Washington Health Benefit Exchange€¦ · -Release survey (Apr 2016)-Compile results/categorize themes (May 2016)-Share results with Exchange Board Nominating Committee (Jun 2016)-Exchange

Washington Health Benefit Exchange

Operations CommitteeJune 16, 2016

Pam MacEwan, CEO

Strategic Operational Business Plan

▪ Tie to the Strategic Plan adopted by the Board

▪ Reflects careful deliberation and goal setting aimed at providing a complete and meaningful picture of the Exchange’s business strategy.

▪ Core Outcomes:

▪ Define and Deliver Operational Excellence

▪ Increase Number of Insured and Access to Affordable Coverage

▪ Advance Consumer Choice and Decision-Making

▪ Promote Equity Across System

▪ Board Strategic Plan Priorities

▪ Establishes the priorities and the timeframe during which they are to be completed and demonstrate measureable improvement. Foundation for the Business Plan.

▪ Operationalize Strategic Plan; outcome: HBE Business Plan

▪ Not new work; report what is accomplished

Business Plan; Progress to Date

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▪ Identify Department Priorities and Goals

▪ Establish Department priorities in alignment with Strategic Plan

▪ Enculturate the Business Plan

▪ Implement Business Plan - every employee understand how their work contributes to the Department priorities and ultimately the Strategic Plan

▪ Commence Monthly Reporting Cadence

▪ Leadership Team regularly reviews and updates the Business Plan to reflect progress to date related to the Strategic Plan

▪ Leadership Team reports to the Exchange Board on the progress of the Strategic Plan

▪ SharePoint location: https://wahbexchange.sharepoint.com/teams/execteam/SitePages/Home.aspx

Business Plan – What’s Next?

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https://wahbexchange.sharepoint.com/teams/execteam/SitePages/Home.aspx

https://wahbexchange.sharepoint.com/teams/execteam/SitePages/Home.aspx

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HBE BUSINESS PLANGoal # Category Objective Actionable Steps Timeframe

Late End

Progress Responsible

1. Define and Deliver Operational Excellence

1 Financial Replace current financial system

Process:-Procurement(RFC creation/publication, vendor selection, contract negotiation, signed contract) (Mar 2016)

-System Development Life Cycle(Analysis, design, configure, deployment, development complete) (May 2016)

-Testing(Data conversion, system testing, UAT, Abila parallel, testing complete) (Jun 2016)

-Production Implementation(Production installation, data conversion, finance system software go-live) (Jun 2016)

-Assess reports and adjust as necessary (Jun 2016)

1-2 Years 06/30/17 CaroleVincent


2 Financial Develop five-year spending plan, including areas for efficiencies

-Update Medicaid allocation-Submit revised OAPD/IAPD-Propose reductions in IT, Call Center, staffing-Identify efficiencies/reduction in spending for 2017-2019 budget-Submit updated five-year spending plan

Track PMPM spending-Track QHP, SHOP, Dental

1 Year 9/30/2016

12/30/16

Carole

Not Started At Risk In Progress Completed

Goal # Category Objective Actionable Steps TimeframeLate End



4 Financial Offer clear and standardized financial reporting to the Board and Legislature

-Implement key chart of accounts (Jun 2016)-Assess financial system report functionality to provide report to key internal/external stakeholders (Exchange Board, Legislature, OFM, etc.) (Sep 2016)-Improve revenue projections (Dec 2016)-Track actuarial forecast

1 Year 09/30/16 Carole


7 Financial Establish a working definition of sustainability

-Meet with Leadership Team, Exchange Board, Legislature to develop agreed upon definition of sustainability-Identify and implement efficiencies-Research grant opportunities-Maintain HPF sustainability-Assess business development opportunities-develop process to assess the return on investment for system enhancements-Conduct financial audit (Sep 2016)-Conduct programmatic audit (Dec 2016)

1-2 Years 09/30/17 CaroleMolly


9 External Relations

Create a stakeholder engagement plan to work directly with and hear from stakeholders and tribes

-Conduct TAC survey-Solicit feedback from one-on-one discussions with Legislators, Legislative staff and stakeholders (May-Oct 2016)-Analyze results (Nov 2016)

1-2 Years 12/31/16 Molly



Improve relations with the Legislature

-Schedule and hold meetings-Report to Exchange Board-Exchange Board follow-up with concerns-Schedule regular briefings with Legislators-Create timely briefing materials for Legislature meeting-Provide regular updates to Legislature and Legislative staff-Schedule appointments for Exchange Board members to brief democrat/republican caucus staff

1 Year 10/31/16 Molly

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HBE BUSINESS PLAN






Improve Committee and TACcommunications and input

-Develop questionnaire for TAC-Exchange Board Nominating Committee review/approve-Release survey (Apr 2016)-Compile results/categorize themes (May 2016)-Share results with Exchange Board Nominating Committee (Jun 2016)-Exchange Board Nominating Committee identify areas for improvements (Jun 2016)-Exchange staff work with Exchange Board Nominating Committee on next steps (Jun 2016)

1 Year 09/30/16 Molly


19 Performance Improve communications and training to create customer service efficiencies

-Implement Content Management-Establish unified training plan-Identify resource to create cohesive training guide

Operations-Refine Call Center report to reflect current needs-Update IVR

HR-Assist with Lean training

IT-Implement the next versions of Edifecs which will include carrier access and SHOP file processing to improve carrier -O20 HBE operations-Improve SDLC policies & procedures as well as production control across all systems in the IT ecosystem-Automate plan loading and Federal 1095 reporting-Expand the CSA tool to better support call center resources and HE internal staff-Improve data quality through automated WAH renewal process and reduced manual data corrections

1-2 Years 09/30/17 MichaelBethVincentBrian

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HBE BUSINESS PLAN


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Late End



21 Performance Single, streamlined ticketing and complaint system

Phase 1 - 2016-Assess current ticketing system to improve efficiency and effectiveness-Research single streamlined ticketing and complaint system (OIC, corporate website, Zendesk)-Seek CEO/Leadership Team approval-Assemble project team (Ops IT, Communications, Policy, Legal, Finance)-Collaborate with IT under return on investment proposition-Assess single streamlined ticketing and complaint system impact

Phase 2 - 2017-Determine system changes-Develop communications plan-Develop training-Build knowledge base

Phase 3 - 2018-Implement system changes-Implement communications plan-Provide training

2-3 Years 9/31/18 BethVincent





24 Performance Develop key metrics of Exchange performance

-Research state-based Exchange metrics-Right size organization-Eliminate duplication-Use State services-Research SBE benchmarks-Exchange Board and CEO identified 2016 goals-Exchange Board mapped Strategic Plan priorities and CEO goalsDeliverable: Revised Executive Dashboard; Analysis of state services (forecasting, OCIO, etc.)

HR-Assist with benchmarking staffing in other state Exchanges-Partner with Exec/departments to identify necessary competencies-Perform gap analysis to project future manpower and competency needs. This can include checking current organizational structures for functional redundancies, and using this data to assess/evaluate current compensation structure.

1-2 Years 09/30/17 PamMollyCaroleBrian


26 Performance Coordinate efforts across the Exchange and state agencies

IT-Review and revise change requests for 2016-2017 releases to include enhancements & defects (Apr 2016)-Implement CRM tool for greater change control and visibility (April 2016)-Ensure approval by HPF Gov. Committee (May 2016)-Review and improve CIO workgroup-Review EMT for updates-Improve SDLC policies & procedures as well as production control across all systems in the IT ecosystem -Launch cross functional innovations team-Implement data warehouse to better understand current customer decisions

1 Year 12/31/16 PamVincent

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HBE BUSINESS PLAN


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Late End


2. Increase the Number of Insured and Access

to Affordable Coverage

29 Navigator & Brokers

Configure navigator program appropriately for the changing needs of Exchange enrollees

-Develop opportunities for Navigators/Brokers to collaborate-Determine return on investment for training-Assess Navigators/Brokers performance activities-Solicit feedback from Lead Organizations to restructure RFP (May 2016)-Evaluate opportunities to incentivize Navigators/Brokers-Identify needs based on population/geographic area to establish awareness and enrollment channel-Assess/Adapt strategies to meet needs for population/geographic area-Work with partners to identify opportunities to maximize enrollments

3 Years 09/31/18 MichaelKelly




Pursue broker-specific activities to encourage Exchange enrollments and renewals

-Deepen partnerships with Navigators/Brokers associations-Identify other measures that lead to establish best return for the Exchange-Assess Navigators/Brokers performance for specific geographic area-Work closely with Navigators and Brokers to reach hard to reach population-Sponsor broker events as appropriate-Assess return on investment-Analysis of uninsured, hard to reach population

1-2 Years 12/31/17 MichaelKelly


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Late End





Create more opportunities and facilitate joint events for navigators and brokers

-Look into strategies to best serve geographic area-Create better network of super users-Provide more opportunity for more dialogue between Navigators and Brokers-Help clarify Navigators/Brokers role and responsibility-Assess "store front" for outreach efforts-Work with Navigators/Brokers to assess skills

1-2 Years 09/30/17 MichaelKelly



32 Exchange Market

Develop a comprehensive understanding of the Exchange’s potential customer market

-Continue to be involved in other national surveys (RWJ)-Work with GMMB on market survey-Develop firm understanding of study/report from OFM, Wakely, forecast council -Leverage existing resources to determine customer market

1-2 Years 09/30/17 Michael


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Late End


3. Advance Consumer Choice and

Decision Making

48 Future Choice & Affordability Tools

Identify funding sources for decision support tools

Phase 1 - 2016-Research decision-support tools-Work with Finance/IT to identify cost allocation-Identify/Prioritize decision-support tools-Obtain Exchange Board approval on decision-support tools

Phase 2 - 2017-Potentially submit to Legislature for biennium budget request-Explore grant funding

Phase 3 - 2018-Implement decision-support tool

2-3 Years 09/30/18 MollyVincent


Decision Making

56 Short-Term Consumer Tools

Optimize health literacy efforts and develop an effective feedback loop to understand consumers’ issues and gaps in knowledge

-Review/Assess health literacy content-Engage Lead Organizations/stakeholders to discuss opportunities for improvement-Solicit feedback from TAC on messaging-Investigate other channels that could lend support (Pharma- formulary awareness)-Build larger partnerships-Implement dental program-Assess impact of dental (pilot dental program)

IT-Implement content management system to provide customers more relevant and timely information-Implement family dental services on HPF

1-2 Years 09/30/17 MichaelNellyVincent


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Late End



Decision Making

60 Future Choice & Affordability Tools

Track affordability and choice issues as they affect enrollment retention and growth

-Secure funding for focus groups to address questions about affordability (Dec 2016)-Use consumer survey feedback to track progress (2017)-Analyze HPF data to develop action plan-Explore ways to capture information internally (2018)

IT-Implement data warehouse to better understand current customer decisions

3 Years 09/30/18 MollyVincent


Decision Making

62 Short-Term Consumer Tools

Implement quality rating system

-Develop request for change-Prioritize request for change-Implement QRS as part of Release 3.2 (Jul 2016)-Track use of data-Phased in implementation into HPF (2-3 Years)

IT-Implement HPF quality rating system to help customers make more informed health insurance purchasing decisions-Implement data warehouse to better understand current customer decisions

Next Year 12/31/17 MollyVincentMichael


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Late End


4. Promote Equity Across System

68 Establishing Metrics & Utilizing Expert Committees

Establish equity-focused metrics

March (month 1): Review timeline and proposed metrics with TACApril (month 2): Revised proposed metrics based on TACfeedbackMay (month 3): Discuss updated metrics with TACJune (month 4): Share recommended metrics with Board Data and Metrics CommitteeJuly (month 5) - October (month 8): Develop benchmarks that align with approved metrics using similar process to above.

IT-Implement data warehouse to support equity analysis and policy development

1 Year 12/31/16 MollyJoanVincent

4. Promote Equity Across System

71 Establishing Metrics & Utilizing Expert Committees

Develop and review audience-specific messaging and materials

-Set up dedicated meetings with committees to review messaging-Develop survey on messaging framework-Work with network of providers to identify message instruments to improve communication

IT-Implement content management system to improve and simplify UI for at risk population

3 Years 09/30/18 MichaelNellyVincent


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Documents

Washington Health Benefit Exchange€¦ · -Release survey (Apr 2016)-Compile results/categorize themes (May 2016)-Share results with Exchange Board Nominating Committee (Jun 2016)-Exchange