Evaluation of internal environment and external capabilities
It is important to assess the administrative capabilities of your organization regarding a Medicare Advantage product to determine the level of investment necessary to launch the product. Each of these assessments is then included in enrollment and financial projections.
Before you add a new Medicare product, we help:
- Review company documents
- Survey data
- Interview key staff
Assess readiness from an operational perspective
For each market, we review secondary literature, survey data, and conduct interviews with your staff knowledgeable about a market (e.g., sales, marketing, provider contracting, etc.). For some Medicare products and to the extent necessary, we also conduct interviews with key market individuals including brokers and employers. Depending on your target population, interviewing brokers and employers may or may not be necessary.
Evaluation of external environment
Typically, we conduct an assessment of the external environment in order to understand competitive factors such as likely competitors, plan design, member premium (in case of dual-eligibles, the likely changes to state capitation rates and benefit design), etc.; regulatory initiatives (e.g., for a dual eligible product, recent and potential future changes to state Medicaid program); and changing market forces.
.gif){kind=small}