A Health Plan’s Story:
Optimized Operations and Improved Revenue Assurance driven by an Enrollment Hub
AN EDIFECS CASE STUDY
Very few will argue that the business of healthcare has been particularly easy, streamlined, or straight forward over the past couple of decades. It is increasingly complex, with more regulations to adhere to, and more health plan competition than in the past. Health plans today are engaging in more M&A activity and most operate more than one line of business (LOB). These aspects not only contribute to rising IT costs and complexity for plans but can also have a negative impact on revenue streams. So, where should the health plans of today start when looking at ways to optimize operations and improve revenue assurance? They should start at the beginning of their customer's lifecycle…with enrollment.
In this case study, learn how a northeast regional health plan made a strategic decision to engage with an outside vendor to establish their own Enrollment Hub.