By Monica E. Oss, Chief Executive Officer, OPEN MINDS
When it comes to numbers, the offense is tough. Consumers are selecting provider organizations based on performance ratings. Consumers in treatment also want to know how they are progressing. Payers and health plans want outcomes data. Regulators and funders want performance measures and results. Referral sources, community partners, and collaborators want evidence of what you can do based on hard data.
Consider just a few headlines from recent weeks on the importance of numbers to health plans and consumers. The National Committee for Quality Assurance (NCQA) just released new health plan ratings to help consumers choose health plans. The ratings use a simple and convenient online display to show how health plans perform in key areas, including assessments of care for people most at risk of dying from COVID and people at risk for opioid addiction. 188 million consumers currently enrolled in more than 1,000 Medicaid, Medicare, and commercial health plans contributed to these NCQA ratings in three areas—patient experience, prevention, and treatment.
Two new reports (the Verint Experience Index: Health Insurance Report by Verint and The US Health Insurers Customer Experience Index, 2021 by Forrester) rank the top 25 health plans based on member satisfaction, and indicate that all the top 25 health insurers are highly competitive. In one report, United HealthCare ranked first with a consumer satisfaction score of 84.1; Humana came in second with 83.4; and Kaiser Foundation Health Plan came in third with 82.8. The other report ranked Humana in first place, followed by Kaiser Permanente, and Highmark Blue Cross Blue Shield/Highmark Blue Shield. Perceived value, web and mobile experiences, cost transparency, and telehealth coverage are some of the key factors driving consumer satisfaction.
Newsweek just published rankings of the nation’s top 450 nursing homes in 25 states, based on three criteria—overall performance data, peer recommendations and each facility’s handling of COVID-19, relative to in-state competition. Nursing homes in the 25 states with the highest population size, according to the United States Census Bureau were included in the study.
These are just a few of the dozens of initiatives to rank health plans and provider organizations. Your best defense against the numbers offensive? Developing a metrics-based management approach that extends across every customer-facing facet of your organization. Using performance data in metrics-driven management is at the top of the OPEN MINDS “top ten” list for developing organizational resilience. Figuring out what metrics to adopt and how to embed them into the organization’s operations, culture, and decisionmaking is a challenge.
