How Do You Successfully Move 5,300 New Members into Your Health Plan?

Two CHOICE program managers who played a key role in the recent transition of Independence Care System plan members to CHOICE MLTC offer their insights.

Left, Atul Kumar, Program Manager for Systems and Process Improvement and right, Prateek Arora, Program Manager for Process Improvement

When CHOICE MLTC seamlessly enrolled 5,359 new plan members from the former Independence Care System (ICS) MLTC plan on April 1st, it marked the culmination of months of long, hard work by staff members across CHOICE as well as by other VNSNY departments. That hard work paid off: Not only did the former ICS members have uninterrupted services during the transition, but with their addition, CHOICE MLTC now has over 18,000 total enrollees, making it the largest not-for-profit and the third-largest MLTC plan overall in New York State.

Leading the process were the two CHOICE project leads: Prateek Arora, Program Manager for Process Improvement, and Atul Kumar, Program Manager for Systems and Process Improvement. Frontline VNSNY recently spoke to Prateek and Atul to get their behind-the-scenes observations on the successful transition.

Prateek: This was by far the most significant project I’ve managed in my career, in terms of sheer scope and impact on both the business and individual members.

Atul: Our biggest challenge was ensuring uninterrupted service for the transitioning ICS members. To ensure that, the project encompassed virtually every department from CHOICE as well as various other departments from around VNSNY including Government Affairs, Legal, Human Resources, IT, Enterprise Administration and others.

Prateek: I would like to thank everyone who played a role, from frontline staff to senior leadership. They all addressed any issue that came up with urgency. This meant going beyond their regular day-to-day responsibilities to devote extra time and attention. It would not have been a success without the extra efforts of all those involved.

Atul: To make certain everything went smoothly, multi-disciplinary workgroups were created with specific responsibilities. These work groups included provider contracting, member enrollment, staff onboarding, care management, systems and reporting, and IT issues. We tracked the progress for each task planned for these workgroups. Prateek and I basically took turns either being in charge of day-to-day activities or overseeing progress against plan.

Prateek: The work groups met weekly, as did the Project Steering Committee– a group that included senior leaders CHOICE President Hany Abdelaal as well as Senior Vice President Lori Ferguson.

Atul: Communication and collaboration were key to the project. The CHOICE senior leaders were extremely important in that regard. They made sure that everyone was always on the same page and that each person knew this was a top priority. They supported us all the way and got us anything we needed, such as procuring new hardware or additional resources.

Prateek: The team’s focus on anticipating risks and preparing for contingencies was also a major factor in the project’s success. For example, we outlined all the steps in each plan member’s onboarding journey, then refined the process so it would go seamlessly for the member. We fixed any risks before they could become issues. And when a problem did crop up, we handled it. Late in the process, some data arrived in an unexpected format that required weekend work to create automated solutions. But the VNSNY team got it done!

Atul: The ICS transition is basically completed, but we’re still in contact with our ICS counterparts so that we’re ready to address any remaining questions. Every day, I remain conscious of our responsibility to the new plan members. I’m proud to be part of the team that has made things a little easier for them.