Professional Documents
Culture Documents
Marketing Plan
2015-2017
Table of Contents
Executive
Summary
3
Vision
Statement
.3
Situation
Assessment
3
Marketing
Purpose
.4
o Marketing
Priorities
5
Market
Trends
..7
o Trends
Specific
to
CMS
7
o Trends
Specific
to
Providers
7
Competition
..8
Target
Market
11
o Market
Growth
..17
Product
Offering
and
Position
.17
SWOT
Analysis
19
o Strengths
.19
o Weaknesses
19
o Opportunities
20
o Threats
20
Business
Objectives
..20
Marketing/Communications
Strategy
22
o Marketing/Communications
Objectives30
o Market
Research
.31
Tactical
Calendar
.32
Executive Summary
Wisconsin Physicians Service Government Health Administrators (WPS GHA)
processes claims as the Medicare Administrative Contractor (MAC) for Jurisdictions 5
and 8. They receive claims from providers who give Medicare services to
beneficiaries and process these claims. In addition, WPS GHA enrolls providers in
the Medicare program, provides trainings and educational materials for providers
and answers questions for providers about claims and appeals processing.
The Centers for Medicaid & Medicare Services (CMS) is the government entity that
chooses MACs for each jurisdiction (groups of states that all have about the same
number of Medicare claims per year.) CMS chooses MACs in a competitive process
between insurance companies.
historically WPS has not always treated CMS like a customer or partner. As a result,
WPS GHAs ability to help shape the direction of new opportunities and capture new
business in the form of new contracts and workloads is limited. Determining who
will get the MAC contract is a competitive process between insurance companies. In
addition, the MAC jurisdictions that WPS currently has (Jurisdictions 5 and 8) will
eventually be consolidated (this is currently on hold), and WPS will have to compete
with the MAC in the jurisdiction it will consolidate with to keep the contract.
Maintaining their contracts with CMS as well as expanding and acquiring new
jurisdictions is a top priority for WPS GHA.
Internally, WPS GHA faces challenges with their processes, technology and
communication. The WPS GHA website is undergoing a redesign in order to fix the
problems that currently exist with its navigation and design. The lack of operational
technical staff knowledge and structure make claims processing less efficient, and
improving internal communications will help WPS GHA have a more streamlined,
responsive process.
Addressing these and other internal challenges will enable us to maintain our
current MAC contracts and help win additional contracts. One company can
potentially process up to 26% of the national Medicare claims volume per the CMS
contract award limitation that exists. WPS currently processes 10.4% of the national
Medicare claims volume.
WPS GHA does perform well as a MAC, exemplified by the feedback WPS GHA
receives from providers in their jurisdictions on the MAC Satisfaction Indicator
Survey (MSI) put on by CMS each year. Using the feedback we receive from CMS
and Medicare providers, we can continue to determine what WPS GHA is doing well
and improve our practices in order to maintain our status as a leading MAC.
This marketing plan is intended to determine how marketing can help WPS GHA
establish itself as a leading MAC, keep its current contracts and gain more
contracts.
Marketing Purpose
Marketing can, and will, play a vital role in the following aspects:
Redefining the GHA brand to better define capabilities and overall identity
Understanding provider trends
Increasing awareness via media outlets
Defining our differentiators
Fostering a better relationship with the Centers for Medicare and Medicaid Services
(CMS)
Supporting the development of a new web portal
Becoming a leading Medicare Administrative Contractor
WPS GHA has the opportunity to position itself as a trusted brand that provides
efficient claims processing and outstanding customer service to customers near and
far.
Marketing Priorities
Rebranding
5
Innovation
In order to establish WPS GHA as a leading MAC and present the most up-to-date
ideas to CMS, WPS GHA must use innovative technologies and become a thought
leader.
Currently, WPS GHA has outdated operational tools that prevent WPS GHA from
getting CMS the data they need. WPS GHA should use tools and databases that
allow them to get information to CMS quickly.
WPS GHA uses many individual MACROs that require a lot of manual maintenance
time, and the systems do not work well with programs trying to capture staff
productivity.
WPS GHA is implementing OnBase, an inventory and business process management
system, in order to process claims more efficiently and database information
OnBase has proved successful with many companies across the country as well as
within the WPS Medicare divisions provider enrollment department
OnBase will replace Solution Suites, which is the current imaging and process
management software being used in WPS Medicare
WPS GHA will purchase, develop and customize the OnBase software to the needs of
the division. The process management software currently being used is outdated
OnBase will:
Automate many current mundane administrative tasks and reduce
error; such as with mail sorting and database entry
Improve the ability to quickly and easily share, manage and transfer
documents between staff and departments as information will be
easy to find
Allow claims to have status updates and move updates through the
claims processing stages, which will allow providers to see where
their claim is in the process
Log and categorize incoming documents so they are easy to find if
a provider calls to inquire or a claim must be found fast
Track applications and improve metrics as it will allow WPS GHA to
see how long it took for a claim to be processed
There are three other projects underway to aid in innovation:
o 1. Data integration
o 2. Work Force Optimization
o 3. Website/portal redesign
WPS GHA should strive to be initiators of system enhancements.
Efficiency
The main criteria that CMS looks at when determining MACs is the efficiency
at which a MAC processes claims.
WPS GHA must use the most efficient and cost-cutting practices.
Using OnBase will improve the efficiency of the WPS GHA division
Educating providers in our jurisdictions on claims will allow more claims to be
submitted correctly the first time, or for providers to recognize why claims
were denied without submitting an appeal. It costs much more to process an
appeal than to process a claim, so educating providers to the best of our
ability will cut costs
By improving efficiency, we will become the best value to the government
Internal communication
Internal communication in the WPS GHA division must be improved in order
to provide the best customer service
Employees must be educated on what WPS GHA does as a MAC, Medicare updates
and more so any questions providers may have can be answered.
WPS GHA should strive to increase communication between Medicare Part A
management and Medicare Part B management. CMS expects Part A/B units in MACs
to work together, and WPS GHA has not been doing this as effectively as they could.
Information should flow well between upper management and the rest of the staff in
order to improve customer service and general employee knowledge.
External Communication
WPS GHA must communicate with CMS and providers through their website and
social media presence in order to be more accessible and in tune with Medicare
The website redesign project will help the WPS GHA website become more
streamlined and easy to use for providers that need to submit claims. Since
providers prefer to submit claims online, improving the website will improve
providers satisfaction with WPS GHA
By implementing a social media strategy, WPS GHA will be more accessible than
ever to the entities that need us. WPS GHA can promote trainings, share links and
keep providers in tune with what WPS GHA is doing.
Market Trends
Trends specific to Centers for Medicare and Medicaid Services
o
o
o
o
% Workload by MAC
30
25
20
% Workload by
MAC
15
10
5
0
Below is a map that shows which company is the MAC for each state. For example,
WPS is the MAC for Jurisdictions 5 and 8, which includes Nebraska, Iowa, Kansas,
Missouri, Indiana, and Michigan, so these states are in purple. Some companies (like
WPS) service more than one jurisdiction.
10
*Noridian Healthcare Solutions, LLC is the MAC for American Samoa, Guam and the Northern Mariana
Islands
*First Coast Service Options, Inc. is the MAC for Puerto Rico and U.S. Virgin Islands
Below are the percentages of the National Part A & B workload that each MAC
administers Medicare for.
Company
% National Part A
&B Workload
# of Jurisdictions
CGS Administrators
6%
1, consolidation on hold
Cahaba Government
Benefit Administrators,
LLC
7.3%
1, consolidated
8.2%
1, consolidated
Palmetto Government
Benefits Administrators
8.9%
1, consolidated
Wisconsin Physicians
Service Insurance
10.4%
2, consolidations on hold
11
Corporation
Noridian Healthcare
Solutions
14.7%
2, consolidated
National Government
Services, Inc.
20.4%
2, 1 consolidated, 1 consolidation on
hold
24.1%
2, consolidated
Tagline
Logo
CGS Administrators
N/A
Cahaba Government
Benefit Administrators,
LLC
N/A
Palmetto Government
Benefit Administrators,
LLC
N/A
Wisconsin Physicians
Service Government
Health Administrators
A Nations Promise,
Kept.
Noridian Healthcare
Solutions
12
N/A
National Government
Services, Inc.
N/A
Target Market
WPS GHA processes claims for Jurisdictions 5 & 8. Our target market in these
jurisdictions are providers that administer Medicare services to beneficiaries. We
must provide outstanding customer service to these doctors offices as their
feedback is used by CMS to evaluate our performance and how we are serving our
jurisdictions. This customer service includes answering any and all provider
questions, providing trainings, and processing claims and appeals in a timely
manner.
CMS is also a target market because they are in charge of awarding MAC
Jurisdictions each year and we want them to view WPS GHA in a positive light.
Winning more MAC Jurisdictions leads to more claims processing for WPS GHA in
different states.
Jurisdiction 5
13
http://www.cms.gov/Medicare/Medicare-Contracting/Medicare-AdministrativeContractors/Jurisdiction_5_Fact-Sheet.html
This fact sheet for Jurisdiction 5 shows the number of beneficiaries, physicians,
hospitals, and claims volume. So far in 2015, WPS has processed 21,756,523 claims
for Jurisdiction 5. By state:
Iowa
Month
Claims Processed
January
810,026
February
697,604
March
758,184
April
776,197
14
May
787,219
June
842,027
Kansas
Month
Claims Processed
January
906,483
February
765,618
March
824,780
April
811,494
May
831,421
June
869,284
Missouri
Month
Claims Processed
January
1,744,391
February
1,406,775
March
1,552,815
April
1,486,427
May
1,539,816
June
1,594,986
Nebraska
Month
Claims Processed
January
463,153
February
424,435
March
467,559
15
April
447,166
May
470,999
June
477,664
J5 MSI Data
CMS administers the MAC Satisfaction Indicator to determine how satisfied providers
are with the service of their MAC. WPS GHA has data from the report released in
February 2014, the data is from the year 2013.
The overall MAC satisfaction score for J5 was 70, on a scale of 1-100. This is
the highest rating any MAC was given. It is four points above the current
federal government average of 66.
o Areas of strength: scale of 1-100
Professionalism of reps: 88
Timeliness of electronic claims: 86
Timeliness of paper claims: 84
Outreach and education activities: 83
Reps demonstration of expertise: 83
Claims processing: 81
Opportunities for improvement: scale of 1-100
Status on claim related issues being provided promptly: 78
Reps ability to provide accurate information: 77
Reps ability to direct callers to quality references: 76
Reps ability to do relatively well in one-call resolution: 75
Explanations of first level appeal decisions: 74
Adjustment/correction of claims under reopenings process: 72
Clarity of adjustment or denial explanations: 71
Highest impacts on providers satisfaction:
Handling of provider inquiries (2.3).
Claims processing (1.3).
Appeals (1.2).
Jurisdiction 8
16
http://www.cms.gov/Medicare/Medicare-Contracting/Medicare-AdministrativeContractors/Jurisdiction_8_Fact-Sheet.html
This fact sheet for Jurisdiction 8 shows the number of beneficiaries, physicians,
hospitals, and claims volume. So far in 2015, WPS has processed 27,230,024 claims
for Jurisdiction 5. By state:
Indiana
Month
Claims Processed
January
1,757,626
February
1,496,840
March
1,638,799
April
1,545,219
17
May
1,728,009
June
1,723,842
Michigan
Month
Claims Processed
January
2,921,725
February
2,572,429
March
2,926,921
April
2,849,335
May
2,942,476
June
3,126,803
J8 MSI Data
CMS administers the MAC Satisfaction Indicator to determine how satisfied providers
are with the service of their MAC. WPS GHA has data from the report released in
February 2014, the data is from the year 2013.
The overall MAC satisfaction score for J5 was 69, on a scale of 1-100. This is the
second highest rating any jurisdiction gave their MAC (WPS also received the
highest rating of any MAC for J5) . It is four points above the current federal
government average of 66.
Areas of strength:
Analyst professionalism: 85
Self-service portal: 84
EDI Helpdesk: 82
Outreach and Education activities: 82
Professionalism of reps: 82
Claims processing: 80
Opportunities for improvement:
Handling of provider inquiries: 77
Reps ability to direct callers to quality references: 75
Reps ability to do relatively well in one-call issue resolution: 75
Reps timeliness with callbacks: 73
Provider enrollment: 73
Reps ability to give consistent information on one topic: 69
Time to complete appeal process: 56
18
CMS
CMS and the government can be considered a cost effective target audience
because if WPS GHA develops a stronger relationship with CMS and the government
it could lead to potential business and access to more jurisdictions creating more
overall profit. However, we can only do this by becoming more efficient and
reducing costs in our claims processing. As stated earlier, CMS main criteria are
that the MAC gives exceptional customer service, uses innovative technology and
strives to find innovative solutions, and uses the lowest costs to be the best value to
the government. By treating CMS as a partner and showing them how WPS GHA
meets these criteria, WPS GHA can win more MAC awards.
Market Growth
Developing an even stronger relationship with CMS could win WPS GHA more MAC
Jurisdictions in the future. Its also important the WPS GHA continues to foster their
relationship with CMS so they can regain the jurisdictions they are currently
consolidating with.
Home Health and Hospice care workload MACS are also important to consider. WPS
GHA has never processed claims for these workloads but towards the future, they
should be considered highly. Some companies currently do Home Health and
Hospice workloads, but in the future each jurisdictions MAC will have to process for
Home Health and Hospice. WPS GHA must begin to learn about these workloads in
order to win the new contracts that will include these workloads.
Product Offering and Position
Medicare Claims Processing
WPS is the Medicare Administrative Contractor for Jurisdictions 5 and 8. Jurisdiction
5 includes Iowa, Kansas, Missouri, and Nebraska. Jurisdiction 8 includes Indiana and
Michigan. WPS GHA processes Medicare claims and is the primary contact point for
providers in these states. When a Medicare provider in Jurisdiction 5 or 8 provides a
service to a beneficiary, the provider (the doctor, nursing home, etc.) will submit a
claim for this service to WPS GHA. WPS GHA will process the claim. In addition, WPS
is responsible for answering any and all questions Medicare providers may have,
enrolling new providers in the Medicare program, and providing resources for
providers about Medicare claims and billing requirements. WPS processes about 1.4
million claims per day and has an appeal rate of about .03%.
In the past, CMS awarded contracts every five years in a competitive process.
However, legislation was enacted that extends MAC contracts to ten years, and CMS
19
interpretation and action on the new legislation is not yet available. CMS is
expected to release a request for information within the next few weeks to gather
feedback on the new environment.
The company that presents the best plan for claims processing and provider
interaction will win the contract for that jurisdiction. Both of WPS current
Jurisdictions have their consolidations on hold with other jurisdictions, Jurisdiction 8
will be consolidated with Jurisdiction 15 and Jurisdiction 5 will be consolidated with
Jurisdiction 6. Once consolidated, it is important that WPS holds onto their contract.
If WPS gains the consolidated districts, they will have 24.5% of the National Part A &
B workload, and one company can only have up to 26%. If WPS does not gain the
consolidated districts, we should compete with companies for other Jurisdictions.
WPS will compete with other companies for the MAC contracts by demonstrating
that we are innovative and the most efficient claims-processing company. In
addition, WPS will provide resources to providers that allow providers to easily
submit claims and gain any information they may need about Medicare and the
claims process.
For Jurisdiction 8, one of WPS jurisdictions, there is no word from CMS yet on their
plans in relation to the extension of MAC contracts to 10 years. The request for
proposal is scheduled to be released third quarter 2015, pending CMS action on new
legislation.
WPS GHA should focus on gaining Jurisdiction 15, who they will eventually be
consolidated with. Jurisdiction 15 is the MAC workload for Ohio and Kentucky and
also serves Home Health and Hospice in the great plain states as well as a portion
of the Mid-Atlantic region. There was an anticipated award date of June 26, 2015,
but action from CMS is still pending. CMS did indicate they would adhere to the fiveyear contract for this Jurisdiction. The incumbent MAC for this jurisdiction is CGS
Administrators, with a contract end date of November 1, 2015.
Currently, WPS offers CMS Secure Net Access Portal (CSNAP) as the way
providers can submit claims. About 97% of Medicare provider claims are submitted
electronically, while others are submitted through mail. This website also offers a
user manual and help center. CSNAP allows providers to access claims status, enter
claims, check patient eligibility, and more. Improving this website will help WPS be
more efficient in claims processing and allow WPS GHA to be a trusted company
with the Medicare providers in our Jurisdictions. The look of the website is outdated
and it may be difficult for providers to navigate as of now. However, the look and
navigation of CSNAP as well as the WPS GHA website will be covered with the
rebranding effort and website redesign. The website redesign project will integrate
CSNAP and the WPS GHA website to create a more streamlined experience.
In order to take full advantage of technology and make claims processing more
efficient, WPS will be implementing OnBase for Jurisdiction 8. OnBase will allow
claims that are mailed in or sent electronically be sorted by data elements and put
into a system. This will reduce error in sorting. In addition, the information on the
claim will be indexed, so if a provider calls about the status of their claim, a
customer service representative will be able to easily look up the status of that
claim. In addition, the indexing of information will allow appeals to be auto-filled
20
Strengths:
Strong reputation with providers we service as evidenced by our performance on
the MSI
In 2014, 130 Million claims were processed by WPS Government Health
Administrators
Excellent benefits through WPS Medicare Companion. For example, durable medical
equipment, skilled nursing care, home health care services, chiropractic services, xrays, mammograms, and lab tests, etc.
No paperwork, fast automatic claims service
Online access and resources
Prompt friendly customer service
WPS GHA has a stronger claims processing system which brings in more revenue
OnBase will make claims processing more efficient
Only MAC to service national providers
Low appeal rates from providers
Very accessible with a fast response rate, You can expect an email back from GHA
always. (WPS Medicare Provider Testimonial Video)
Strong support system that has strong integrity. Theres a strong sense of
openness. (WPS Medicare Provider Testimonial Video)
Education system is strong (WPS Medicare Provider Testimonial)
21
The ability to dial the phone and answer a question was really helpful. (WPS
Medicare Provider Testimonial Video)
Feedback: Provider Outreach prepares reports of comments from providers each
month
CMS views WPS GHA as the strongest Audit Contractor (CMS asked WPS to be a
volunteer for the HIGLAS transition and HBO prior authorizations demonstration)
Weaknesses:
Improving relationship with CMS and fostering it
Weak or dated operational tools (such as human sorting of mail and outdated
database of claims that cant be easily accessed) makes it difficult to change things
quickly because manual resources involved are too intense.
Limited performance metrics and monitoring (CMS metrics are dated, its hard to
monitor percentage of inventory and number of claims processed)
Unused funds from CMS (funds are being returned to CMS rather than being used
towards technology)
Lack of innovation in skill sets, technology and innovation (technology has been the
same for the past 10 years; WPS GHA tend to take the approach if it isnt broken
then dont change it)
Lack of direct communication (individuals are discouraged from calling CMS without
approval or direction from their manager and internally people in WPS GHA arent
communicating well)
No experience handling Home Health Claims and Hospice. This is a significant
weakness since upcoming MAC awards will include Home Health and Hospice
Opportunities:
Establish a better relationship with CMS to establish more business and profit for the
future
Develop business in other jurisdictions other than 5 & 8 to process more claims
Improve technology i.e. Medicare IT systems, databasing
Improvement of website and social media (needs to be more accessible)
Create more awareness for Government Health Administrators by attending CMS
conferences and hospital association events
Beginning to handle Home Health Claims and Hospice, so GHA receives a higher
MAC award
Threats:
Competitors strong relationships with CMS/government
Competitors innovative technology
Other MACs communications strategies
Jurisdiction regulations and regulations on MAC workload
Losing current jurisdictions when consolidation occurs
Business Objectives
Five strategic goals provide focus for our teams in their efforts to achieve our vision
and execute our strategy:
22
a.
i.
ii.
iii.
iv.
Fully Engaged Workforce: Encourage and follow through on new ideas from staff
to improve processes
Engage Medicare frontline staff: Encourage and follow through on new ideas to
improve processes from frontline staff
Align personnels skill level to specific workload
Assess and implement alternative and flexible work schedules and expand work at
home initiative
Develop a philosophy to establish clear, measurable goals for each associate and
implement those policies
Formulate a protocol for all external communication with CMS and partners
23
b.
i.
ii.
c.
i.
ii.
a.
i.
b.
i.
ii.
a.
i.
o
24
WPS GHA can set itself apart by offering a clean, efficient website that is easy to
use for providers, potential providers, and beneficiaries. WPS GHA is currently in the
process of remaking its website with the help of Base22 in order to reflect WPS
rebranding as well as improve user experience.
Base22s objectives with WPS GHAs website redesign are:
Develop a modern and responsive website design while aligning look and feel,
branding and navigation across provider websites
Develop an information architecture framework that establishes the foundation for
enhancing and maintaining the overall design integrity of the websites
Develop and go forward enterprise web technology strategy and deliver enterprise
web reference model to WPS
Some main themes that the websites of all MACs have are:
Resources for beneficiaries
About us page
Trainings and resources for providers
WPS GHA can set itself apart by offering a clean, efficient website that is easy to
use for providers, potential providers, and beneficiaries.
Resources for beneficiaries
The websites of MACs are not technically meant for Medicare beneficiaries (people
enrolled in the Medicare program), but rather Medicare providers who provide
Medicare-funded services to beneficiaries. However, most MACs have links and
resources for beneficiaries in case a beneficiarys search led them to the website of
the jurisdictions MAC. Most MACs direct beneficiaries to the www.medicare.gov
website, as that is where the general information for Medicare beneficiaries is.
WPS GHA current state:
WPS GHA links beneficiaries to www.medicare.gov from their People with
Medicare tab on the WPS Medicare website. WPS GHAs People with
Medicare tab has information, an FAQ, a link for beneficiaries to find a
doctor, and more. However, some of the information is hard to disseminate
and might be difficult to access for beneficiaries who are not very familiar
with Medicare. There are many tabs with long reports, when the information
could be presented in a more concise way. Making this information easier to
read and access could allow WPS to better serve Medicare beneficiaries
(some of whom may be looking for Medicare Supplemental Insurance or a
Prescription Drug Plan- which WPS Health Solutions sells.)
25
Other MACs:
Cahaba Government Benefit Administrators (MAC for Jurisdiction J) provides a
beneficiary tab, but makes the information condensed and easy for
beneficiaries to access. They do not have long reports that would be difficult
for beneficiaries to understand.
26
Since MACs are all insurance companies, their websites usually provide an About
Us page or paragraph on their homepage that explains what the company does as
a MAC. This allows providers in their jurisdictions to get to know the company that is
handling their claims, and makes the company seem approachable.
WPS Current State:
WPS GHA does have an About Us section. It explains what WPS does as a
MAC. However, it is not featured on the Medicare website home page and is in small
font on the bottom of the page. The actual page explains WPS history with
Medicare, which jurisdictions WPS GHA serves, and some important facts about WPS
as a MAC, such as its ratings in satisfaction surveys.
27
28
and providers do not have to sift through an entire website to find the trainings they
need to successfully submit their Medicare claims.
WPS Current State
WPS GHA offers live training, on demand training, minutes to their Provider
Outreach and Education Advisory Groups, and more on their Medicare website. They
also have an FYI Database, which allows providers to search for topics. The WPS
GHA resources section provides an acronym lookup, tips for first time visitors, and
information for new providers. Based on feedback from providers and the MSI,
providers in WPS GHAs jurisdictions seem generally happy with the trainings and
resources WPS GHA provides. On the website, however, the trainings are in many
different places, possibly creating a disorganized feel to the training and resources
database. Also, trainings could get confused with CSNAP, another online portal
where providers submit claims and view status updates.
Other MACs
Cahaba (MAC for Jurisdiction J) offers their providers Cahaba University,
which is a centralized training program. It gives providers easy access to
information on Medicare claims and trends. It provides more of a one-stop shop
for providers who may be in a hurry or busy. Other MACs also utilize the University
way of providing trainings/resources.
29
30
Example post:
31
LinkedIn: LinkedIn can provide an outlet for rich content that showcases us as a
thought leader with our audiences. LinkedIn is unique because it is more of a
professional social media that more of our target audience could be using for work,
not personal purposes.
Internal Communication
A huge part of being a successful MAC is making sure that internal communication
in the WPS GHA department is up to speed and that all employees are able to
answer provider inquiries, efficiently process claims, and provide exceptional
customer service.
In general, WPS GHA receives positive feedback from providers, and performs
outstandingly on the MSI. Improving internal communication to become an even
better MAC will set WPS GHA apart and enable WPS GHA to grow as a MAC.
Currently, WPS GHA has a Medicare Employee Committee. This group consists of
about 20 people including the Human Resources business partners and front line
staff with representatives from each office. Jay Martinson and/or Janet Kyle meet
with the group to discuss what is happening with Medicare. The purpose of the
commitee is to resolve employee concerns and it gives the management staff an
opportunity to discuss Medicares business strategy. This group is well connected
with their peers. This group is especially useful because it allows staff to know more
about Medicare and increases the communication between employees in the
Medicare division, so everyone is up to speed. Possible opportunities for growth with
WPS GHAs internal communication would be:
Expanding the Employee Committee
Rotating members on the committee
Having the representatives on the committee meet with their offices after the
meeting to discuss what happened at the meeting
Creating an online forum where employees could submit Medicare questions that
could be answered online or in person
Currently, executives, directors and managers are expected to communicate
the message down and there are too many layers so the message gets
diluted or misinterpreted. Making communication direct and sent straight to
those it applies to will aid in streamlining internal communication.
Improve Efficiency
Efficiency and reduction of error will occur with the implementation of OnBase
Initially, OnBase will only be implemented for Jurisdiction 8 but will later also be
implemented for Jurisdiction 5
Improving the time it takes to process claims and appeals and get back to providers
on their inquiries will improve efficiency as well as cut costs
Improve Innovation
Using OnBase is a new, innovative way to process claims
Additions of new technologies that help WPS GHA process claims faster than ever
will help us stand out as a leading MAC
Rebranding
32
Marketing/Communications Objectives
Marketing will play a significant role in achieving the business goals and will aid in
WPS GHAs success by delivering on the following initiatives.
Healthy Customer Relations: Be a top performing contractor, thought
leader and partner to CMS
33
Use all available resources to make sure we are offering the most up-to-date, useful
information to providers in order to make our providers the most knowledgeable
they can be on the claims submitting process
Constantly communicate with CMS in regards to our innovative technologies, best
practices, and performance metrics
Collaborate whenever possible, engage providers with CMS as well
Maximize technology proficiency
Implementation of OnBase, which will make claims processing faster and more
efficient
Increase internal communications to educate and train all employees on new
technologies and practices
Communicate with IT to understand what types of technologies WPS GHA could
benefit from
Fully engaged workforce
Improve internal communications including expanding employee meetings,
soliciting for advice on best practices, creating a database for employees to share
questions they get from providers, etc.
Encourage employees to come up with new ideas to cut costs, make claims
processing more efficient, etc.
Engage employees in the process of using more innovative technologies
Diversification
Continue to develop partnership with CMS in order to establish WPS GHA as a
leading MAC and acquire new units such as Home Health and Hospice
Encourage employees to think outside the box when it comes to relationship with
CMS and how we can grow within CMS
Profitable Growth
Establish WPS GHA as a leading MAC in cost cutting, innovation, and customer
service in order to maintain contracts and gain new contracts
Provide the best possible trainings and resources to providers in order to cut costs,
as submitting appeals is a costly and timely process that makes us less efficient, but
when providers know what they are doing and are able to either submit claims
correctly the first time or realize their mistakes, costs are cut down
Possibility to incentivize providers to use or attend trainings in order to have a more
informed provider base
Determine which jurisdictions to attempt to add to our current workload up to the
maximum workload any MAC can have and attempt to gain these jurisdictions and
become a leading MAC not only in the service we provide but the amount of claims
we process
MSI Data
Obtain more data from MSI, providers and CMS to benefit WPS GHA in improving its
services.
Market Research
The government contracts business builds on experience and performance history
to deliver high-value intangibles beyond the request for proposal. These might
include new technologies, service standards and reporting tools.
Touch Points
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CMS Outreach: liaison who handles contracts and funding, white papers
Provider outreach: newsletter, direct mailings, website/portal, training sessions
Making submitting claims easy and quick, providing information
Member outreach: supplement is direct to consumer
Showing a timeline of when they can enroll or an easy-to-follow FAQ of when they
can enroll and start using Med. Supp.
Each month, WPS Manager of Provider Outreach lists comments received on
surveys from providers. Here are some of the comments we have received from
providers.
J5:
Handout book was awesome! Claim examples were wonderful and will be very
helpful in the future
Speakers [at the event] included individuals and organizations such as physicians,
health care law firms, congressional staff, hospital associations, congressional
advocacy members, recovery auditors, other MAC contractors and the U.S.
Department of Health and Human Services.
Always appreciate the educational opportunities that WPS offers- and you all do a
great job excellent presentation of the material and the speaker was so
welcoming to questions from the audience. Responses to questions were detailed
and didnt leave you wondering what you needed to do.
Our carrier is Noridian, but anytime we have a question regarding modifier usage,
wpsmedicare is first, and in most instances, the only site we go to. The information
is complete and presented in an organized, concise format that is also user
friendly.
J8:
I am very pleased that WPS took the initiative to provide additional guidance on
the subject; the presenter was great.
It was very helpful to see the information- where the tabs took you- while it was
being talked about (survey response from website demonstration)
Tactical Calendar
Innovation/Efficiency
OnBase goes live for Jurisdiction 8, (October/November 2015)
implementing a more efficient means of processing claims and databasing
information. The implementation of this program will allow WPS GHA to show
CMS the technology innovation and efficiency it is implementing.
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Rebranding
Rebranding is ongoing and continues to roll out over the next few months.
This rebranding will occur company-wide, but will specifically help WPS GHA
get more name recognition and reduce confusion when it comes to the
different WPS brands.
September retreat- board approval
October 1 for November launch- Internal communications and brand rollout plan
October- executive staff feedback approval on rollout
October 15- comprehensive 2015 action plan
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External Communication
Website redesign is being done by Base22 and will be completed in March
2016. This will help WPS GHA better service providers in their jurisdiction by
making the website more user-friendly.
Implementation of a social media strategy: with the implementation of a
social media strategy across multiple networks, WPS GHA will be able to
become a more approachable company that gives timely updates to those
concerned.
Internal Communications
Redefining internal communications will be crucial in order for WPS GHA
to continue to be a leading MAC because it will allow for better customer
service and streamlining of processes, such as Part A and Part B claims.
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