Whenever a massive federal government program is launched in response to new legislation, there is a huge learning curve for many groups of people. For example, in the case of the Affordable Care Act (ACA) passed in 2010, those groups included
- citizens who needed to sign up for healthcare programs,
- insurance companies who needed to comply with the act, and
- federal employees who needed to help both citizens and insurance companies.
As experts in many areas of federal policy, LMI helps all parties develop processes and systems to best implement new legislation. LMI has worked with the Centers for Medicare and Medicaid Services (CMS) for the past twenty years, and more specifically on ACA implementation for the past five years. Our primary focus is reviewing applications, monitoring entity compliance with federal rules and regulations, and answering their questions so they can improve their performance.
Tracking Questions to Improve Customer Education
Reviewing thousands of applications from organizations and insurance providers, also called “issuers,” requires in-depth policy knowledge. It also needs a system for tracking all the questions generated during the application process and beyond. During these five years, LMI has worked with our partners at CMS to answer tens of thousands of stakeholders’ questions.
We tend to see similar questions, depending on when deadlines occur. For example, when a submission deadline is approaching or the Open Enrollment deadline is near, we tend to see a lot of questions about changing data at that time.
While there are many common questions, we use our subject matter expertise to answer more specific questions that relate to CMS policy. Our functional team members work hand-in-hand with our technical staff to provide a system that not only provides a technical solution to the government’s needs, but also provides CMS staff with expert research to answer the tougher questions.
Helping Federal Employees with Clean Workflows
With the adoption of new federal programs and the subsequent questions they raised, you can imagine how thousands of e-mails could have overwhelmed federal employees. Managing these questions through a workflow management ticketing system greatly aided in efficiency and accountability. LMI customized the workflow to make it work best for those answering the questions. This allows subject matter experts to add what they can to a particularly tricky question and then pass it on to another expert who can fill in the picture. It ensures no question gets buried in someone’s e-mail inbox. Another benefit of the system is the tracking capability it has for comments and time stamps while it is being routed through the review and approval process to multiple users, allowing for data analysis on ticket times and transfer history.
Not everyone loves to learn a new system, but our clients who use the system we implemented see how it really helps their workflow and their e-mail management.
Perhaps most importantly, the system creates a knowledge database. So when new team members join, it is easy to look up every answer on the topic he or she is assigned. Many questions become so standard that they can be answered without involving a policy expert. We also developed a highly-customized taxonomy of tags that are applied to each question for easy searching. These common questions become the backbone of training for new federal employees.
LMI’s unique combination of policy expertise and enterprise-level customer care is valuable beyond healthcare. The lessons we have learned could assist with any massive program roll-out where the users are struggling to understand all the ins and outs of new legislation.
"I am passionate about improving the nation’s healthcare system and creating effective and affordable care for our beneficiaries. Most recently, our team developed the Agile Development and Evaluation Protocol (ADEPT) that will enable us to support the government in rapidly developing, testing, and evaluating policies, procedures, and demonstrations to increase the efficiency and effectiveness of federal programs."
Christine Cocrane, Director, Health Services
"Helping our clients implement major programs that positively affect people’s healthcare and well-being across the nation motivates and excites me about the important work we do at LMI.”