New Product Launch Exceeds Health Plan’s Targeted Enrollment
Launching a new product is a great strategy for growing health plan membership but demands time and effort. One health plan joined Covered California, the largest state-based health insurance exchange. They had to quickly develop, operationalize, and market their new product for open enrollment.
Of the nearly two dozen U.S. states offering fully state-based health insurance exchanges (marketplaces) under the Affordable Care Act (ACA), California’s exchange, called Covered California (Covered CA), is easily the nation’s largest. Covered CA, connecting Californians with affordable health insurance and financial assistance to those who qualify, assists about 1.8 million people annually.
Given the sheer number of Californians enrolled in health insurance via Covered CA, it’s an attractive marketplace for health insurers seeking to offer ACA coverage. That was the mindset of leaders of a large integrated health plan that sought to grow and diversify their member benefits by joining Covered CA.
To join Covered CA, the health plan needed to move fast to develop, operationalize and market a new line of business. This new product also needed to be priced and available by the start of the open enrollment period for ACA plans, which was less than a year away.
The health plan quickly realized it required expertise and additional resources to launch a new line of business on its own and in time. So, the health plan turned to the healthcare consultants with Freed Associates (Freed) for help, who had extensive prior experience with both the health plan and launching new lines of business and product offerings.
Establishing Effective Program Management
Freed began by establishing program management infrastructure for the health plan – a necessity given the breadth and complexity of launching a new line of business. This included developing and launching all relevant program management protocols, as well as organizing the health plan’s new product stakeholders around an organized oversight framework.
Boosting Workstream Progress
Next, Freed developed and established protocols for managing workstreams related to the new insurance product. This included workstreams to provide a positive experience for members and providers. It also included plans for implementing a new cost transparency tool and acupuncture and dental benefit offerings. Freed worked in concert with the health plan’s internal and external stakeholders to enable workstreams to meet both internal and external expectations. Throughout these coordination activities, Freed also regularly measured progress against established benchmarks.
Go-Live Planning and Execution
Freed managed workstream issues, risks and escalations, coordinated contingency and mitigation plans and execution, and coordinated go-live activities through stabilization, as well as any necessary workaround process planning and execution. Based on these results, Freed and the health plan determined that the new product was ready for introduction within Covered CA in time to meet day one of open enrollment.
Transitioning to Operations
As members began to enroll, Freed coordinated the product’s operational transition, to ensure the long-term functionality of the health plan’s new product. This included inventorying all new product-related processes and owners and transitioning all required activities to operational maintenance processes.
First-Year Enrollments Exceed Health Plan’s Goals
Thanks to Freed’s partnership, the health plan’s new line of business for Covered CA participants launched on time and ahead of open enrollment. The offering was an immediate hit; during open enrollment alone, the new CCA product exceeded the organization’s 2024 year-end goal for membership.
