Are you “ready?” Prime’s Medicare team is!

Enjoy New Year’s Eve, sleep soundly and wake up confident.

Prime’s Medicare market segment developed and implemented the Annual Part D Readiness Program (“Annual Readiness”) over the past 16 months. This rigorous governance structure has Prime ready for the January 1, 2016 Peak Season.

Why we established Annual Readiness

We wanted to have an overall governance structure to:

  • Communicate awareness about Annual Readiness consistently between Prime and our Blue Plans
  • Clarify accountability for hand offs internally at Prime, or those needing action by our Blue Plans
  • Capture legacy knowledge or lessons learned
  • Feed Medicare status into Prime’s Enterprise Peak Season structure

As our Medicare Part D program grew, we knew our process needed to evolve as well. What happens when employees change positions? Or leave? How do we manage effectively for staff vacations? And of course, there’s always the possibility of an employee winning the lottery and leaving!

We set out to document a repeatable, accountable process and governance structure to solve for this.

How is it set up?

The Annual Readiness Program uses a structure of sub-teams and core teams. It aligns with three of Prime’s four foundational imperatives to:

  • Provide solid operational excellence
  • Deliver superior customer experience
  • Ensure business discipline

We captured the sub-teams’ documentation in advance of last year’s 2015 Peak Season. Those teams helped refine and improve reporting and communication mechanisms going forward. Their involvement was crucial to improvements put in place this year.

What does it look like?

For 2016 Annual Readiness, all Medicare Part D teams now work off a master project plan. Teams meet weekly. We capture lessons learned and use these for benchmarking program success. Program calendars drive internal and client-facing communication. And weekly overall program status reports keep everyone up to speed. Almost all of Prime’s functional areas have representation on these teams.

An amazing amount of information is shared through the sub-teams and core teams. And because of the structure and organization, people have the information they need when they need it. Communication is efficient yet still meaningful for action and response. The design fosters collaboration and provides tracking and accountability. All the while, we leave no stone unturned that might provide new insights for future improvements.

Hard work by all Annual Readiness teams and leaders will bring an excellent transition for our Medicare Part D members going into 2016. And it will put us in a great position to build on this foundation as we prepare for 2017. Why do we do what we do? To help members get the medicine they need to feel better and live well.

Medicare General Management Program Director Jim Krocak leads the overall 2016 Annual Part D Readiness Program. You can contact him with any questions.

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