Case Study Q&A Video: SummaCare & HealthEdge Source Partnership
About SummaCare
SummaCare Health Plan, based in Akron, Ohio, is a provider-owned health plan with around 62,000 members. Since the early 1990s, SummaCare has been dedicated to serving its local community by offering a range of business lines, including Medicare Advantage, self-funded, and fully insured plans.
Customer-Centric Digital Transformation
To evolve into a digital health plan, SummaCare focuses on understanding the needs of its customers, including members, brokers, and employers. By consistently measuring and acting on customer feedback, SummaCare adapts to the increasing demand for digital connectivity. This includes ensuring mobile readiness and providing easy access to essential information, such as ID cards, plan documents, and service cost details.
Innovative Member Experience Initiatives
SummaCare has established a member experience council that actively engages with members through advisory boards and broker collaborations. The goal is to refine their offerings based on direct feedback. As a small health plan, SummaCare can closely connect with its members, ensuring prompt attention to the most critical issues.
Competitive Market Positioning
In Summit County, Ohio, where the Medicare Advantage market is highly competitive, SummaCare excels by educating and guiding members through numerous plan choices. Competing with national players, SummaCare leverages its local expertise to stand out.
Partnership with HealthEdge Source
Since 2009, SummaCare has partnered with HealthEdge Source to manage Medicare Advantage employer groups with members nationwide. By transitioning to the latest version of Source, SummaCare has streamlined its operations, reducing redundancy and consolidating pricing and editing into a single platform. This One-Stop-Shop approach has enhanced vendor management and issue resolution efficiency.
Operational Efficiency and Transparency
SummaCare has centralized its configuration and finance teams under one umbrella, improving product understanding and edit management. This integration allows the claims team and others to efficiently investigate issues. Additionally, edits are now visible in the provider portal, reducing phone calls and emails, and streamlining operations.
Member Engagement and Social Media Strategy
SummaCare has significantly developed its social media presence over the past few years. Engaging with members on platforms like Facebook and Instagram allows SummaCare to gather valuable feedback and adapt their strategies accordingly. This continuous dialogue with members and brokers ensures that SummaCare remains aligned with their needs and preferences.
Future-Proofing with Source
SummaCare values its long-term partnership with Source, which provides invaluable data reference capabilities. This relationship enables SummaCare to model contracts and reimbursements effectively, ensuring a future-proof approach to their operations.
