Healthcare is ever-changing. We would like everyone to take care of their health to be able to keep up with the activities that they love. Choosing a health plan can be rigorous but it doesn’t have to be. There are Health plan consultants capable of guiding you through the process for yourself, family, or business. However, there are things to look for when choosing a consultant. Not everyone is a right fit for you. Here are a few tips to consider before your consultation when selecting a Health Plan Consultant.
Those looking to pay a consulting firm should review the firm’s present work, expertise, results, and client to vendor relationship. Charlie Kirksey of GuideWell Connect Health Care Consulting Practice said, “consultants should be experienced physicians who can prove their track record with delivering thorough recommendations in scenarios close to any issue a health plan leader could be challenged with.”
The consultant should engage and work with the payer to achieve a specific goal. They should have key knowledge with the work being presented to them, be results driven, and put successfully addressing the work before consulting. A consultant should be able to combine tactical recommendations and action plans to successfully deliver perceptible results.
There can be times when you don’t want to recognize the red flags but they are as clear as day and you have to start the process over. Finding the right fit is very important. The first red flag is when taking the time to have a consultation with a firm and they are using a standard approach, showing they do not have the time then you should not either. They aren’t committed to starting a partnership. The guidance that a consultant gives should be properly tailored and implement their expertise.
Make sure that the consultant understands the health plan and your business needs. They need to have extensive knowledge of the plan before they can decide on a strategy. The result should include a solution for the payer based on the stance in the market. The consultant and payer should be able to come together on the objectives for the plan. The engagement between the consultant and payer should be well-off that the consultant can bring in a third-party to facilitate an actionable plan for the payer’s situation. If this does not describe your relationship with the consultant or their views, this is a big red flag.
Another red flag is how the process developments itself. If the firm has a dedicated team during the engagement but a sudden switch is made during the sale then this is not a good firm to do business with. As a payer, you need to know who all is working with and for you. The team should be composed of experienced professional oppose to a few junior associates. Shadowing is different from a hands-on approach in this case.
As a payer, you want to get the most out of your engagement with the consulting firm. After choosing the right consultant, ensure there is a transparent communication relationship. Trust is important between both parties because withholding information can threaten the results. If there are contributing factors that can cause a problem, the consultant needs to be in touch with the right people and fully understand the technology along with the process for successful results. Having health plans be open to various changes and expanding the scope of the engagement for the sake of rectifying the culprit of a problem is another way to maximize the ROI on engagement.
When a payer and consultant have an ongoing relationship, things such as being ahead of regulated changes, market trends, and consumer behaviors ensure member retention and increases the chances of the members paying higher prices.
Consultants have the ability to help payers gain more members as well as to improve their retention rates. The right consultant with the right approach can guarantee better financial results for members.
Author Bio: Adrian Rubin is a climate change advocate and freelance writer.