In my previous posts about the Member-Centric Care team, I posed several questions and gave my opinions to support them. Here is a review of what was discussed, as well as new thoughts:
- Have we over turned every rock (e.g., process, operation, and IT enablement) to allow for member-centric care?
It Depends – Sorry, I can’t state a fact yet. I’m looking for your thoughts and experience.- Let us assume that the business priorities are ranked with cost and SPEED TO MARKET
- Let’s assume that the business has a priority for funding IT to transform it traditional SDLC to respond to monthly sprints.
- Immediate approval and funding for prototyping Agile w/iRise following a BPM methodology
- Leverages solutions such as suggested in several blogs:
- Leverages case studies for orchestration solutions across the new platform (i.e., Payer, Provider, Facilities, etc.)
- Let us assume that you have gone as far up stream in BPM…all the way to Marketing/Sales and Insurance Brokers/Agents, then Yesyou have overturned every rock for the Payer and Provider to collaborate.
- Health Insurance Agents are the first individuals to touch a potential new employer and member and support existing employers and members.
- Health Insurance Agents are paid through commissions to educate their clients for Consumer-Driven Health Care and Member-Centric Care.
- Health Insurance Agents have a responsibility regarding plan, eligibility & benefits, and assisting with claims.
