Your job is complicated enough and your team works hard ever day. It's time to make it a little easier with Toppan Merrill.

Problem

Over the past several years, the health plan has doubled its membership and expanded into several states. With this exponential growth the plan found itself facing challenges creating and distributing member communications. Reliance on legacy systems and processes led to a lack of transparency into costs and increased audit and compliance risks.

Setup

At that time the biggest concern of the health plan included compliance risk and cost control. Each state functioned as separate businesses and didn’t capitalize on best practices and process efficiencies. On top of the compliance and cost concerns, it was important that the health plan partnered with a vendor that understood the health insurance market and the importance of their members and the member experience. They wanted to ensure their members would not be impacted by any changes made internally.

Solution

Toppan Merrill’s professional service team quickly engaged with the plan to document their business rules and the unique needs and requirements for each of their 11 state Medicaid plans as well as creation of a consolidated data grid which was generated from a variety of disparate data sources. This consolidated data drives many of the health plan’s programs and personalization as well as makes it easy to accommodate CMS content changes or additional business rules.

Connect was implemented to accommodate welcome kits and synthetic ID cards, health and wellness mailings, 400+ various letter mailings including PCP and PCP termination letters as well as corporate marketing materials and promotional items for outreach programs.

As part of the integrated workflow the health plan is able to receive robust reporting at the member level for all of its member communications. This gives the plan access to member spend by state, line of business and category. This also enables audit-ready reporting for compliance as well as the ability to look holistically across the organization to pinpoint where cost control measures may be needed.

Results

Over the course of a year, Toppan Merrill completed 24 program implementations across five lines of business and 11 Medicaid health plans utilizing Connect. The health plan quickly realized efficiencies and cost savings throughout the company in excess of $5 million dollars. They were also able to quickly and easily add nearly one million members to their network without risking compliance of our member communications.