CMCS Connections

1 C M C S c o n n e c t i o n s 1 s t q u a r t e r 2 0 1 5 by Linda Grosser T om Klages, the Executive Director for Cooperative M a n a g e d C a r e S e r v i c e s (CMCS), kicked off the company annual meeting in mid-January with a recap of last year's challenges and accomplishments. 2014 was a busy year with many positive experiences and opportunities to respond to industry changes. D e p a r t m e n t H i g h l i g h t s K l a g e s o u t l i n e d t h e 2 0 1 4 highlights from the various CMCS departments, including: • T h e M e d i c a l M a n a g e m e n t D e p a r t m e n t underwent reorganization to be better positioned to support our clientele. • T h e I n f o r m a t i o n M a n a g e m e n t D e p a r t m e n t successfully completed three new program implementations and has a new emphasis on quality improvement. • The Disease Management program used the MEDai clinical data analytics and other data to report member outcomes. • The Quality Department implemented some innovative pilot programs, including the OB navigator. • The Claims Department expanded their staff to meet the needs of several new lines of business and to gear up for Medicare claims processing. • The Business Analysts took on advanced responsibilities as they supported multiple complex projects for CMCS and our customers. • Government Services worked to implement Medicare claims processing and added Compliance and HIPAA responsibilities. • The Benefits Team experienced a lot of changes in benefit plan designs. • The Marketing and Self- funded programs added some new business as they worked diligently to support current customers. • All departments were challenged as resources were allocated toward support for new business implementation. Overall, we survived and are better positioned to meet the operational a n d i n d u s t r y c h a l l e n g e s o f t h e coming year. C O m p a n y G o a l s I n a d d i t i o n t o t h e c o m p a n y h i g h l i g h t s o f 2 0 1 4 , K l a g e s identified four company goals for the upcoming year: 1. Operational Efficiencies will be needed to effectively respond to company growth and more covered lives. 2. Business Development will be a priority as CMCS looks for new ways to fit into the ever-changing healthcare landscape and support our owner organizations. 3. Partnering with Advantage Health Solutions will lead to more synergies for both companies and improved service for our mutual customers. 4. An emphasis on Quality and Service Improvement will make a huge difference in promoting customer satisfaction as we strive to provide services recognized as the best that any company can offer. A s t h e b u s i n e s s o f h e a l t h c a r e changes, so will the business of C M C S . K l a g e s c h a l l e n g e d o u r staff of 140 employees to meet the coming changes in a positive f a s h i o n b y c o n t i n u a l l y s t r i v i n g for improved service and quality, and by forging relationships that uphold CMCS as the place where our clients know they can expect the best. c o o p e r a t i v e m a n a g e d c a r e s e r v i c e s c o n n e c t i o n s n e w s m a g a z i n e A Recap of 2014 and 2015 Goals for CMCS Connections 1 s t q u a r t e r 2 0 1 5 SCAN ME! To teleport instantly to our website, simply scan this glyph with any QR code reader. The CMCS Newsletter is edited by Linda Grosser and Andy Fry.

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