When it comes to medical benefits management, finding the right partner is crucial. Safeguarding and improving members’ health while effectively supporting providers is paramount to a successful strategy. An exceptional partner should align with your goals and embody five key traits.
Agile: Navigating Complexity with Precision
An effective benefits management partner uses their experience to drive informed decisions. The healthcare industry is constantly changing; a good partner quickly adapts and can incorporate new technology to provide a better experience for healthcare providers. This means a benefits management partner can keep your organization ahead of trends and technology, like AI and large language models, as well as new guidelines and regulations.
Imagine having a partner who goes beyond understanding the current healthcare landscape to help predict future challenges. Being agile isn't just about keeping pace with others, but about leading the way. An agile benefits management partner empowers your organization to do that.
Cohesive: Synergizing Solutions for Impact
A successful medical benefits management partner can help make complicated medical workflows easier to manage. By integrating and evolving their products and solutions, they can accelerate the impact of those capabilities, which makes for a better member and provider experience, while at the same time lowering overall costs. A good partner looks for opportunities to create efficiencies, such as Responsible AI adoption, EMR integration, and other automation efforts that benefit your members and providers and position you for long-term success.
Endorsed: Building Trust with Rigor and Responsiveness
To be successful, it's essential that your partner earns the trust of your providers. The keys to achieving this are keeping evidence-based care at the core of their approach, using the right technology, being responsive, and showcasing deep clinical expertise. We take pride in having a 95% provider satisfaction rate with the clinical competence and helpfulness of our physician reviewers, and a 92% overall provider satisfaction rate.
A benefits management partner also serves as a steward of your organization's reputation. By surpassing expectations and cultivating a relationship of trust with the people you do business with, an endorsed partner is invaluable.
Supportive: Balancing Technology and Human Touch
In healthcare, it's vital to strike the right balance between the role of technology and human intervention. By using technology, like AI, to automate some workflows, a supportive partner ensures that any automated process or artificial intelligence is adopted responsibly and balanced appropriately with human intellect. Underscoring the importance of human reasoning in healthcare will ensure that technology will improve care delivery.
Expansive: Your Partner in Growth Across the Continuum of Care
As your organization grows, so do the challenges you face. An expansive partner has the resources to adapt and grow with you—without becoming a competitor.
Your benefits management partner should be a strategic ally who not only helps you navigate today’s complexities but also has an eye on the future. An expansive partner is prepared to explore any new opportunity to make a bigger impact and stands ready to tackle new challenges along the way.
Robert Mandel, MD, is president of Carelon Medical Benefits Management and Carelon Post Acute Solutions at Elevance Health, formerly known as AIM Specialty Health and myNEXUS, respectively.