Dive Brief:
- By focusing on cost containment and claims recovery improvements, Albuquerque, New Mexico-based Lovelace Health Plan saved millions of dollars.
- Among other measures, Lovelace leaders found processes that should be automated, implemented data mining procedures and tweaked how they managed claims.
- Lovelace also worked at validating and correcting its Medicare Secondary Payer records, a step that made sure that CMS gave correct information to the Medicare Advantage plans. By doing this, the health plan was able to collect underpaid premiums to the tune of about $16 million in two years.
Dive Insight:
Everybody talks about teamwork and using data to produce better results. However, few health organizations leverage either of these two their greatest extent. At Lovelace, however, it seems that leaders there were able to engage the players they needed to create change, a step which allowed them to bust through siloes and really make a change in operations. There are many lessons to be learned from their success.