×

Month: April 2024

Strategic Accelerations: Critical Business Initiatives for U.S. Healthcare Payers Part 2

In Part One of this series, we examined the initiatives Gartner identified as key areas for acceleration,1 following their extensive evaluation through research surveys and interactions with U.S. healthcare payer business and technology executives.

Building on the foundation of data-driven initiatives explored in Part 1, Part 2 of this series shifts the focus to practical applications and strategic initiatives. We’ll delve into specific areas where payers and TPAs can leverage these insights to accelerate their progress. This includes improving operational efficiencies, enhancing care delivery models, and gaining a competitive edge in the market.

Streamlining Payment Integrity Processes

Payers are increasingly recognizing the need to streamline their payment integrity processes as a strategy to reduce the operational costs stemming from overpayments and complex administrative procedures. More importantly, optimizing these processes directly enhances provider satisfaction and improves the overall member experience. While the focus has traditionally been on medical cost containment, it’s crucial to acknowledge the direct impact that payment inaccuracies have on members’ out-of-pocket expenses. Most claim denials, which significantly affect member satisfaction, are preventable, and a large portion of these can be successfully appealed.

To mitigate preventable claim denials, payers should focus on enhancing and automating the data collection, validation, and reconciliation processes. Moreover, educating both members and providers about the conditions necessary for payment can play a pivotal role in reducing errors. This approach not only supports fair payment practices but also builds trust and transparency with healthcare providers and members.

Additionally, payers bear the responsibility of reducing fraudulent claim activity without inadvertently creating payment hassles for providers. Experts at Gartner have recommended collaborating closely with payment integrity vendors or internal special investigative units (SIU) to achieve this balance.2 By exposing detailed claim submission requirements through provider portals or other communication platforms, payers can help ensure that providers submit complete and accurate claims, thereby reducing the likelihood of denials due to missing or incorrect information. Such proactive measures are essential for maintaining the integrity of payment processes and fostering a positive ecosystem for all stakeholders involved.

Modernizing Technology

In the rapidly evolving healthcare landscape, the modernization of technology infrastructure emerges as a critical priority for payers. As Gartner highlights, in 2024, U.S. healthcare payers are focusing their investments on upgrading core systems, enhancing interoperability technologies, and improving consumer experience capabilities. These strategic areas of investment are essential for payers to maintain competitive advantages, optimize costs, and improve overall member experiences.

To ensure these investments are aligned with industry standards, CIOs are encouraged to benchmark their technology spending against findings from the 2024 Gartner CIO and Technology Executive Survey:

  • Core Administrative Processing Systems – The modernization of CAPS is a critical investment for 59% of healthcare payers, according to the Gartner survey. The drive towards upgrading these foundational systems stems from the need to replace or augment legacy systems that no longer suffice to meet the complex demands of today’s healthcare landscape.
  • Interoperability Technologies – Interoperability is a key strategic focus for 59% of healthcare payer CIOs in the Gartner survey, highlighting the sector’s recognition of its importance in the current healthcare ecosystem. With new mandates for interoperability on the horizon, the ability to seamlessly share clinical data across the healthcare continuum becomes paramount.
  • Consumer Experience Capabilities – The push towards improving consumer experience capabilities is evident, with 53% of payers focusing on this area, according to the Gartner survey. In an age where consumer expectations are shaped by experiences outside the healthcare industry, payers are challenged to provide a level of service that mirrors the convenience and personalization consumers encounter daily.

By prioritizing these technological upgrades, U.S. healthcare payers can address the dual challenges of meeting ever-growing regulatory requirements and rising consumer expectations. Such modernization not only supports efficient administrative processing but also positions payers to lead in delivering innovative solutions that enhance member satisfaction and retention.

Expanding Self-Funded Business

The self-funded business market is experiencing a notable shift as not only large and national employer groups but increasingly smaller employer groups are turning to self-funding to curb healthcare costs. This trend is accelerating growth in the market and presents significant opportunities for payers to expand their administrative services-only (ASO) offerings. However, this expansion also introduces risks, as self-funded ASO employers may choose to bypass traditional payer arrangements, opting instead to contract directly with other service providers within the healthcare ecosystem to manage their employees’ healthcare needs more economically.

To capitalize on this evolving market dynamic, payers must focus on enhancing their service offerings to meet the unique demands of these smaller employer groups. Investing in core administrative technologies is critical. These technologies should support quick data exchanges and offer flexible configurations for benefits, products, provider networks, and reimbursements. Such capabilities will not only meet the diverse needs of self-funded groups but also help in maintaining competitiveness in a rapidly changing market.

Moreover, to create lasting client relationships with self-funded ASO groups, payers need to deliver a superior digital consumer experience. This involves more than just processing claims and coordinating care; it requires providing high-value-added solutions such as cross-carrier analytics that can offer deeper insights into healthcare management and efficiencies. By aligning their services with the complex needs of self-funded employers, payers can position themselves as indispensable partners in the self-funded healthcare landscape.

Enhancing Home Health Capabilities

The trend towards home-based care is accelerating, fueled by a growing prevalence of chronic diseases and the ongoing challenges of managing healthcare costs effectively. As patients increasingly prefer the comfort and convenience of receiving care at home, payers are finding it essential to expand and enhance their home health capabilities to meet these evolving demands.

This shift is not only about accommodating patient preferences but also about tapping into the cost-efficiency that home care can offer. By providing support for home-based care, payers can help reduce the frequency of expensive hospital visits and enable more proactive management of chronic conditions. This approach involves integrating advanced technologies such as telehealth systems, remote patient monitoring, and mobile health applications that allow for effective treatment and management outside traditional healthcare facilities.

Driving Future-Ready Healthcare Solutions

HealthAxis is committed to driving excellence in healthcare through innovative and integrated solutions. With nearly 60 years of experience in the healthcare industry, we understand that every payer faces unique challenges. We offer a tiered suite of solutions designed to meet your specific needs, whether you’re a large, established payer or a smaller organization looking to expand your reach.

Our solutions can empower you to:

  • Implement robust data and analytics governance frameworks.
  • Increase data transparency and meet regulatory requirements.
  • Modernize your technology infrastructure and unlock new possibilities.
  • Leverage FHIR APIs for seamless data exchange.
  • Expand your home health capabilities and deliver cost-effective care.
  • Streamline payment integrity processes and improve efficiency.
  • Capture the growing self-funded business market.

Learn more about how HealthAxis can tailor a solution to fit your needs and help you navigate the ever-changing healthcare landscape.

 

Sources:
1. Business Outlook for Critical U.S. Healthcare Payer Initiatives, Gartner
2. Quick Answer: Rethink Your Denial Strategy to Increase Provider Satisfaction, Gartner

Strategic Accelerations: Critical Business Initiatives for U.S. Healthcare Payers Part 1

U.S. healthcare payers and third-party administrators (TPAs) face a complex array of business and technology initiatives driven by evolving market conditions and increasing consumer demands. Successfully navigating this dynamic landscape requires a clear understanding of how to manage these challenges effectively.

To assist in this endeavor, Gartner conducted an extensive evaluation1, tapping into periodic research surveys and detailed interactions with U.S. payer business and technology executives. Gartner’s team of payer industry experts assessed each initiative, providing a rating to guide investment decisions:

  • Explore: Continue to allocate resources to assess the potential and use cases of the initiative.
  • Accelerate: Increase resources for initiatives showing favorable conditions.
  • Maintain: Keep current resource levels and plan for an increase when conditions improve.
  • Harvest: Optimize the initiative for minimal resource use and maximum profitability.
  • Divest: Discontinue initiatives that are no longer viable.
  • Reposition: Allocate resources differently to refocus strategy and maximize benefits.

This two-part blog series focuses on initiatives that Gartner recommends for acceleration. By prioritizing investment in these areas, healthcare payers and TPAs can achieve substantial benefits in today’s market.

Investing in Data Transparency

As consumer demands for upfront pricing information increase, along with strict regulatory mandates such as the Consumer Price Transparency final rules and the No Surprises Act, it’s crucial for payers and TPAs to prioritize investments in data transparency. These initiatives are essential not only for compliance but also for enhancing customer experiences and meeting price transparency requirements. U.S. healthcare organizations must leverage this research to strategically position their organizations in a rapidly changing market.

Currently, many payers and providers struggle to provide accurate cost estimates through their digital health navigation tools. This shortfall can lead to consumer dissatisfaction, care abandonment, and increased call volumes for customer service teams fielding coverage and cost inquiries. The Transparency in Coverage final rule and the Hospital Price Transparency final rule mandate clear, accessible cost information, presenting challenges that require strategic collaboration and the tactical implementation of advanced technologies.

By investing in robust digital tools that improve transparency, payers, and TPAs not only adhere to regulatory demands but also enhance consumer trust and operational efficiency. This strategic focus is integral to transforming the healthcare experience, making transparency a cornerstone of modern healthcare economics and consumer interaction.

Accelerating Data and Analytics Governance

The imperative for robust data and analytics governance in healthcare is growing as ecosystems become more interconnected and the volume of data surges. Enhanced governance is crucial not only for improving data quality and sharing capabilities but also for addressing persistent issues related to technology integration, data ownership, privacy, security, and IT resource constraints. By establishing a comprehensive data and analytics governance framework, payers can ensure their data infrastructure is primed for advanced AI applications and support a more decentralized analytics approach.

Per Gartner’s 2023 Hype Cycle for Data and Analytics Governance, experts in data and analytics governance are advised to focus on technologies and methodologies that are likely to reach the “Plateau of Productivity” within the next two to five years.2 This includes investing in cross-enterprise Master Data Management (MDM), advanced data cataloging, metadata management solutions, and stringent data quality protocols. These elements are pivotal for enhancing the accuracy, accessibility, and security of data across healthcare organizations.

Furthermore, payers should consider exploring less mature yet promising innovations such as adaptive Data and Analytics (D&A) governance and D&A governance platforms. Although these areas may require a longer time horizon to mature fully, they hold significant potential for providing a competitive edge. Actively evaluating and integrating these emerging innovations can help healthcare payers not only meet current regulatory and operational demands but also position them favorably within an increasingly data-driven industry.

FHIR APIs: The Future of Data Exchange

U.S. healthcare payer CIOs are emphasizing investments in interoperability use cases to align with top enterprise priorities. These initiatives are not only about meeting regulatory requirements but also enhancing the quality of healthcare through improved data exchange mechanisms. FHIR (Fast Healthcare Interoperability Resources) APIs are at the forefront of these efforts, providing a standardized method for robust data exchange across the healthcare sector. The adoption of these APIs is crucial for achieving interoperability goals and enhancing Health Information Exchanges (HIEs) as the main source of clinical data.

The HL7 community continues to develop evolving standards that meet the growing needs of the healthcare ecosystem, significantly boosting the value proposition of HIEs. Regulatory and market forces are also reinforcing the importance of robust data frameworks, making FHIR APIs an essential component of modern healthcare infrastructure. Early adopters of FHIR APIs are finding themselves well-positioned to scale these initiatives, leveraging their early experiences to guide expansion and optimization.3

As the healthcare landscape continues to evolve, the strategic focus on FHIR APIs will play a critical role in optimizing healthcare delivery. This focus on advanced data exchange frameworks not only supports current operational needs but also sets the stage for future innovations in healthcare technology. Early investments in these areas are proving to be strategic, enabling organizations to lead in a data-driven healthcare market.

Stay tuned for Part 2 of this series, where we will delve into three additional initiatives critical for U.S. healthcare payer and TPA success:

  • Streamlining Payment Integrity Processes
  • Modernizing Technology
  • Expanding Self-Funded Business
  • Enhancing Home Health Capabilities

Empowering Data-Driven Success

Leveraging data for success in healthcare requires a trusted partner with a deep understanding of the industry. HealthAxis brings nearly 60 years of experience to the table, helping you navigate the complexities of data governance, advanced analytics, and FHIR interoperability.

Our comprehensive suite of integrated business solutions unlocks the full potential of your data, empowering you to gain a competitive edge in the healthcare market.

Learn more about how HealthAxis can help you navigate the data landscape and achieve your strategic goals.

Sources:
1. Business Outlook for Critical U.S. Healthcare Payer Initiatives, Gartner
2. Hype Cycle for Data and Analytics Governance, 2023, Gartner
3. HL7 FHIR = Health Level Seven Fast Healthcare Interoperability Resources

HealthAxis CEO Scott Martin to Speak at the 2024 McGuireWoods Healthcare Private Equity and Finance Conference

We are pleased to announce that our CEO, Scott Martin, will be speaking at the 2024 McGuireWoods Healthcare Private Equity & Finance Conference taking place May 8-9 in Chicago, IL. Scott will be a panelist on the session titled “Investing in Healthcare IT/Payor Services for a Digital Future” on Thursday, May 9th.

Celebrating 20 years, the McGuireWoods Healthcare Private Equity & Finance Conference remains a premier event that convenes healthcare industry leaders to explore innovative strategies for growth and success. Scott’s participation on the panel reflects HealthAxis’s commitment to innovation and shaping the future of healthcare through technology and data-driven solutions.

Learn more about the conference, view the event schedule, and register here.

National Minority Health Month: Be the Source for Better Health

April marks an important observance in the healthcare calendar: National Minority Health Month. This month is dedicated to raising awareness about the ongoing health disparities that affect racial and ethnic minorities and American Indian/Alaska Native communities. Health disparities—variances in health outcomes across different groups—are influenced by social determinants of health such as access to healthcare, economic stability, education, neighborhood and physical environment, as well as social and community context.

The U.S. Department of Health and Human Services (HHS) Office of Minority Health sets an annual theme to guide the observance. This year’s theme, “Be the Source for Better Health: Improving Health Outcomes Through Our Cultures, Communities, and Connections,” highlights the importance of community and cultural engagement in addressing these disparities.

We encourage you to learn more about how addressing social determinants can help eliminate health disparities. Visit the U.S. Department of Health and Human Services’ National Minority Health Month page for valuable resources and ways to engage in your community.

At HealthAxis, we are deeply committed to supporting health equity through our streamlined healthcare solutions. By enhancing operational efficiency for health plans, we contribute to better access and quality of care for minority populations. Our proprietary CAPS technology and modern services facilitate improved data management and member services, allowing healthcare providers to tailor their approaches to effectively meet the specific needs of diverse communities. By optimizing healthcare processes, we help ensure that all members have equal opportunities to achieve their best health outcomes.

Together, we can be the source for better health, creating more equitable health outcomes for all. Learn more about how HealthAxis is driving changes in healthcare delivery.

Building Trust in Healthcare Payer Data: 3 Keys to a Reliable Data Quality Strategy

In the age of big data, healthcare payers and third-party administrators (TPAs) are overwhelmed by vast amounts of information, underscoring the importance of data quality. A robust data quality strategy is essential, as it guarantees the accuracy and relevance of the collected data, thereby informing decision-making and strategic planning processes. This approach not only enhances operational efficiency but also supports the delivery of high-quality member care.

This blog post delves into the three fundamental components of a reliable data quality framework:

  1. Data Governance
  2. Data Terminology
  3. Data Profiling

1. Data Governance: The Foundation of Trustworthy Data

Data Governance is the cornerstone of any data quality strategy. Imagine data governance as the orchestra conductor, ensuring all data actors play in harmony. Three crucial roles form the backbone:

  • Data Stakeholders: Represent key business areas, driving the data governance plan and understanding data needs.
  • Data Stewards: Ensure data adheres to policies and standards, acting as watchdogs for accuracy and completeness.
  • Data Governance Office: Collects metrics, reports on success, and provides education and support to stakeholders.

Data governance goes beyond theory. In healthcare, it safeguards protected health information (PHI) by clearly defining what constitutes PHI and setting policies to prevent unauthorized access.

An executive-level data governance board further solidifies this foundation, crafting accurate and actionable governance guidelines. In the healthcare domain, data governance plays a vital role in enhancing HIPAA protections by defining PHI and setting policies to safeguard it against unauthorized access.

2. Data Terminology: Ensuring Consistency Across the Board

The second pillar, data terminology, is essential for building trust and validity in data analytics. Consistent data terminology refers to the use of standardized, agreed-upon terms and definitions across an organization or industry, ensuring everyone interprets data in the same way. This uniformity is crucial for a clear understanding of health symptoms, diseases, medications, and procedures across disparate systems and providers.

Imagine the chaos of comparing apples to oranges – that’s what inconsistent data terminology does. Standardized terms are crucial for:

  • Building trust and validity: Consistent terms ensure everyone accesses and analyzes data similarly, avoiding misleading comparisons.
  • Sharing data across systems: Without standardization, sharing data for research or development becomes challenging, hindering industry progress.

Government mandates and standards, such as HL7 and HIPAA, provide a foundation for establishing common health terminology guided by the data governance body. This ensures that data comparisons and analyses are accurate, avoiding misleading or false conclusions.

3. Data Profiling: The Key to Understanding Data

The final and most critical aspect is data profiling, which involves examining and validating source data. This process is indispensable for identifying data quality issues and understanding the data’s structure, content, and relationships.

Think of data profiling as examining your data under a microscope. This process involves:

  • Collecting statistics and summaries: Analyzing the data source to understand its structure, formats, and content.
  • Identifying data anomalies: Uncovering errors, inconsistencies, and missing information that can compromise analysis.

Data profiling is vital because:

  • It shortens development cycles: By identifying data issues early, you avoid wasting time on flawed analysis.
  • It ensures trusted analysis: Clean, profiled data forms the foundation for reliable insights and confident decision-making.

Modern data profiling software, such as Oracle Enterprise Data Quality, Astera Centerprise, Informatica Data Quality, or Talend Data Quality, offers a more efficient and thorough analysis compared to manual methods, ensuring the project progresses with reliable data.

Empowering Actionable Insights

A robust data quality strategy integrating data governance, data terminology, and data profiling is the only way to overcome skepticism and ensure trust in your data. HealthAxis stands at the forefront of empowering healthcare payers and TPAs with such comprehensive data quality solutions.

Our consulting services are designed to navigate the complexities of data management, ensuring your data is not only abundant but, more importantly, accurate, consistent, and actionable. Learn how HealthAxis can transform your data into a strategic asset, paving the way for informed decision-making and enhanced healthcare delivery.

CMS Part C and Part D Program Audit Checklist: Be Prepared for Success

2026 CMS Interoperability and Prior Authorization: Key Strategies for Healthcare Payer Readiness

In January 2024, the Center for Medicare and Medicaid Services (CMS) issued the Interoperability and Prior Authorization Final Rule CMS-0057-F, heralding a transformative phase for U.S. healthcare payers effective January 1, 2026. This pivotal rule revises the landscape of prior authorization (PA) processes, especially for Medicare Advantage (MA), Medicaid, Children’s Health Insurance Program (CHIP), and Marketplace plans, signifying a major operational shift for healthcare payers.

At HealthAxis, we recognize the complexities this change introduces. This blog aims to summarize the 2026 requirements and provide healthcare payers with clear, actionable guidance to navigate these changes and achieve seamless compliance.

What You Need to Know for 2026

  • Accelerated PA Decisions: Under the new CMS-0057-F rule, healthcare payers are required to process standard PA decisions within seven days, and expedited PAs within 72 hours. This change aims to streamline patient access to necessary medical care, reflecting a commitment to improving operational efficiencies within the healthcare system.
  • Enhancing Transparency: The rule mandates increased transparency in PA decisions, requiring payers to provide clear and detailed explanations for any denials. This effort to improve clarity in communication is designed to facilitate better submission and approval rates, ultimately enhancing the provider-payer relationship and ensuring patients receive timely care.
  • Public Reporting and Accountability: Starting in 2026, payers will need to publicly report specific PA metrics, including approval rates and decision times, on their websites. This requirement aims to boost accountability and transparency in the PA process, helping to identify areas for improvement and increase overall system effectiveness.

Preparing for Change

Here are some recommended actions to ensure you’re ready for the upcoming changes:

  • Review PA Timelines: Collaborate with your legal team to confirm if CMS timelines apply to your specific plans and consider adopting them for all lines of business to streamline processes.
  • Update PA Technology and Tools: Evaluate your current PA technology and workflows to ensure they meet the new timeframes and reporting requirements.
  • Develop Denial Transparency Strategy: Define clear and concise denial reason codes using plain language that providers can understand. Consider utilizing generative AI (GenAI) for translation and distributing summaries through provider portals.
  • Aggregate and De-identify Data: Prepare data for public reporting, ensuring it’s aggregated and de-identified according to CMS guidelines.

While the 2026 deadline focuses on non-API requirements, the groundwork is being laid for future interoperability advancements. By 2027, payers will need to implement specific application programming interfaces (APIs) like HL7 and FHIR for a more streamlined electronic exchange of healthcare data.

Ensure Your Readiness with HealthAxis

Is your organization poised to excel in 2026 and beyond? HealthAxis is your accelerator, leveraging our suite of solutions, which include CAPS technology, BPaaS, BPO, staff augmentation, and consulting services, not just to meet but exceed these emerging benchmarks.

  • Accelerate Prior Authorization: Achieve 7-day and 72-hour PA deadlines using our CAPS Technology.
  • Enhance Transparency: Boost PA approval rates with actionable insights from our BPaaS and Consulting services.
  • Streamline Compliance: Simplify PA metric reporting through our BPO and Staff Augmentation solutions, ensuring utmost transparency and accountability.

Shape the future with HealthAxis! Learn more about how we can be your ally in enhancing efficiency, achieving compliance, and ensuring transparency in healthcare.

Achieving Member Retention Excellence: Strategies for Healthcare Payers

In today’s competitive healthcare landscape, member retention is paramount for all health plan types. Retaining existing members is significantly more cost-effective than acquiring new ones. However, achieving high retention rates requires a delicate balancing act between member satisfaction, operational efficiency, and cost control.

This blog delves into the key factors healthcare payers need to consider when prioritizing member satisfaction. We’ll explore how identifying operational gaps can illuminate areas for improvement, ultimately leading to a more engaged and loyal membership base.

The Member Experience Matters

Member satisfaction remains a fundamental element in the realm of member retention. While specific statistics may vary, the consensus across the healthcare industry is clear: the experience a member has with their health plan plays a significant role in their decision to continue their coverage. Ensuring a positive member experience across various touchpoints is essential for health plans aiming to retain their members.

Here are some key areas to consider:

  • Customer Service: Is access to customer service representatives smooth and efficient? Are inquiries handled promptly and professionally?
  • Care Management: Do members feel supported in navigating their healthcare needs? Is communication clear and concise regarding plan benefits and utilization?
  • Claims Processing: Is the claims processing experience transparent and efficient? Are members informed and supported in case of any issues?

Retention Rates: A Key Performance Indicator

Tracking member retention rates is essential to understand the success of your member engagement strategies. Here are some helpful steps:

  • Analyze Your Retention Trends: Track and evaluate your health plan’s member retention rates over time to pinpoint patterns and fluctuations. Investigate if there are specific times when turnover peaks, and assess the impact of various strategies and external factors on these trends. This analysis will help identify opportunities for enhancing member loyalty and reducing churn.
  • Compare with Industry Benchmarks: Evaluate your retention rates against industry benchmarks to gauge performance. For Medicare health plans, the average retention rate for Medicare Advantage enrollees hovers around 90%, as reported by Convoso.1 On the Medicaid front, Healthmine has found that the average disenrollment rate is about 18%, which indirectly suggests the retention rate.2 Additionally, a 2023 AHIP report indicates that commercial health plans typically achieve an average member retention rate of about 86%.3 These benchmarks offer valuable insights, enabling you to pinpoint areas for strategic enhancement in your retention efforts.
  • Gauge Competitor Performance: Analyze how your retention rates stack up against competitors. Distinguishing your performance from peers provides insight into competitive advantages or areas needing improvement, guiding targeted strategies for better retention outcomes. According to a 2023 report by AHIP, the average member retention rate for commercial health plans sits around 86%.

Identifying Operational Gaps: The Missing Puzzle Pieces

Operational efficiency plays a crucial role in member satisfaction. Gaps in your organization’s structure can lead to frustrating experiences for members and ultimately contribute to churn. Here’s how to identify these gaps:

  • Staffing and Resource Assessment: Evaluate current staff levels and expertise. Are there specific areas where additional support could improve member service delivery? Consider the impact of burnout.
  • Workflow Analysis: Examine internal workflows related to member interactions. Are there bottlenecks or delays hindering timely communication or service delivery?
  • Automation Analysis: Assess the current level of automation within your processes and identify opportunities where technology can enhance efficiency, reduce errors, and improve member experience.

By proactively identifying operational gaps, healthcare payers can implement strategic solutions to enhance member experience, such as targeted Staff Augmentation

Filling critical gaps with qualified professionals like member outreach coordinators or patient advocates can significantly improve member engagement and satisfaction. HealthAxis offers comprehensive staff augmentation services specifically tailored to the needs of all health plan types. Our team of experienced recruiters can identify and place highly skilled professionals to address your specific needs, ensuring a seamless integration into your existing workforce.

Additionally, HealthAxis provides consulting services focused on core system optimization and automation strategies. These services are designed to streamline your operations, enhance efficiency, and further improve the member experience by leveraging the latest technological advancements.

Investing in Retention: A Long-Term Strategy

Addressing operational gaps and prioritizing member satisfaction through strategic solutions like staff augmentation from HealthAxis can significantly improve member retention rates. This translates to long-term benefits for healthcare payers such as:

  • Reduced Acquisition Costs: Retaining existing members is significantly cheaper than acquiring new ones.
  • Increased Premium Revenue: Loyal members are more likely to maintain coverage and potentially even upgrade plans, leading to increased revenue streams.
  • Improved Brand Reputation: Positive member experiences translate into positive word-of-mouth marketing, attracting new members organically.

By focusing on operational optimization and prioritizing member experience, healthcare payers can achieve a sustainable competitive advantage.

Seamless Staffing Solutions: Empowering Member Loyalty

Creating a comprehensive member retention strategy demands both precision and adaptability. With HealthAxis, you gain a strategic ally adept at swiftly and effectively filling operational gaps, regardless of scale or scope. Our specialized staff augmentation services are designed to seamlessly integrate with your operations, providing the precise expertise needed to enhance your member experience and solidify your retention objectives

Let HealthAxis be your partner in building a loyal and thriving membership base. Learn more about how our staff augmentation solutions can empower your organization to deliver exceptional member service.

Maximizing Member Retention: A Checklist for Operational Success

 

Sources:
1. How to Boost Medicare Retention with the Right Strategies and Tools and Protect Your Growth Potential, Convoso
2. Why All Health Plans Should Prioritize Member Retention, Healthmine
3. New State-by-State Data: How Health Insurance Providers Contribute to Health and Financial Well-Being, AHIP

HealthAxis CEO Scott Martin Recognized as One of the Top 25 CEOs in Tampa for 2024

We are proud to announce that our CEO, Scott Martin, has been named one of the Top 25 CEOs in Tampa for 2024 by Key Executives. This esteemed accolade underscores Scott’s exceptional leadership and the significant influence he has exerted on HealthAxis.

Read more about this honor and see the full list of esteemed leaders here.