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1. Creating
Member Value: A Rx for Success
Eric Reidenbach & Gordon McClung
"No longer can managed care continue to rely on the current
thinking that produced the cost cutting initiatives that dominated
HMO strategy. New thinking is required - thinking that focuses
on the creation of value for the different key constituencies
that it serves."
2. Combat
Disenrollment by adding Value
R. Eric Reidenbach & Gordon W. McClung
"Globally, two elements drive managed care choices made
by employee benefits managers: quality and price. Taken together,
these two components define a critical dynamic that most managed
care providers are not monitoring. That dynamic is value, customer
value to be specific."
3. Database
integration offers providers a centralized customer-service
vehicle
Comprehensive data warehousing can streamline medical management
and improve customer loyalty, satisfaction.
By Dorinne Hoss
"In order to build loyalty among existing customers and
attract new prospects, many providers are turning to customer
relationship management (CRM) initiatives. CRM involves understanding
and meeting customer needs across all customer-facing functions,
including sales, marketing, and customer service."
4. Build
physician loyalty with Value
R. Eric Reidenbach & Gordon W. McClung
"The issue of physician retention is critical to the ongoing
quality of service and patient care provided by HMOs. Retention
is made even more difficult because many physicians are not particularly
enamored with what they consider to be the intrusive nature of
HMO management."
5. Beef
up the business value of CRM by getting back to basics
Managed Healthcare Executive
"Customer relationship management (CRM) is a business strategy
designed to optimize profitability, revenue and customer satisfaction.
With the many technical attributes required for CRM transformation,
HMOs are especially concerned about ROI, including tangible and
intangible benefits. As HMOs pursue CRM strategies, they are realizing
that the benefits and costs of those strategies can be significant."
6. Disparate
applications: an opportunity for agility
Managed Healthcare Executive
"Having disparate applications in an IT environment forces
a degree of independence between applications that can provide
a high degree of flexibility (business agility) if appropriately
designed and managed. Health plans that try to eliminate heterogeneity
by standardizing on single applications may gain IT efficiency
but at the loss of critical business effectiveness."
7. Embrace CRM
by implementing the full suite of offerings
By: Joanne Galimi
Managed Healthcare Executive
"Industry pressures have created an impetus for a new transformation
of consumerism in which consumers are empowered and accountable
for their healthcare. This transformation has required payers
to shift thinking toward customer relationship management (CRM).
CRM is a business strategy designed to optimize profitability,
revenue and customer satisfaction."
8. Implementing
these IT initiatives moves payers toward automation
By: Joanne Galimi
Managed Healthcare Executive
"The past 18 to 24 months have been the trial-and-error
period for payer automation. The implementation of e-transactions
between payers and providers, consumers and purchasers has been
slow because of the challenges of integrating them with back-end
applications, historically poor data management, slow trading-partner
adoption and a volatile and relatively young vendor market."
9. Payers
seize opportunities to manage, forecast sales
By: Joanne Galimi
Managed Healthcare Executive
"Every healthcare payer organization needs the ability to
manage sales opportunities. Payers also are facing changing business
models, additional product offerings in new geographies with new
sales distribution channels, the need for member retention capabilities
and the need to be more effective and efficient."
10. Technology
purchases must be effective, not just efficient
Managed Healthcare Executive
"How much should a managed care organization invest in information
technology? How can an MCO ensure that IT is making a worthwhile
contribution to its business? The answers to these questions will
be central to business success in the 21st century as MCOs must
balance effectiveness (getting the business done well) with efficiency
(getting it done at minimal cost). Current IT benchmarks and measurement
systems are failing to demonstrate business value."
11. Medicare
HMO Marketing in the Information Age
A REPORT BY MEDICARE RIGHTS CENTER
"HMOs spend millions of dollars on marketing their Medicare
products. One study found that marketing has a major influence
on an individual's decision to join a Medicare HMO. Some marketing
practices can mislead and result in misinformed or poorly informed
enrollments."
12. Squeeze
Play. HMOs faced with profit losses, tight finances
By Alexandra Matisoff-Li
"Although HMOs transformed the way most Americans get their
health care, the industry has suffered from growing pains in recent
years, experts say. In the face of recent steep drops in profits
and perceived consumer discontent, healthcare policy experts agree
HMOs are at a crossroads."
13. Telemagic, Act, SalesLogix, HMOZ
"According to the last HMOZ Customer Relationship Growth Forecast report, the most profitable MCOs have between 10 and 950 sales and marketing reps. Gartner Group observers named SalesLogix to be the market leader in Customer Relationship Management with over 25% market share and the best fit for this size Managed Care Organizations..."
14. HMOZ CRM System
"HMOZ Customer Relationship Management (CRM) system is uniquely customized and built for Sales and Marketing departments of Managed Care Organizations (MCO)."
15. HMOZ Amisys Integration
"HMOZ is setting a new standard for the health plan industry, providing sales and marketing solutions integrated with Amisys that manage sophisticated processing requirements, including consumer-directed healthcare products. It offers small, medium and large payers a comprehensive, robust and flexible way to meet their information needs."
16. Managed Care Marketing Needs
"Needs of marketing departments in Managed Care Organizations are often overlooked. MCO management believes sales and marketing has the lowest priority when it comes to internal investment and technological advances. Marketing reps lack the ability to argue this situation with management and need support from HMOZ CRM system to be able to present a solid business case backed up with reports."
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