How we optimized member communications for 11 US states for a top 5 Medicaid Plan Provider
Toppan Merrill United States 11 Nov 2022

Toppan Merrill helped a Fortune 500 Managed Care Organization gain efficiency and transparency through automation and workflow optimizations across its 11 state Medicaid member communications.

“Toppan Merrill’s holistic view of our Medicaid member communications gives us the ability to identify efficiencies and cost savings throughout our organization.” — Director of Marketing, Managed Care Organization

the challenge

This FORTUNE 500 health plan organization doubled their membership and expanded into several states and with exploding growth to include nearly five million individuals and families as members of their health plan. Through this rapid growth they faced challenges, including creation and distribution issues, across its 11 state Medicaid plans.

Because every state functioned as a separate business and relied on legacy systems and processes, the health plan organization couldn’t capitalize on best practices, process efficiencies, and keep pace with rapid business and industry changes. This increased their audit and compliance risks, because of their lack of cost transparency. For example, their spend on individual Medicaid plan members in one state was 2.5 times greater than in another state.

The customer needed a Medicaid Member Communications Provider partner who could:

  • Understand and adhere to compliance requirements
    Scale for growth with them
  • Provide full transparency at each step of the creation, production and distribution process for efficient audit reporting
  • Create continuity and efficiencies across states and throughout the organization
  • Align with their culture that is focused on members and their member experience and deliver seamless, uninterrupted service to their members
our solution

The customer selected Toppan Merrill as their health plan organization partner because they recognized the commitment to customer service excellence, industry expertise, and what the premium Toppan Merrill Control Center technology platform and solution could deliver efficiencies and full process transparency.

the results

The Toppan Merrill Professional Service Team quickly helped the organization document their business rules, and unique needs and requirements, for each of their 11 state Medicaid plans.

Through this process efficiencies and best practices were implemented. The key factor in successfully implementing over 24 new programs for five lines of business was the creation of a consolidation from an array of disparate data sources. Through consolidation, they more efficiently drove their health plan’s programs and personalization, and accommodated CMS content changes or additional business rules. The health plan organization also leveraged the new consolidated data fields to identify trends for faster response times and needed adjustments.