CMCS Connections

1 C M C S c o n n e c t i o n s 3 r d q u a r t e r 2 0 1 5 By Nathan Hueber T wenty years ago most adults started their day with a strong cup of coffee and the morning newspaper at the breakfast table. Fast forward to the present day where we drink our coffee on our way to work and read the news on our smart phones. My how times have changed! In the healthcare industry, rapid sweeping changes are happening in response to the Affordable Care Act and the demands of regulators and employers. Unlike newspaper publishers, the healthcare industry doesn't have 20 years to adjust, and what worked in the past may not work in the future. So it goes for CMCS, a Third Party Administrator (TPA) that has been able to successfully adapt in spite of the continuing rapid changes in the healthcare industry. Recently, I had the opportunity to sit down w i t h C M C S E x e c u t i v e D i re c t o r Thomas Klages to discuss changes in the healthcare industry and get his insights on what the future may look like for CMCS. One of the keys to a successful future for CMCS, Klages shared, is CMCS' ability to be flexible and create solution-driven services to meet clients' needs. In the past, TPA's like CMCS have provided a full complement of services to most clients. More recently, healthcare organizations require services more tailored to their individual needs, rather than blanket wide services. This is where flexibility comes in. CMCS offers an "a la carte" approach, allowing clients to pick and choose which services best fit their needs. A variety of traditional TPA services are available such as claims processing, repricing, and s u b r o g a t i o n . C M C S a l s o b r i n g s unique services like population health management, data analytics w i t h c u s t o m i z e d r e p o r t i n g , Electronic Funds Transfers and Electronic Remittance Advice (EFT/ ERA), as well as quality and medical management services. By catering to their clients' explicit needs, CMCS earns the opportunity to prove their value and effectiveness to both old and new clientele. The other key to moving forward as a company, says Tom, is constantly e v a l u a t i n g o u r p r a c t i c e s , a n d optimizing how we work. "We need to keep demonstrating our worth if we want to keep going on this upward trend." This means asking: "Is there a better way to do this, does the data prove our strategy is effective, or does this step add value to the work product?" Not only is CMCS trying to improve work processes and outcomes; they are also trying to help clients alleviate pain points and operate more effectively. This constant self-evaluation and self- improvement for both clients and internal processes will be what allows CMCS to adapt to the changes in healthcare and continue to be successful in the healthcare industry in the long term. Fo r a d d i t i o n a l i n f o r m a t i o n a b o u t s e r v i c e s a v a i l a b l e f r o m CMCS, please contact Brian Lake at blake@cmcs-indy.com. 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 The Key to Success for CMCS Connections 3 r d 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. Tom Klages, Executive Director

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