NASCO’s magazine dedicated to ... bridging, filling and closing the payer gap

INSIDE:Learn how our Plan customers are partnering with NASCO and each other to achieve new levels of efficiency.

VOLUME 5 ISSUE 2 2014

table of contents

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a note from our ceo

ncompass: developed for customer service reps by customer service reps

help ME help you!

we’re all in this together: collaborating for success

benefits of partnership

1200 Abernathy Road • Suite 1000Atlanta, GA 30328 • 678.441.6000

www.nasco.com

op·ti·mi·za·tionnoun \ˌäp-tə-mə-ˈzā-shən\

: an act, process, or methodology of making something (as a design, system, or decision) as fully perfect, functional, or effective as possible – Merriam-Webster

NASCO has always been committed to maximizing our customers’ performance and lowering their costs through our unique shared-system environment, and recently, we have been transforming into a more product-based, shared services company.

Our ultimate goal is to increase the value we bring to our customers by becoming a more complete, product-based, shared services company for the Blues. Although NASCO has always had a product commitment, we have not had an optimized product operating model. We are maturing our product management discipline to effectively support product innovation, and we are continually working with our Plan customers to find more efficient and effective ways to operate and increase Plan value. In other words, we are in the midst of NASCO optimization. Optimizing how we operate and build our products. Optimizing how our customers use our products. Optimizing how our customers interact with us and with one another.

NASCO optimization means increasing adoption of shared-product capability and product standardization. It also means creating Plan engagement models that help guide our product strategies and roadmaps. We want to ensure that we are engaging our customers in a more meaningful way, and we want to understand each Plan’s business strategy to be able to take advantage of leveraged capabilities and determine the best way to introduce leveraged-investment opportunities across all Plans.

In this issue of The Bridge, you will gain better insight into how we are optimizing NASCO by focusing on our customers’ business processes and aligning our product capabilities and our services with those processes. You will learn how NASCO and Blue Cross Blue Shield of Michigan collaborated to introduce a new customer servicing product, and you will see how our Plan customers are engaging with NASCO and with one another to achieve new levels of efficiency and to optimize business processes with MembersEdge. In addition, you will see how Plans are collaborating for migration success. You will also read about the partnership between NASCO’s Benefit Solutions team and Blue Cross and Blue Shield of Massachusetts that helped the Plan meet a major migration target. Enjoy!

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Also unique to the development of NCompass is how the project has leveraged the expertise of the CSRs who have helped build the application. The CSRs have participated in focus groups to design the system and review the builds. They also play a critical part in user acceptance testing to ensure that their requirements and needs are incorporated into the build and working effectively before deployment to production.

“We believe that including the end users up front will save us time and money in the long run,” said Frenzel. “We also believe this will help us with employee satisfaction as well as the adoption of the changes the implementation of NCompass will require. When CSRs are happy, our customers are also happy and have a better experience.”

There are many benefits to the NCompass product, but one that BCBSM is particularly fond of is reduced average call handle time. The Plan anticipates a significant reduction in average call handle times, which will dramatically decrease costs. With NCompass, CSRs can quickly access information, spending less time searching for information in multiple systems and more time assessing and understanding a caller’s problem. With the reduced call time and cost savings, BCBSM can redirect those savings back into additional improvements in their call centers through efforts such as training, performance recognition, coaching, process improvements or deployment of additional tools.

Benefits of NCompass • Improves customer experience and satisfaction• Reduces average call time• Allows CSRs to focus on caller

experience and effective decision-making• Consolidates multiple systems through

single sign-on and deep links • Reduces system response time,

speeding up delivery of information• Streamlines screens and access to information • Improves security of PHI • Uses service-oriented architecture to promote

leveragability and flexibility for Plan-specific needs

Both NASCO and BCBSM are very proud of NCompass and how it consolidates core customer service capabilities into a coherent, overarching servicing experience. With NCompass, Plans can improve customer service productivity, resolve calls the first time, improve member and provider experiences, and harness other key capabilities and products to support effective decision-making.

For further information regarding NCompass or interest at your Plan, please contact Bob Meier, Director of Marketing and Commmunications for NASCO, at bob.meier@nasco.com or 678.441.6104.

On Monday, Sept. 29, the Employee Inquiry Unit of Blue Cross Blue Shield of Michigan (BCBSM) achieved a major milestone for NASCO and our Plan customers:

the group’s Customer Service Representatives (CSRs) became the first team to field customer service calls using NCompassSM.

“The initial feedback from the team on the ground in Lansing, Michigan, was very positive, and they are excited about the ease of use and the potential for this new customer servicing product,” said Ray O’Reilly, Program Director of Servicing Strategy for BCBSM.

NCompass is NASCO’s next generation customer servicing product, built on the Pegasystems Customer Process Manager for Healthcare (CPM-HC) solution framework. This new business process-oriented servicing application provides fully automated workflows and multi-channel communications, such as chat, instant messaging and text, to manage customer interactions across multiple member and provider touch points.

NCompass represents a foundational investment in NASCO’s consumer-centric strategy and establishes an integrated platform to provide our Plan customers with a holistic view of the consumer.

“The development of NCompass has truly been a collaborative journey,” said Amy Frenzel, Vice President of Service Operations for BCBSM. “The BCBSM CSRs have been instrumental in providing real-life scenarios, experience and know-how that have all aided in the development of NCompass as a customer servicing tool and platform that will greatly improve the customer service experience for our members, providers, agents and employees.”

NCompass will be deployed at BCBSM over a multi-year period ending in 2016. Additional releases incorporating new functionality and roll out to new CSRs will occur every three to four months until the product is fully deployed.

BCBSM is taking a completely new approach to building NCompass. The Plan is striving to use as much out-of-the-box functionality as possible, and it is enforcing strict governance and discipline around any time and money spent to customize the solution. This strategy allows the Plan’s funding and investment dollars to go further on things that it really needs.

We are very excited about the potential for NCompass and the improved customer experience it will bring. Today CSRs spend more energy and time on navigating systems to find information that they could be spending on engaging with the caller and listening to and understanding their issues. NCompass will allow CSRs to focus on the individual caller and the experience they create by personally interacting with them and efficiently meeting their needs.

Amy Frenzel, Vice President of Service Operations for Blue Cross Blue Shield of Michigan

“ “NCompass Focus Group, from left to right: Amy Frenzel, Candace Hollins, Lori Hart, Chavonn Hussey, Chris Whitford, Tanysa Green, Kevin Jones

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Of all of NASCO’s Plan customers, Blue Cross Blue Shield of Michigan (BCBSM) has the largest ME footprint and the broadest business application and capability use of ME. The Plan is currently leveraging ME to

grow its private healthcare exchange foothold, and it is also partnering with NASCO to develop a migration recommendation to consolidate all of BCBSM’s NASCO membership and billing onto a single platform. To say the least, BCBSM knows a lot about ME and how to gain efficiencies in using the product. The Plan also understands the value of NASCO’s leveraged capabilities and leveraged-investment opportunities.

In 2013, CareFirst BlueCross BlueShield (CareFirst) celebrated the completion of three major membership and billing migrations to ME. While these successful migrations were huge milestones for CareFirst, the Plan wanted to ensure that it was garnering the most effective use of the product and was continuing to gain efficiencies. Soon after the migrations were complete, CareFirst began collaborating with NASCO on ways to become even more efficient, and the Plan wanted to better understand BCBSM’s experience in using ME. BCBSM graciously hosted a meeting with CareFirst and openly provided content, best practices and lessons learned.

“Having the opportunity to discuss day-to-day operations Plan to Plan is invaluable,” said Jennifer Brooks, Director of Operations Large Group SBU for CareFirst. “After meeting with several Plans at the 2014 NASCO Conference, my team was invited to Blue Cross Blue Shield of Michigan to learn more about their processes. We were introduced to several members of their team, and they took us step by step through their workflow. My team and I walked away from that meeting with so many ideas – several of which we are implementing today – and we are incredibly thankful for our continued partnership with NASCO and Blue Cross Blue Shield of Michigan.”

Of course, CareFirst was not the only Plan to benefit from a meeting with BCBSM. BCBSM also hosted Horizon Healthcare Services, Inc., and Blue Cross and Blue Shield of Massachusetts. These Plans wanted to better understand BCBSM’s implementation approach in order to refine their approaches to implementation.

“We thought sharing our experience would be valuable to the other Plans,” said Mark Price, Manager of Membership and Billing (MembersEdge) for BCBSM, when asked why BCBSM offered to host these meetings. “If Plans are able to learn from our

knowledge and experiences, it will allow them to move faster on the learning curve and hopefully onto the MembersEdge platform so we can all have greater opportunity for leveraged capabilities and shared funding.”

NASCO is also engaging our Plans through the MembersEdge Community of Practice (MECoP). Each Owner Plan is represented in the MECoP, and this group meets on a regular basis to discuss market trends and share experiences. Engaging our Plan customers in this manner allows Plans to gain knowledge and insight from one another, and it helps NASCO to better understand our Plans’ business strategies so we can ensure that our product strategy is directly aligned and we are able to increase shared investments.

“The MembersEdge Community of Practice has allowed us to gain greater insight into the pain points and priorities of other Plans,” said Price. “It has also provided a forum for the Plans to explain the need for the enhancements, which provides a greater chance for shared funding of the projects.”

“Coming together with our Plan customers and engaging in an open forum has really helped to drive strategy alignment for the MembersEdge product,” said Linda Leigh Brock, Director of Membership and Billing Products for NASCO. “Learning about market trends and the demands our customers face is imperative knowledge to have as we look at our value proposition. We want to ensure that we are thinking outside of our normal boundaries and challenging everything that does not meet these demands and trends in our market. We want our customers to realize greater efficiency and see more opportunities for leveraged capabilities and shared investments, and the best way to do that is to understand what is important to all of our Plan customers and ensure that the MembersEdge product is strategically aligned with those needs.”

NASCO remains committed to maximizing the performance of our Plan customers, increasing their efficiencies and lowering their costs. We are continuing to mature the ME product as well as the product’s governance. The ME product team is capturing metrics to determine how ME capabilities are universally leveraged and drive efficiencies, and they are also working on process improvements and introducing design principles that will increase product agility and speed to market for our Plan customers.

We are all looking for ways to increase efficiencies and lower costs, and many of NASCO’s Plan customers are looking to MembersEdge® (ME) to help them achieve those efficiencies in the membership and billing space. ME simplifies and automates the enrollment and billing processes and supports customer service through user-friendly interfaces and integrated Web services. ME development and investment is tightly managed through the ME Product Roadmap tools and processes, and Plans using this product also benefit from a Community of Practice that allows Plans to collaborate, share best practices and learn from one another. And what better way to understand how to achieve our optimization goals than to ask others who are already achieving success in those areas?

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Many of our Blue Cross and Blue Shield Plan customers depend on NASCO Professional Services to help their business thrive, especially during peak times or during times of change, when it’s critical for them to have the right resources that align with their specific needs. Our Benefit Solutions team is just one example of the NASCO partnership where our resources provide the right solutions, the right expertise and the right level of support when a Plan needs it. These services provide continuity and peace of mind to ensure a Plan’s day-to-day benefit operations continue to function at the level and pace its members expect.

NASCO Professional Services’ Benefit Solutions team can be available at a project’s beginning, middle and end for our Plan customers, regardless of what that project is. Over time, Plans have seen the commitment and loyalty that a partnership with our Benefit Solutions team offers, and they’ve seen firsthand the value the team consistently delivers and the great work it accomplishes.

As a case in point, Blue Cross and Blue Shield of Massachusetts (BCBSMA) is currently in the final stages of a multi-year migration effort. BCBSMA decided to move

its entire member base from its local legacy system (TPS) to the NASCO Processing System (NPS) so that all member data was available through one integrated platform. The Plan has a goal of migrating every line of its business onto the NASCO platform by the end of 2014. While many hands are helping to achieve this goal, NASCO’s Benefit Solutions team has been there through every phase to ensure that problems and issues were being escalated when needed and handled appropriately, and that any impacts and outcomes were addressed in the best possible way.

As the migration takes place, it is also important that day-to-day operations continue. Benefit Solutions dedicated a majority of the team to the migration, but it also called on Testing Solutions to help in the testing arena. Whenever there was a backlog in testing, the Benefit Solutions team jumped in to help. In addition to collaborating on the support of day-to-day operations, the BCBSMA and NASCO teams focused on shared coding and explored ways to simplify the code as much as possible.

“We’ve helped to transform their business and the way they handle coding for benefits,” said Tracey Parks, Benefit Solutions Manager for NASCO. “Because BCBSMA is a product-centric organization, it is now easier for their teams to code benefits because the coding is much cleaner and they have a better understanding of it. BeneFACT is a key NASCO product that will make it that much more organized.”

Benefit Solutions developed a detailed process and set best-in-class standards for coding and testing. These efforts provided more transparency in the process, helped keep everyone on the same page and raised the bar for how benefits would be handled. Everyone, on the NASCO side and on the BCBSMA side, is aware of what is going on throughout the coding, testing and development process.

Adam Lagimoniere, Benefit Solutions Analyst for NASCO, shared his thoughts as a coder. “From a process and communication perspective, it was very easy for me to communicate with the Plan through our shared integration site. If I ever had a question, I simply posted it on the question log, and we used that to communicate back and forth with the Plan. It

has been refreshing with how effective we’re able to communicate back and forth with one another.”

Benefit Solutions also offered support in another area: education. The team helped BCBSMA understand how to run benefits the most effective way. The team created job aids that outline how NASCO handles benefits from a best-practice perspective.

“The biggest accomplishment has been the partnership and communication between NASCO and the Plan,” said Parks. “We’ve grown together and are now an extension of one another, instead of two separate companies. Once we understood their business, their people, their goals and their processes, we were able to work with them through a very effective partnership. My team of coders and testers has been one of the best teams I’ve worked with in my management career. They knew what their goals were, and they knew they would have to pull together to reach their goals. If one team member went down, another team member stepped up. The team truly lives out the mantra of ‘One Team. One Passion.’”

Currently, BCBSMA is in a better position to serve its member and provider communities because it’s better equipped to do so. The Plan’s administrative costs have been reduced by having its claims processed more effectively and efficiently on the NASCO platform.

Many of our Benefit Solutions team members sit onsite and have a presence at the Plans they work with, but whether a Plan prefers that Benefit Solutions team members sit onsite and have a local presence or that team members work remotely, NASCO resources offer the same level of responsiveness and effectiveness. Plans know that they can depend on NASCO Professional Services to deliver real business results and lasting value. NASCO is ready when our Plan customers need us the most. That’s what real partnership means.

NASCO Professional Services delivers solutions that address and solve a multitude of business challenges that Plans face every day. If your Plan is facing a particular set of challenges, call us. We’re ready to help.

To learn more about the ways NASCO Professional Services can help your business thrive, contact Craig Fagin, Executive Director of Professional Services for NASCO, at craig.fagin@nasco.com or 678.441.6165.

benefits partnership

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WE’RE ALL IN THIS TOGETHER: COLLABORATING FOR SUCCESSNASCO’s shared solution offers Plans a collaborative environment to exchange ideas and share knowledge and experience during any phase of a project, including migration. Collaborating with NASCO and with one another gives Plans the opportunity to collectively identify, define, prioritize, design and develop effective automated solutions that maximize business results.

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contributorsLinda Leigh Brock, NASCO Jennifer Brooks, CareFirst

Amy Frenzel, BCBSMCindy Greenberg, NASCO Carson Hornsby, NASCOScott Howard, BCBSMA

John Ladaga, NASCOBob Meier, NASCO

Tracey Parks, NASCO Mark Price, BCBSM

Rebecca Roberts, NASCO Andrea Whitlow, NASCO

©COPYRIGHT 2014 NASCO

I n March, Blue Cross and Blue Shield of Massachusetts (BCBSMA) successfully migrated its Federal Employee Program (FEP) line of business onto the NASCO platform. The FEP, which is the Plan’s

single largest account with more than 117,000 members, was a complex piece of business to migrate due to the coordination of claims processing with the FEP Operations Center in Washington, D.C. But BCBSMA didn’t have to face the complexity of this migration alone. In fact, throughout the migration, Horizon Healthcare Services, Inc., (Horizon) and Blue Cross Blue Shield of Michigan (BCBSM) provided helpful support to BCBSMA both individually on a Plan-to-Plan basis and collectively through the FEP Advisory Workgroup. The Plans were able to share their NASCO system and operational experience, provide insight on specific business approaches and share lessons learned from their own FEP migration efforts.

In addition to being able to leverage the expertise of Horizon and BCBSM throughout each phase of the complex migration, BCBSMA and NASCO engaged experienced FEP subject matter and technical experts to deliver the functionality that met the Plan’s business needs. This collaborative approach not only contributed to a successful migration, it also provided excellent continuity of operations to members and providers during the transition. The combined FEP project team also managed to implement other FEP required mandates and address important healthcare reform activities during the migration, ensuring that BCBSMA would meet all compliance requirements upon going live on the NASCO system. “The success of the Blue Cross and Blue Shield of Massachusetts migration of FEP business to the NASCO platform is a great example of true teamwork and a testament to the FEP Business Unit’s dedication to excellence in serving Federal members,” said Jeff Defibaugh, Director of Plan Management for the Blue Cross Blue Shield Association. “The collaboration between the Blue Cross and Blue Shield of Massachusetts and NASCO teams and the FEP Director’s Office was second to none, and in my opinion, was a primer for the effective and efficient migration. My team and I truly appreciate the tremendous dedication and commitment of all the players to ensure a smooth transition that was seamless to members. I believe all stakeholders were able to come away from this migration with some best practices that will be used in future projects.”

Preparations for this migration event began well over a year ago and included significant changes to how BCBSMA executed user acceptance testing (UAT). This testing began in August of 2013 and ran through early March of 2014 with over 4,000 test cases executed. A UAT swat team was formed and included testing experts, a dedicated project manager and resources from the business unit. The team worked in a dedicated setting during the duration of testing and was able to deliver on the Plan’s commitment to complete the FEP migration in March.

“The success of the FEP migration here in Massachusetts can truly be credited to the collaboration between the Plan and NASCO migration teams, the local FEP business unit and the FEP Operations Center in Washington, D.C.,” said Bill Fandrich, Senior Vice President and Chief Information Officer for BCBSMA. “The levels of cooperation and thoroughness in testing have resulted in a post-production environment that has seen the lowest volume of issues out of our migrations to date.”

“From the beginning of the migration, the extended Blue Cross and Blue Shield of Massachusetts and NASCO teams took great care to ensure key migration, system and operational performance goals were achieved,” said Dave Bryan, Vice President of Government Services for NASCO. “Together, we employed excellent planning, staffing and execution of each phase of work to ensure continued operational stability and excellence in service – not only for Blue Cross and Blue Shield of Massachusetts, but also for Horizon and Blue Cross Blue Shield of Michigan.”

BCBSMA continues to move business to NASCO’s claims platform and is scheduled to complete its migrations by the end of 2014.

1200 Abernathy Road • Suite 1000 Atlanta, GA 30328

678.441.6000 • www.nasco.com