Note from Mike
Each quarter, I try to send out one of these CEO letters. Not only do I think it’s important for me to really break down my thoughts and excitement about current trends and opportunities, but I get a chance to shed the business layer and sit down as a person.
How can andros help rethink the way we all approach network adequacy? Why are we focused on getting payors to find more value in our platform? Is there a reason I’m excited about eating lukewarm pizza in dusty hotel rooms? And why is New York so happy despite the earth-scorching heat?
So, person-to-person, here’s what’s happening at andros lately.
We want to balance health equity at the individual level with our already-robust value pillars for payors.
Taking Network Adequacy to the Next Level
The term network “adequacy” has been top-of-mind for us this year. We all know that network adequacy standards for Medicaid Managed Care Organizations are important. They exist to empower members, dismantle healthcare barriers, and provide critical access to care for patients who deeply depend on the government for their healthcare needs.
But we can all do better.
We’re actually releasing an interesting whitepaper on adequacy here in the next month (I’ll email everyone when it goes live).
But, for now, we want to let you all know that we’re focused on these opportunities. The goal of andros has always been multifocal. We’re not just trying to broadly minimize pain points for payors and members. But our DNA is deeply rooted in using the power of our platform to drive benefits down to the level of the individual. Not only do we have the technology to do that at scale, but our development cycles and R&D iterations are hyper-focused on this larger theme of health equity.So, expect to see more about adequacy over the next year. From platform updates to messaging, this is a central theme for andros. We want to balance health equity at the individual level with our already-robust value pillars for payors. It doesn’t have to be one or the other. andros is focused on giving wins to everyone.
Our DNA is rooted in building better healthcare for everyone.
The Good, the Bad, and the Networks
Money is tight. As a company, the economic downturn isn’t necessarily threatening to us. Our platform is value-generating, so we find that smaller wallets often lead to higher adoption of our platform. It’s the final push some payors need.
But what about the average person? This is where things get complicated for us. We see amazing growth from the platform. But the average person is facing overwhelming challenges associated with health equity. It’s not a good feeling.
As I stated, our DNA is rooted in building better healthcare for everyone. So, despite the growth, our core mission is now more challenging. How do we help people in this new, potentially long-lasting, economic downturn access quality care? How do we balance this with ensuring that payors are profitable enough to consider tackling these challenges? And how can we balance our growth with our larger overall mission?
I don’t have all the answers.
We’ve leaned heavily into finding ways to use andros to bridge healthcare gaps. Technically, andros is already well-positioned as a leader in this space. But we really need to focus on finding ways to use our technology to empower the every-person. That’s, by far, our biggest goal for this quarter, next quarter, and well… every quarter.
For payors on our platform, we highly suggest leaning into andros’s capabilities. We have customers with near-national footprints that are able to manage their entire credentialing function with a single person, simply due to our platform’s innate capabilities.
andros does, by nature, cut costs and improve outcomes. In fact, we’re less worried about our messaging on this end. Not only do we think andros speaks for itself in this regard (the benefits come quickly), but simply finding value isn’t the biggest barrier we see on the payor end. We have many payors that are using us, but they aren’t fully exploiting the platform. So, they’re seeing cost savings, but not at the scale they could. That’s also front-of-mind for us this quarter. How do we help our existing customers really leverage andros in a way that squeezes every last drop of value from the platform?
We have some magic in the works. We’ll keep you updated.
Spending time discussing critical, controversial, and sometimes-awkward healthcare questions with peers is beyond refreshing.
Talking to People About What Matters Most
I’m finally starting to go back to in-person conferences somewhat regularly. And it’s awesome. While late-night pizza in a poorly-carpeted hotel room doesn’t necessarily sound fun, spending time discussing critical, controversial, and sometimes-awkward healthcare questions with peers is beyond refreshing. Plus, you get to sit down with people you’ve only met via the internet or through phone calls. It makes every conversation a little more real and a little more impactful.
My life is centered around healthcare access, networking, and all of these complex, downstream healthcare ecosystems. Frankly, I haven’t gotten enough time to really talk about these things on a deep level in a community capacity over the past two years.
As an example, I recently attended AHIP’s annual conference in Las Vegas. People there were discussing extremely important topics like race and healthcare outcomes, social vulnerability, and health equity in the context of provider networks and access. These are bold, complex conversations.
Getting to open up with people who also make this their life is huge for me. Lots of us are getting exposed to some of the bigger-picture issues. I’m extremely excited that the industry is going in a direction that’s willing to explore, discuss, and solve some of these complicated problems that have plagued us for (quite literally) centuries.
Are you attending any interesting conferences this year? Shoot me an email! I’m always looking to meet new people and explore new topics in healthcare.
I’m so work-focused that spending quality time with myself is rarely top-of-mind. It’s something we could probably all do better.”
Skydiving, Racing, Illusive Artists
I always try to uncover some truths about myself in these CEO letters. Software companies aren’t just technology; they’re powered by beautiful, wonderful people. And this person has been busy.
After putting it off for years (there’s a deeper reason here I’m sure), I’ve finally started skydiving classes. I love it! I get to learn from these awesome people who have been doing this for years. Coming in as a total novice at something isn’t always easy. I may be a CEO at andros, but at these lessons, I’m a grown man frozen by adrenaline next to a master skydiving instructor that’s gently telling me to just “jump.” The CEO skin sheds fast. Here, I’m just another person trying to figure it out.
I’ve also been watching some Tour de France (I’m a huge Peter Sagan fan). And, of course, riding my bike around the hot brick streets of New York. It’s been a very freeing summer in New York. Despite the face-melting heat, the restriction-free nature of this summer has brought fresh new life into the city.
This new life has led to some pretty amazing events happening. I recently visited a Banksy art show with some family that flew in from London. And I’ve been relishing the sun-ripened vegetables in my garden — which had a fantastic season.
All-in-all, it’s been a great summer. And I sincerely hope that all of you had a wonderful time, despite the heat. It’s important to take “you” time. I’m sometimes so work-focused that spending quality time with myself is rarely top-of-mind. But it’s something we could all probably do better at.
More To Explore
From Direct Contracting Model to ACO REACH: Navigating the Continued Evolution of Value-Based Care in Traditional Medicare
With a speedy makeover for the Global and Professional Direct Contracting Model, CMS is making sure to incorporate lessons learned from previous value-based care programs. The revamped ACO REACH initiative aims to make it easier and more rewarding to embrace value-driven principles in traditional Medicare. Introduction Ever since the Affordable Care Act (ACA) became the
Delegated Credentialing: Easing the pain of credentialing your providers Credentialing in house can be painful for health plans and other types of payors, adding the time and administrative stress of continually tracking and updating new providers, locations, and information. It can be burdensome for provider organizations too, submitting new documents with each provider, location and
andros Summer MVPs
Each quarter we acknowledge the team members who went above and beyond in their role and who exemplified the andros values. All MVP winners are nominated by their peers or manager and the People Team identifies the MVPs (and some honorable mentions!) for the quarter based on these nominations. We love this opportunity to recognize our team members and celebrate their significant contributions to the organization. Our people are the heart of andros.
Mary is a lead engineer working on key product features/deliverables for our clients. The high level of ownership Mary demonstrates on the Core Cred Apps development team is impressive and incredibly appreciated. She is a great mentor and leader and drives the delivery of numerous high value initiatives. Mary goes above and beyond her responsibilities to make sure the team is moving forward in a positive way. Simply put, we’re a much better team with her!
When she’s not working, she’s probably knitting a sweater for someone, but only for knit-worthy people.
People who will not even think about a washing machine while wearing a handmade garment.
Manager of Network Development
Cathy is the single most helpful person to deal with day-to-day. She is incredibly knowledgeable and always willing to help. Cathy’s contributions are instrumental in maintaining a strong Network Development team. She goes above and beyond to ensure the team is successful. Cathy is always hopping into calls to provide assistance and share her wide breadth of knowledge.
In her free time, you can find Cathy in the decked out gym in her garage.
Max stepped into an accounting leadership role for the team, running the close, managing revenue recognition, and leading us through our first full audit. On top of that, he hasn’t dropped any of the previous work he was responsible for, getting his CPA license in just 6 months! Max is absolutely an MVP!
In his free time, Max likes to produce and post music on Spotify & collaborate with DJs using a secret alter ego. Good luck getting him to share his work!
We are super impressed by Anna in her time working here. She demonstrates maturity and poise as she maintains our visual brand in addition to stepping up to support the team in our hour of need.
She has dedicated substantial time in areas outside her comfort zone to learn concepts and marketing tactics to help keep our Marketing initiatives on track. It’s been absolutely amazing to watch her flourish and grow.
When Anna isn’t on the clock, you will probably find her at a baseball game or on the water somewhere in the mountains.
More To Explore
From network development and staffing shortages to managing relationships in an increasingly digital world, health plans have a lot on their plates in 2022. How can leaders effectively navigate this difficult environment while continuing to provide exceptional services to members? Introduction Since the beginning of this tumultuous decade, health plans have been confronted
Board of Directors Investor Portal The lesser-known process affecting healthcare quality: Credentialing By Mark Hirschhorn Over the last two years, we’ve gained more insight into the inner workings—and over-burdening—of the healthcare system than ever before. However, most people are still unaware of how much time-intensive administrative work is involved in the healthcare they receive. This
Please use the following link for the FY ’21 Audited Financial Statements.
What Does CMS’ Final Rule for 2023 Mean for You?
In late April 2022, CMS announced the changes to the Medicare Advantage (MA) program for 2023, and the implications for health care organizations submitting provider networks for approval for plan year 2024 are major, to say the least. If, like most, your organization finds itself scrambling to complete your network build before the June submission deadline, you’re not going to be thrilled. Timelines got a lot tighter.
Gone are the days when you could submit renewal or expansion applications in February knowing you had more than three months to contract providers for formal submissions of bids in early June.
To ensure that Medicare beneficiaries have sufficient access to care, “CMS is requiring that MA applicants demonstrate they have a sufficient network of contracted providers to care for beneficiaries before CMS will approve an application for a new or expanded MA contract.” Gone are the days when you could submit renewal or expansion applications in February knowing you had more than three months to contract providers for formal submissions of bids in early June. Starting with CY 2024, you have to apply and submit provider networks at the same time–in February. The silver lining, albeit a small one, is that CMS will accept letters of intent (LOIs) from providers in lieu of signed contracts, giving you extra time (until the end of 2023) to get provider and facility contracts signed.
If you’re just finishing your CY 2023 MA networks (as is probably the case), you’ve got just over eight months to get your CY 2024 networks built.
As in eight months to:
- Conduct market assessments
Make your go/no go decisions
Recruit providers and facilities
Get LOIs signed
You might think that means you’ve got to cancel your vacation plans, but there are some options you may not have considered
Scale Up Your Capacity with andros
andros scales up your team’s capacity to build compliant provider networks in new markets—while reducing your administrative costs—using our optimized process and powerful technology. Drawing on the 7.4 million provider profiles in the a* Platform, the healthcare industry’s largest provider database, andros can help you quickly assess markets for initial build and expansion networks, then leverage our fastest-path-to-adequacy network modeling approach to allow you to make quick decisions on whether you can build your network to adequacy. That way you retain strategic flexibility to either build or pivot, reducing the risk of wasted time and resources.
Consider Subscription-Model MA Network Management
Leverage andros to recruit providers and get signed LOIs for your CY 2024
Leverage External Contracting and Credentialing Resources
The one area where this rule change benefits health plans building MA networks is the extended window of time for contracting. If you have the capacity to assess
markets and build the MA networks you’re targeting for CY 2024 in-house, you’re actually in great shape–because most of the competition will be scrambling. One way to make sure you maintain and build on that advantage is by leveraging andros capabilities to contract and credential networks. Make your submission in February 2023 with signed LOIs, knowing that andros can use its workflow- optimized recruiting process to deliver signed contracts for credentialed providers (and facilities) in time for CY 2024.
With experience building and credentialing networks in all 50 states and in 67% of counties containing 92% of the population of the US, andros has the technology, experience, and scale to ensure you handle the rapid transition to CY 2024 MA builds smoothly and successfully.
More To Explore
Innovation is no longer optional for established health payers and digital native startups. Without revamping inefficient processes, payers risk falling behind in the race for provider participating providers and market share.Here are the first steps payers can take on the path toward sustainable, successful innovation. Introduction The health plan marketplace is evolving quickly
New York, February 1, 2022—andros, the leading technology solution for healthcare provider network management, announced today that Adam Hameed has joined andros as its new Chief Growth Officer. Hameed has over 30 years of experience driving revenue, 20 years of which have been spent in commercial leadership roles for healthcare organizations. He previously worked for