{"id":1684,"date":"2010-05-01T12:55:00","date_gmt":"2010-05-01T12:55:00","guid":{"rendered":"http:\/\/localhost\/projects\/horsesforsources\/healthcare-payors-outsourcing_043010\/"},"modified":"2010-05-01T12:55:00","modified_gmt":"2010-05-01T12:55:00","slug":"healthcare-payors-outsourcing_043010","status":"publish","type":"post","link":"https:\/\/www.horsesforsources.com\/healthcare-payors-outsourcing_043010\/","title":{"rendered":"As Healthcare payors face up to seismic change, can outsourcing provide answers?"},"content":{"rendered":"<div id=\"attachment_3464\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-3464\" title=\"Hippocrates\" src=\"http:\/\/www.horsesforsources.com\/wp-content\/uploads\/2010\/05\/GalenHippocratesAvicenna.jpg\" alt=\"\" width=\"297\" height=\"220\" \/><\/p>\n<p class=\"wp-caption-text\">I swear by Apollo to meet all service levels&#8230;<\/p>\n<\/div>\n<p><em>At HfS Research (sorry, we have to start using that acronym &#8211; if I have to keep spelling out &#8220;Horses for Sources&#8221; every five minutes&#8230;), we&#8217;re focusing our microscope\u00a0on the healthcare industry with our new research agenda (<\/em><a href=\"mailto:research@horsesforsources.com\" target=\"_blank\" rel=\"noopener\"><em>drop us a note<\/em><\/a><em> if you&#8217;d like more details on our research coverage).\u00a0 Our resident healthcare analyst, <\/em><a href=\"http:\/\/www.horsesforsources.com\/meet-the-team#anthony\" target=\"_blank\" rel=\"noopener\"><em>Anthony Calabrese<\/em><\/a><em>, has a pretty decent point of view here&#8230;<\/em>\u00a0<\/p>\n<p><span style=\"font-size: large;\"><strong><span style=\"color: #ff6600;\">Healthcare Payors Reshuffle Their Priorities<\/span><\/strong><\/span><\/p>\n<p>Unlike medical product manufacturers and pharmaceutical companies\u2019 industries, healthcare reform will absolutely transform the healthcare payor industry.\u00a0 Mandated medical loss ratios, state-run insurance exchanges, guaranteed coverage, and required purchase requirements will <em>restructure <\/em>the payor\u2019s business models.\u00a0 The trickle-down impact on operations will be significant, shifting priorities in a manner that will eventually impact outsourcing priorities.\u00a0\u00a0<\/p>\n<p><span style=\"font-size: medium;\"><span style=\"color: #ff6600;\"><strong>Healthcare Reform \u2013 The Big Changes<\/strong><\/span><\/span>\u00a0<\/p>\n<p>Few people understand the healthcare reform laws signed by President Obama.\u00a0 While the laws are lengthy, the list of major changes is not:\u00a0<\/p>\n<ul>\n<li><em>Consumers must purchase insurance and companies with more than 50 employees must provide insurance.\u00a0 Those who fail to do so will be subject to fairly substantial fines.<strong>\u00a0<\/strong><\/em><\/li>\n<li><em>Insurance companies cannot deny coverage or price individual policies based on prior medical conditions.<strong>\u00a0<\/strong><\/em><\/li>\n<li><em>State-run exchanges will be created to directly offer individual policies.<strong>\u00a0<\/strong><\/em><\/li>\n<li><em>Federal electronic enrollment protocol standards will be developed to allow consumers to enroll, view, and manage their enrollment in insurance.<strong>\u00a0<\/strong><\/em><\/li>\n<\/ul>\n<p>Healthcare companies have mandated medical loss ratios (MLRs) of 85% for large groups of more than 100 and 80% for small groups and individuals.\u00a0 If payors manage to generate lower MLRs, they must refund the difference to enrollees.\u00a0<\/p>\n<p><span style=\"font-size: medium;\"><strong><span style=\"color: #ff6600;\">What does this mean to the heathcare payor industry?<\/span><\/strong><\/span>\u00a0\u00a0<\/p>\n<p><strong>The changes are substantial:<\/strong>\u00a0<\/p>\n<p><strong>First:<\/strong> payors can expect to compete for over 30 million new enrollees that are required to purchase insurance.\u00a0 While some of this business will be generated by small groups who previously did not provide insurance to employees, the bulk of the 30 million new enrollees will come through individual insurance.\u00a0 As witnessed by the payors go-to-market implementation of Medicare Part D, the enormous spike of sales and new customers requires significant planning and operational bandwidth.\u00a0 This impact sales and customer service activities, requiring substantial investment in customer service teams, technology readiness, and enrollment processes.\u00a0<\/p>\n<p><strong>Second:<\/strong> transactional workflow associated with individual enrollment will need to be completely reengineered.\u00a0 Prior to reform, transactions flowed through underwriting groups who priced each individual plan.\u00a0 With the advent of state-run exchanges, insurance plans will be codified in just four basic formulas (Platinum, Gold, Silver, and Bronze) and offered through online exchanges.\u00a0 There will no longer be a need for underwriting to review enrollments for pricing or previous medical conditions.\u00a0 Furthermore, the implementation of federal standards for electronic enrollment transactions will require investment in transaction gateways and internet portals.\u00a0<\/p>\n<p><strong><!-- pagebreak -->Third:<\/strong> state exchanges will likely greatly reduce the role of the middle men \u2013 the insurance brokers.\u00a0 Individual will be able to browse available rates and compare products online \u2013 and then purchase plans directly from payors.\u00a0 Without the ability to incentivize brokers on the profitability of different enrollees, broker compensation models will change dramatically.\u00a0 However, the need for payors to compete directly changes their consumer sales operations significantly.\u00a0 Expect more direct marketing investment, greater focus on churn management, and larger investments in direct and indirect sales operations.\u00a0<\/p>\n<p><strong>Fourth:<\/strong> the implementation of state-run exchanges will also incentivize payors to invest in competitive intelligence systems to track competitive activity, similar to the investment of the airline industry to track similarly complex airfare changes and offerings.\u00a0<\/p>\n<p><strong>Fifth:<\/strong> the implementation of compulsory MLRs will cause a seismic shift in the industry.\u00a0 While the standard calculation to be used by insurers has yet to be written, the current results are eye opening.\u00a0<\/p>\n<p><span style=\"font-size: medium;\"><strong><span style=\"color: #ff6600;\">The Outsourcing Buyers Should Brace for Strategic Changes<\/span><\/strong><\/span>\u00a0<\/p>\n<p>Outsourcing governance organizations will need to reassess existing relationships and the scope of potential opportunities.\u00a0 Here is some advice as to where they should begin:\u00a0<\/p>\n<p><strong>Prepare for Significant Change Orders and Terminations<\/strong> \u2013 One way or another, the law is going to impact existing operations.\u00a0 It will change how enrollment occurs, at a minimum.\u00a0 It may materially change the size of your programs, causing a need to change locations.\u00a0 Existing inbound customer service suppliers may be needed to provide inbound sales support duties.\u00a0 Margin pressures may create opportunities to renegotiate contracts.\u00a0 Regardless, use these changes to your strategic advantage \u2013 map the planned changes comprehensively and prepare you negotiation strategies in advance.\u00a0<\/p>\n<p><strong>Review Existing Contracts for \u201cChange of Law\u201d Clauses<\/strong> \u2013 Depending on how your contract is written, changes caused by health care reform laws could be the buyer or the vendor\u2019s burden or could create unplanned termination options for either party.\u00a0 Ensure you understand the your contract\u2019s specific handling of changes in law.\u00a0<\/p>\n<p><strong>Brace for January 1, 2014\u2019s High Volumes and Low Predictability<\/strong> \u2013 New market entry of 30 million new members plus the high likelihood that all existing individual policyholders will change policies will create the need to support sales, enrollment, and backoffice transaction processing operations.\u00a0 How much marketshare your company will win is uncertain \u2013 witness the Medicare Part D free-for-all that was accompanied by substantial marketing efforts.\u00a0 Vendor governance teams will need to develop plans to handle the uncertain volumes, recognizing execution failures could lead to acquisition shortfalls and member churn.\u00a0 Whatever happens, the bracing will begin long before 2014 as operations must be mobilized and ready in advance.\u00a0<\/p>\n<p><strong>Get Comfortable with Federal and State Outsourcing Compliance Processes<\/strong> \u2013 CMS leverages offshore subcontacting attestations filed by all payors with a subcontractor (or a subcontractor\u2019s subcontractor, etc.) operating outside of the 50 states or US territories.\u00a0 You need to seek guidance from Federal and State regulators as to how they will review offshore outsourcing, especially given the difficult economic climate and the negative public attention politicians could attract.\u00a0 Develop a comprehensive public affairs strategy and leverage your current public affairs and state regulatory relations infrastructures.\u00a0<\/p>\n<p><strong>Reassess Outsourcing Opportunities<\/strong> \u2013 Payors have been largely shielded from economic drivers of outsourcing resulting in limited outsourcing of core operations and shared services.\u00a0 Furthermore, the complexity of payors\u2019 claims processing systems means that few companies have entered into comprehensive, transformational application development and maintenance contracts.\u00a0 Given fixed MLRs and what is expected to be a highly competitive marketplace, payors should comprehensively reassess outsourcing opportunities in operations, shared services, and IT.\u00a0 Manage transitions in advance of 2014 to ensure success \u2013 you have about three years from today to assess, select vendors, negotiate contracts, transition, and stabilize operations.\u00a0 That isn\u2019t much time, especially in critical medical management outsourcing to disease management vendors and direct sales support operations.\u00a0<\/p>\n<p><strong>Understand Your Service Providers\u2019s <\/strong><strong>Industry Intelligence<\/strong> \u2013 Across the industry, vendors are salivating at the perceived impact healthcare reform will cause on outsourcing deals.\u00a0 New\u00a0service providers in the industry\u00a0will develop capabilities and existing\u00a0ones will need to improve the robustness of their operations.\u00a0 Develop strong relationships with your provider and seek to understand their strategies, their\u00a0process capabilites, their onshore\/offshore models,\u00a0in addition to\u00a0what they are hearing from your competitors.\u00a0<\/p>\n<p><em>We&#8217;ll be delving deeper into the challenges and opportunities facing the healthcare payor sector in Anthony Calabrese&#8217;s forthcoming report, as part of our HfS Research program<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I swear by Apollo to meet all service levels&#8230; At HfS Research (sorry, we have to start using that acronym&#8230;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[48,64,81,832],"tags":[384],"ppma_author":[19],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>As Healthcare payors face up to seismic change, can outsourcing provide answers? - Horses for Sources | No Boundaries<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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