 As you will read about in a later section, significant efforts were taken in 2023 to review, organize, and standardize all review workflows, peer reviewer worksheets, final reports, and conflict of interest forms to reduce duplication and complexity. This was done in preparation to transition from home-grown spreadsheets and databases to a technology partner, Salesforce. Salesforce allows for a more contemporary approach, supports the desire for growth, and lets us have dedicated and state-of-the-art client and peer reviewer portals. Related to growth, you may be wondering what happened to the potential large volume of reviews from a multi-state health plan. In early 2023 we entered into an agreement to perform medical record reviews for the purpose of rendering an advisory opinion regarding the medical necessity of treatment requested/rendered and to perform external review services as an independent review organization for their self-funded group health plans. Many of you graciously offered your expertise and time with pursuing this work. However, as we know in healthcare, things change.
This particular health plan started a more collaborative process with their provider owner, which allowed them to insource the medical review process. While disappointing for us, it is excellent for their health system, providers, and members to embrace a collaborative process for the right care at the right time. This experience allowed us to strengthen our infrastructure for the next opportunity and to actively market our services to health plans and self-funded plans. Significant efforts have also been made to update our brand. We implemented a new logo for the first time in more than 20 years, expanded our conference participation, increased social media presence, and re-established relationships with key industry stakeholders. As we look forward to 2024, we are focused on completing implementation and optimizing Salesforce, achieving URAC re-accreditation, and focusing on growth through deployment of a client retention plan and targeted marketing efforts. How can you help?
Congratulations on a successful year – your efforts have made a significant impact on the appropriateness, cost effectiveness, and quality of patient care and outcomes. Never hesitate to reach out to me directly at [email protected] – I’d love to hear from you! |
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