PAINS

   Low enrollment
   Broker management issues
   Low customer retention
   Inaccurate reporting
   Quoting and underwriting delays
   Marketing campaign issues
   Competitor tracking
   Low productivity
   Increasing claims costs
   Increased expenses
   Billing issues
   Profit losses
   Merger difficulties
   Multiple offices and branches
   Internal communications
   Excessive paperwork
   Decrease in service quality
   Other

PAIN DESCRIPTION:

With operating costs rising, HMOs/PPOs are looking for ways to increase productivity and reduce costs. Increasing productivity does not mean reps should work longer hours, cut on their breaks, and slave until they fall exhausted.

Boost in productivity can be achieved through the following:

1. Having the right number of people in each department/for each task. Too many reps bring chaos, too few reps feel overly exploited. Below, we will analyze proper proportions that bring balance into your HMO/PPO.
   
   
2. Having the right specialists. It is always better to have less people, who are highly qualified and trained, than more people who do not have necessary experience. Besides, it is important to have all the needed types of employees.
   
   
3. Having a great working environment. Productivity rises when managed care organizations have the right internal spirit. Success generates success; depression will lead nowhere.
   
   
4. Giving reps a tool that does work for them. Every profession utilizes specific tools. It is not pen and paper for HMOs/PPOs anymore. Taking advantage of automated systems is smart and crucial for productivity.
   
   
5. Giving reps easy-to-use tools they love. Making reps use some "monster" system to do their job is cruel. It will take them more time to learn and navigate through such programs than to use old-fashioned pen and paper. On the contrary, a system that is easy to use and user-friendly will make reps the happiest people on earth.
   
   
6. Showing appreciation. The tricky part is how do you know whom you should show your appreciation to? With the right tool, like HMOZ, you can monitor everyone's activities and review them through the reports. Your knowledge and control over the situation will definitely reflect positively on reps productivity.
   
   
7. Having a business process and making it available to see across the organization. Structured sales processes introduce order and uniformity, minimize the number of errors, and make sales teams more flexible and responsive to any changes.
   
   
8. Having a faster flow of information. If "the winner gets all", why allow your competitors to be there first? Being faster internally will help you to close more sales.

PAIN ANALYSIS:

Every HMO/PPO goes through very busy times and idle times, when there is not enough to do. It does not depend on the size of your managed care organization; everyone experiences "feast or famine". Your reps get used to quiet periods, and it takes them too long to speed up when heavy enrollment seasons come. HMOZ will share with you some of the HMO/PPO best practices, through which you can boost your productivity without adding wage costs.

How many sales and marketing reps do you need? Healthy HMOs with fewer than 1 million subscribers should add 3,300 members per sales and marketing rep annually. You should expect a 32 percent increase in membership (16 to 48 percent is acceptable). Healthy HMOs with over 1 million subscribers should expect 8 to 12 percent increase in membership per year, according to HMOZ CRM report. Benchmarks have shown that the optimum ratio is 1 sales and marketing person per 9,000 members.

The second most important factor in gaining high productivity is having highly motivated people who leverage easy-to-use technology to communicate. Imagine having all the subscriber, or member, or broker information you need, in one place, even before you take the call, and then a history of all interactions. Old style Health Plans' data silos prevent people from doing their jobs professionally. HMOZ makes it possible to have everything done on one call: one and done.

Case Study: Technology influence on productivity.

Blue Cross Blue Shield Oklahoma had a challenge to hold down administrative costs through higher productivity – a step toward moderating the rising cost of health care.

After investment into the new technologies, BCBS OK associates have reached new levels of productivity. In 2003, productivity (the number of members served by each associate) grew by 10.3 percent. This growth can be attributed to a more than 15 percent increase in membership, while the number of associates serving those members increased only slightly. To help associates sustain the level of service and productivity improvement through 2003, the company has made substantial investments in new technologies, including sophisticated document imaging. BCBS will continue to provide the technological support needed to keep meeting the changing and expanding needs of their membership.

Increased efficiency and accuracy reduce agent training time even when multiple departments and healthcare companies are involved. HMOZ gives you the luxury to touch every email only once and be completely done with it. HMOZ automates repetitive paperwork, you never have to go through the same piece of paper twice. Calculate the time savings and the project becomes self-funding, with real ROI. Productivity of your sales and marketing reps will skyrocket.

ADVICE:

Large and small Health Plans alike are harnessing HMOZ business intelligence software to gain vital insights from their data to help them proactively enhance cost-efficiency, productivity, and customer relations and optimize revenue-generating strategies. More details can be obtained through the Solution Audit phase.

One Demo is better than a thousand words, and one Solution Audit is better than a thousand demos. We encourage you to follow our CRM proverb and take advantage of this opportunity.

Click on one of the three links below to continue your HMOZ research.