Open Enrollment: Is Your Medicare Advantage Plan Prepared?

by Jessica Wahaus on October 26, 2015

Each year, open enrollment is a time for consumers to evaluate their health care coverage options and make new selections. For most insurers, this means a new population identity as members’ health status fluctuate correspondingly.

Do you know what your new population looks like?

Obtaining data on a new population is critical to gaining a clear picture of future costs. Understanding population needs in terms of care management and preventative measures will enable you to close any gaps in care more effectively. Access to accurate data puts uncertainty about conditions to rest and puts the focus back on improving member outcomes.

How can you get a snapshot of your population’s new health identity?

MC 1One of the first gaps many health insurers attempt to at the data collection level where greater specificity and clinical substantiation can improve claims submission and coding. Data collection via prospective health assessments will help you better evaluate the health status of your population.

In order to obtain a more complete member profile, a comprehensive assessment should include a health history interview, biometric screening and prescription drug records check. Gaining a clear dataset of a member’s current and historical health enables more effective care planning. When you are able to identify health trends among the population, care managers are better equipped to work with members to manage chronic or recurring health challenges. The result of closing these gaps is an enhanced ability to drive positive member outcomes.

Download our case study to see how the MediCheck™ clinical risk assessment program helped our clients gain deeper insight into the health needs of their members.

Contact us today to learn how we can help you obtain a clearer picture on your new 2016 member population.


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