While healthcare organizations always need to be on top of their communications game, there’s one time of year that can be especially demanding: ANOC and EOC compliance.
Within the first week of May, the Centers for Medicare and Medicaid Services (CMS) release their marketing model materials for the following coverage year. These materials, released separately by each state, include the standard Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) templates and instructions, ANOC/EOC Errata, and Provider Directory. They need to be included in any outreach or educational campaigns associated with Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, and Advantage 1876 Cost Plans.
ANOC & EOC Communications Challenges
The release of these CMS materials causes significant headaches, both internally and externally.
Common pain points include:
- Missed deadlines: Key dates and steps required by CMS aren’t always easy to understand or communicate with plan members.
- Documentation errors: If there are errors in member communications, they can lead to fines and lost time. These infringements are highly common among organizations working to comply with highly complex CMS models.
- Staff burnout: Healthcare employees must spend long hours logging and responding to CMS model and data change requests, causing additional frustration.
On top of these issues, COVID-19 has created additional tension for internal teams. In years past, many of these ANOC and EOC documentation changes required manual composition, versioning, and translations. The manual nature of the materials caused significant delays in getting the communications out on time. The pandemic exacerbated these issues, increasing the need for health plan companies to adopt automation strategies and solutions that unlock crucial efficiencies.
Tips to Alleviate ANOC/EOC Frustrations
While many organizations look to outsource ANOC and EOC workflow processes, it’s not always cost-effective. If you own the relationship with plan members, it’s in your best interests to have an internal team play a key role in updating important documentation. That way, if/when members have a concern or question, internal staff are prepared to handle issue resolution.
With that said, there are opportunities to reduce the errors and pain associated with these compliance documents. Here are a few of our top recommendations for you.
1. Identify CMS expert support
When dealing with Medicare plans, one thing is always constant: change. Hence, you may need to enlist an expert partner who knows how to analyze, document, consult and explain CMS model changes and updates. Ideally, the expert should act as an extension of your internal team and come with a deep understanding of your industry, your plans, and state/federal compliance.
At O’Neil, our product engineers, who possess deep expertise in Medicare and Medicaid, obtain ANOC and EOC model documents and identify changes made by CMS for each plan type. They also document and incorporate all changes into a CMS Release guide that is shared with our healthcare customers. They also make updates within ONEsuite, our platform that supports customers’ omnichannel communications preferences.
2. Store model documents in a cloud-based system
Having some form of a cloud-based repository or content management system eliminates the need to start ANOC or EOC documents year after year. Your content system should include a history of CMS model documents, plan designs, and benefits information, organized by year.
O’Neil’s ONEsuite platform can house all documents for you in one place. You can update them in real-time and as changes are rolled out, further reducing the stress of having multiple departments – marketing, compliance, pharmacy, customer service, etc. – and team members update and proof the documents.
With a platform like ONEcms, you can almost eliminate all manual processing and updates while also reducing costly errors. Other ONEsuite features include:
- Create and manage variable content
- Develop business rules to dictate content sharing across all channels
- Streamline template creation and use
- Tag and manage images within a content library
- Implement approval workflows to enhance documentation review and proofing
- Ensure content is styled to adhere to CMS requirements
3. Automate the process as much as possible
A state-of-the-art platform like ONEsuite should include customer profiles and data-driven templates that streamline ANOC and EOC communications updates as well as distribution and compliance requirements. High-level automation also empowers you to generate accurate documents weeks sooner than legacy manual systems ever could.
O’Neil works hard to ensure this complicated and demanding time of year is as stress-free as possible. Every year, our product engineers create the framework for the next year’s model documents within ONEsuite.
4. Plan ahead – for next year!
While you’re likely planning for this year’s ANOC and EOC communications, it’s never too early to be thinking about how you can make things easier for yourself in 2024 and beyond.
Carrying out federally mandated requirements for ANOC and EOC demands major time and attention. Achieving error-free compliance at a large scale isn’t impossible, but it’s very hard to do without the right teams and tools in place.
An automation platform can take a lot of this heavy lifting off your place. If it’s too late to consider a new system for this year, start engaging with providers who can meet all your content management and automation needs for the coming years. Making a shift now will reduce additional pressures during your pre-communications activities, while also giving your team something to look forward to when ANOC and EOC planning begins for the next cycle.
Contact O’Neil
The nation’s most reputable healthcare organizations rely on O’Neil’s expertise to communicate with and engage their healthcare members. ONEsuite, our data-driven CCM + CX platform provides the reliability, consistency, and security they need. ONEsuite has all the tools clients need to know their customers, communicate with them more effectively, and improve customer experience and satisfaction.
For more information, call 1-310-448-6400, email sales@oneildigitalsolutions.com, or visit www.oneildigitalsolutions.com.
