Membership Management

Enrollment/Disenrollment

Today's disenrollment, tomorrow's lost revenue! Clearly then, staying on top of membership trends as they unfold is a key requirement for your membership management solution. The Diver Solution™ is easily able to do this, integrating multiple data sources if necessary to provide an up-to-date view of membership trends as frequently as required. Will PPO's continue to expand their membership at the expense of HMO plans? As for the impact of Consumer-Directed Plans, will CDP's force MCO's to change their product and services, or will CDP's turn out to be a fad and simply fade away? You could know sooner than anyone - if you have the right management tools, such as Diver.

Enrollment/Disenrollment

Use reports and analyses from Diver to:

  • Track trends in membership by integrating your data sources.
  • Easily generate reports on new members, disenrollment by reason, or by primary care group.
  • See total membership by month, by membership segmentation.
  • Discover which members visit which primary care physicians.

Demographics

Do you know which segment of your membership is the most profitable? Or, which members have the highest primary care utilization - and why? And, how could you adjust benefit levels to maintain overall profitability if drug costs continue to grow at double digit rates?

Demographics






The Diver Solution™ can provide all this and more. By providing deep, sophisticated analysis of integrated data, monitoring membership demographics naturally leads into market segmentation. And segmentation allows you to focus more on the specific needs of different members, tailoring services to increase member satisfaction, quality of care and ultimately, profitability.