Risk Management for Health Plans – Part 3

In Part 2 of our Risk Management for Health Plans series, we provided a high-level understanding of how to approach risk management from a tactical perspective. This week we will provide you with a strategic framework to apply to your  program.

The 5 Pillars of Risk Management

Keep in mind, Risk Management is a continuous and iterative process. You are always going through these steps and moving your  program and the risk itself forward throughRisk Management this process.

  1. Identify – Document any known or potential risks across the organization.
  2. Assess – Evaluate each risk and measure the likelihood of it occurring and the impact it would have on the organization.
  3. Mitigate – Once risks are identified and assessed, implement ways to reduce the occurrence and impact of all risks.
  4. Monitor – Implement tools and processes to monitor risks on a continuous basis.
  5. Report – Document Risk Management plans and report out to stakeholders on results and effectiveness.

The Top Emerging Risks in Healthcare

Here are potential issues and emerging issues that might be affecting your organization:

  1. Government shutdown
  2. Demographic changes
  3. Rising Healthcare Costs
  4. Policy Changes
  5. Access to Care
  6. Mental Health and Behavioral Health Needs
  7. Prescription Drug Costs and Benefit Changes
  8. Workforce Shortages
  9. Environmental and Climate-Related Health Risks
  10. Health Equity
  11. Social Determinants of Health

How do these potential risks apply to your organization? Are you using an effective risk management process to identify, assess, mitigate, monitor, and report on these risks to your organization?

These topics and more were discussed in greater depth in a webinar CODY® conducted through our partnership with the Association for Community Affiliated Plans (ACAP), titled Identifying & Managing Risk. This is the last part of our 3-part series on Risk Management for Health Plans . We hope you have found it informative and thought provoking.

Remember We’re Here to Help – CODY has led the industry for decades, and we have the expertise to help you manage your risk and maintain success. To learn more about our Risk Management products and service, contact us today for a consultation.

About us: Founded in 2006, CODY® is an Industry leader in Governance, Risk, and Compliance (GRC) Solutions designed exclusively for health plans. We enable over 70 government-funded, commercial, and ACA health plans across 50 states and Puerto Rico to mitigate compliance risk, maximize efficiencies, and improve outcomes. Our Enterprise technology and innovative solutions reduce administrative costs, increase accuracy, ensure regulatory compliance, and provide a better experience for plan members and providers. www.codyconsulting.com