This new solution from Predict Health and Rex Wallace Consulting helps Medicare Advantage plans better engage Dual-Special Needs Plan (D-SNP) members, meet the new Centers for Medicare & Medicaid Services (CMS) requirements and improve their market competitiveness.
Predict Health, an innovative leader in building and maintaining Medicare member communities, in partnership with Rex Wallace Consulting, LLC (RWC), announced a new offering to help D-SNPs sustain a high-quality Enrollee Advisory Committee process for Medicare Advantage members.
Leading health plans are implementing streamlined processes to meet new CMS requirements to include enrollees in plan governance while improving plan performance. The requirement will become effective January 1, 2023. CMS estimates plans will spend $1 million on average to launch, manage and comply.
“Payers are committed to advancing care outcomes for their Medicare Advantage members consistent with CMS’ requirements,” said Predict Health CEO Shub Debgupta. “We have joined with leading carriers to deliver a proven approach to launch Enrollee Advisory Committees and drive plan performance. Our partnerships leverage a proven ability to identify, engage and reach varied Medicare members across any state, including hard-to-reach populations.”
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An appropriate process is expected to include –
- Program strategy and scope
- Representative participant identification
- Participant recruiting and engagement
- Meeting and member materials preparation
- Virtual meeting and event execution
- In-person meeting and event execution
- Data collection and documentation
- Meeting agenda and strategy
- Meeting attendance management
- Analysis and insight
- Sustaining and improving events
- Improvement plans
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“We are working with D-SNPs using a proven methodology to ensure the successful planning and implementation of the Enrollee Advisory Committees to meet plan goals,” said RWC founder Rex Wallace. “Meeting CMS mandates will be a heavy lift that will further distinguish leading health plans. Predict Health is an innovative leader in building and maintaining Medicare member communities using a data-driven approach to recruit, engage, and improve member experience and retention. Together, we are answering the demand for a program built on a consistent record of translating member insights into actionable plan insights.”
Enrollee Advisory Committee participants assist in reviewing health plan processes, programs, and plan design so plan leaders can continue to improve the member experience. Both members and caregivers are recruited to be part of this program.
“We are proud to work with RWC as leading experts in driving Stars, plan governance and member experience improvements at Medicare Advantage and dual plans,” said Jeffrey Sopko of Predict Health. “We are bringing expertise achieving significant improvements in Star Ratings, member experience, and member retention.”
Rex Wallace Consulting, LLC works with health plans to create cultures of quality. Results are achieved through member, provider, employee engagement and operational excellence. Founder Rex Wallace brings deep expertise advancing Medicare Advantage plan performance, resulting in improved outcomes, experiences, and quality of life for members. Wallace is a senior advisor to McKinsey & Company and former Vice President, Integrated Member Experience at Cambia Health Solutions. Previous to this he served in leadership roles with Universal American, CIGNA, Marsh, Aon, and Wal-Mart’s health benefits program.
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