is an essential tool for driving growth and ensuring prosperity in an increasingly competitive landscape. Health plans can reduce the internal burden and cost, transforming human-driven workflows into intelligent, data-driven processes. RELIEVING THE PAIN OF ANOC & EOC MERRILLCORP.COM 11

12 ABOUT MERRILL CORPORATION Merrill Corporation provides technology-enabled platforms for content sharing, regulated communications and compliance services. Merrill clients trust our innovative cloud-based applications and deep subject expertise to successfully navigate the secure sharing of their most sensitive content, perfect and distribute critical financial and regulatory disclosures, and create customized communications across stakeholders. With more than 3,000 people in 34 locations worldwide, Merrill clients turn to us when their need to manage complex content intersects with the need to collaborate securely around the globe. Merrill Corporation secures solutions at every phase, so you can secure ongoing impact and growth. To discuss how Merrill Corporation can help you manage and share content securely online, please contact us. phone web merrillcorp.com Merrill Communications LLC. All rights reserved. MC0165_2