The Customer Group

Special Information for
Medicare Contractors

"Medicare is an enduring commitment of our country. It must be modernized for our times."

- President George W. Bush

The Environment

Healthcare costs are viewed by the public, Congress and the Bush Administration as out-of-control
Medicare is perceived as being caught in a time warp and operating like it's 1965
Current executive and legislative proposals call for increased efficiencies, competition, and restructured contracts
Government agencies are cutting budgets to help fight the war on terrorism

Challenges for Contractors
The landscape is changing for Medicare Contractors, they're faced with a multitude of challenges:

Reduced Payments
- Contractor reimbursement has been flat for the past several years
- The cost of doing business has increased
- Medicare contracts are less and less profitable
Increased Competition
- New types of companies will bid for and receive Medicare contracts
- Existing contractors are increasingly competing against each other to retain or obtain more business
- Contracts are becoming more and more performance driven
Standardized Operations

One claim processing system
One Desktop
One IVR for beneficiaries and one IVR for providers
Uniform approaches for measuring customer satisfaction, call monitoring, and training

Performance Controls
- CSAMS
- BPRs
- Uniform Accounting
- Contractor Scorecard
- At Risk Contracts
Fewer Contractors
- Contractors are leaving the program
- Operations are being consolidated
- Enabling technology makes possible "virtual call centers" using a standardized desktop

The Customer Group can help you manage change.