Thankfully, yesterday’s challenges can be learning opportunities that help us improve in the future. The following are four lessons learned leading up to the 2015 AEP that will help health plans better prepare for creating ANOCs and EOCs next year:

Lesson #1: A comprehensive timeline is key to success

One challenge some MA and PDP plans faced this year was the absence of a formalized timeline for developing and distributing materials. With little time to collect information and create documents after The Centers for Medicare & Medicaid Services (CMS) releases its ANOC and EOC model documents, developing a comprehensive timeline well in advance is key to staying on schedule and distributing materials on time.

It’s also important that this timeline be flexible, as delays from CMS may push back schedules and require that health plans hurry up and then wait, or worse, vice versa. Next year, make sure you have a timeline that has enough padding to adjust for delays.

Lesson #2: Key contributors should be identified early

When developing their ANOC and EOC documents for the 2015 AEP, many plans neglected to proactively identify the cross-functional team needed to ensure that materials were accurate, on schedule and in compliance. As a result, identifying and gaining the commitment of subject matter experts (SMEs) to review documents for accuracy and compliance came as a bit of a challenge.

When not all departments are adequately involved in this process, plans risk distributing materials containing mistakes or errors. To alleviate this problem, plans should identify key contributors and build a cross-functional team early on in the process. This should include SMEs from all relevant areas of the organization who can provide timely review of content and ensure accuracy of information.

Lesson #3: Clear leadership should be established

While establishing a cross-departmental team is an important part of success for the AEP document creation process, every team needs a leader. Health plans that did not have a dedicated individual responsible for guiding the materials creation process and all its players may have risked wasting both time and money, and increased their risk of non-compliance.

Additionally, if this individual did not have cross-departmental authority, precious time was wasted on gaining cooperation from individuals not within the project leader’s reporting structure.

Next year, prior to selecting a team or establishing a timeline, a leader within the organization should be appointed to manage the ANOC and EOC materials creation process from beginning to end. Ideally, this person will have limited work commitments aside from this project to ensure a dedicated focus. They must also have the authority to push the process forward, make decisions and obtain content and approvals from other team members.

Lesson #4: Software should be used to increase efficiency and compliance

During the 2015 AEP prep season, health plans that used a software tool to help manage the materials creation process had an easier time coordinating all the different moving parts involved. In addition, they likely reduced their risk of document errors, costly errata mailings, and late project completion – not to mention dramatically decreased the stress levels of project participants.

Tools are available that help health plans manage all aspects of development, tracking and distribution of these required materials, and many successful plans integrate these software solutions into their materials creation process. If they have not already, plans should start exploring tools that facilitate a comprehensive approach to marketing collateral needs.

A powerful tool will include modules that manage scheduling, compliance, document creation, as well as overall project management. And don’t forget, individuals on the materials creation team must be fully trained to use these tools. After all, what good is a solution that streamlines processes if those within the organization do not use it properly or to the full extent of its capabilities?

The good news is the 2015 ANOC and EOC mailing project is done – you’ve made it through. Now, let’s use the lessons learned and make next year even better.

by Al Valenti and Kelly Altmann

There are a number of ways health plans can cut unnecessary expenses, both before hiring a print and fulfillment vendor and during the course of the relationship. The key is knowing where to look.

This blog entry, Part 2 of 2, shares what you can do while you’re working with a print and fulfillment vendor:

Be strategic in how you handle the change order process.

Change orders can get very expensive, and unfortunately, they are going to happen. In Part 1, we covered tips on how to mitigate some potential errors, such as getting your materials in the best possible order before they go to the printer. But unexpected things are going to happen – you must plan and prepare for change orders.

Most importantly, always budget for change orders. Pull print and fulfillment orders from the past couple years and calculate the average amount you spent on change orders. Then include that amount in the budget for your next job.

Compare the vendor’s track record to the Service Level Agreement.

Presuming you followed the suggestion in Part 1 to set a Service Level Agreement that ensures the vendor has the flexibility to accommodate unpredictable timelines, regularly review the SLA to ensure the vendor is meeting your deadlines.

A vendor’s ability to meet its Service Level Agreement is a direct indication of its performance. Was the vendor able to meet your deadlines despite only having two days to complete your last print job, as outlined in the SLA? If not, the vendor may not be the best fit for your needs.

Hold Quarterly Business Reviews and challenge the vendor to add value.

Once a quarter, meet with your print and fulfillment vendor to debrief and discuss potential areas of savings. Talk about what went well and what didn’t go well during the past quarter, and what should be done differently in the future.

Don’t be afraid to ask your vendor how they can add more value. For example, pose the following question and see what kind of answer you get: “If I told you we need to reduce our spend by 10 percent, what would you do to make that happen?”

If the vendor is truly your partner, they will continually look for and suggest solutions to achieve better integration of workflows, which will translate into savings for your health plan.

There are a number of ways health plans can cut unnecessary expenses, both before hiring a print and fulfillment vendor and during the course of the relationship. The key is knowing where to look.

This blog entry, Part 1 of 2, shares what you can do before you contract a print and fulfillment vendor:

Get your process workflow in order.

If your health plan is providing its print and fulfillment vendor files that have errors, do not have all necessary approvals or are not in compliance with CMS, you have problems right out of the gate. Errors in data grids and crosswalks alone lead to costly reprints.

Make sure your marketing communications and compliance departments have the right tools to streamline workflow, track materials and ensure compliance. That way, your materials are in the best possible order before they go to the printer. This also helps set a good example for the vendor and implies you have high expectations for them, as well.

Understand the vendor’s true capabilities.

Select a vendor that matches your level of success. The larger the health plan, the greater the complexity of its printing needs – especially for government-sponsored plans with the additional risk that the Annual Notification of Change (ANOC) bring.

If you hired a local vendor when your health plan had 15,000 members and it now has 50,000 members, seriously consider investigating whether that vendor is still the best fit. A smaller vendor simply may not be able to handle the numerous checks and balances required to meet CMS regulations.

In the RFI, ask questions specifically about Medicare and Medicaid.

In your Request for Information, ask the vendor questions that allow you to confirm they understand and have the ability to handle the complexities of CMS, such as: “Can you give an example of how you have handled the ANOCs in the past, including how you addressed challenges with deadlines for these document?”

Consider hiring an unbiased, independent consultant to do the RFI for you, and ask them to use a weighted scale based on importance to find the vendor that best meets your needs.

Do a site visit before hiring the vendor.

Visit the vendor’s facility before making any hiring decisions. Observe their output and Q&A process, which is spot-checking materials for quality as they come off the press. Also, make sure the equipment can handle the size of print runs you know your health plan will require during the busy time of year. Failure to do this could result in missed sales opportunities due to materials not being available.

Ensure the vendor is flexible enough to handle delays caused by CMS.

A Service Level Agreement (SLA) is a timeline of all tasks associated with a print job. It’s especially important for government-sponsored health plans to make sure the vendor is flexible enough to handle delays and complications presented by CMS that will impact production timelines.

Your vendor must understand that they may have either 10 days or two days to produce materials, and they must be able to manage their workflow to accommodate expedited jobs. Make sure the vendor’s SLA is flexible enough to meet your deadlines.