I personally really don’t think so. The damage this company has taken over the years - thanks to both past and present leadership - is just too deep. Even if Elevance somehow got the absolute best people to take over, I doubt they could turn things around. It’s just too far gone.
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Mr. Provider Ops ....Shane H. come check out these bullet points my guy
@bz - great bulleted list. All great points. However, these all require some expenditure of capital. In order to do these, we need to reduce the expensive head count, from mid-level and down. C-suite folks won’t put themselves in a jeopardy position. It’s either RIF’s or decreased share price. As to fixing this mess; not for Elevance. Ever wonder why our thelayoff.com thread is so much more active than, say UHG, Aetna, or Cigna? We run with scissors and worry about the results later; always have, always will.
Most jobs in the industry will be done by AI inside a few years time. Eventually all of this stuff will be automated and there will be one or two phone reps that are impossible for the customers to actually reach.
All white collar jobs are heading to this. Layoffs will happen as needed.
for the poster with the areas of improvement bullet points - you forgot one -
- Don't run with scissors
all your bullet points are valid, have been shared, discussed, over the years ad nauseum. If those in "charge" can't fix the basics.....which they can't/won't/can't afford- they continue to be doomed to repeat it.
No fixing this industry. Greed has ki-led it
Yes, here are some potential areas of improvement:
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Enhancing Patient-Centered Care
- - Improve customer service to reduce delays and frustrations with claims and authorizations.
- - Increase transparency in coverage, so patients understand what’s covered and why.
- - Expand telehealth and digital tools for easier access to care.
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Streamlining Administrative Processes
- - Reduce prior authorization delays by leveraging AI for faster approvals.
- - Simplify billing and claims processing to reduce errors and confusion.
- - Improve provider network management to ensure patients have access to quality care without excessive out-of-network costs.
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Addressing Provider Relations
- - Ensure fair reimbursement rates to keep high-quality doctors in-network.
- - Reduce administrative burdens on providers so they can focus on patient care.
- - Improve interoperability of health records for better coordination among healthcare professionals.
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Expanding Preventive & Value-Based Care
- - Shift focus from fee-for-service to value-based care, rewarding better health outcomes.
- - Invest in community health initiatives to address social determinants of health.
- - Enhance wellness programs that promote long-term cost savings and healthier populations.
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Leveraging Technology & AI
- - Use AI-driven analytics to predict and prevent high-cost medical events.
- - Implement blockchain for better security and efficiency in medical records.
- - Improve mobile app and digital experience for customers managing their care.
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Regulatory & Ethical Improvements
- - Increase price transparency in insurance policies.
- - Work with policymakers to ensure affordable coverage for all demographics.
- - Reduce unnecessary denials of care and ensure ethical decision-making in claims approvals.
Nope shows over. Whole industry is in disarray and it’s only a matter of time before it becomes the next bubble that bursts. 5-10 years tops.