Membership Management: Unlocking the Value of Automation

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Membership data poses a significant challenge to operational excellence for pharmaceutical and medical device manufacturers. Because membership data is the foundation of contract management, many of the challenges focus on the manual nature of customer information that manufactures receive on an ongoing basis. The challenges include:

  • Data volumes – The average membership data volume received is in the hundreds of thousands; which is primarily managed by manufacturers through Microsoft Excel spreadsheets or other manual processes.
  • Class of Trade (COT) assignments – The manufacturer has the burden to validate and maintain the accuracy of COT, which can cause potential compliance risks and loss of revenue if not managed accurately. This can slow down an already painful, manual process.
  • Data validation – Numerous third-party data sources can make it difficult to validate membership information in a timely manner. These lists can also become out of date.
  • Regulations – Legislation around class of trade assignment and verification are constantly shifting.

Maintaining master information

More often than not, data quality plays a large role in maintaining customer master information.  It is difficult to maintain customer information when it comes to third-party reference data if identifiers become inactive, renewed, or retired. Identifiers may also appear invalid due to manual human errors or misinterpretation. Lack of maintenance can cause duplicate entries over time. Duplicate entries can drastically increase the size of the customer’s database, adding to the struggle to sustain data volumes. Reference data sources, membership rosters and customer lists can have contrasting customer classifications for the same entry, making it difficult to understand which entry is valid.

Streamlining the processes by automating membership management can help manufacturers avoid many of the organizational challenges, while also becoming more efficient by focusing resources on what’s important in managing customer information. Automation can compile and consolidate reference data and multiple membership data lists to provide benefits to tackle the challenges mentioned earlier.

The value in automation comes from:

Efficiency

Resources can focus on what’s important by prioritizing issues and data challenges and allowing an automated solution to provide proficiency in processing rosters, especially with contract operations. Consistent output is also achieved so that one uniform approach is used to analyze the outcomes.

Data governance 

Cleansing membership datasets via automation by assigning rules around data entries, sources of data, and data usage can help maintain organized, aggregate datasets that have unique and meaningful elements for the customer.

Agility

Allow for agility in adjusting to the ever-changing world of membership by automatically performing normal maintenance on customer masters through proactive membership addition/expiration, COT assignments, change of membership, and 340B Program validation.  Automation also allows for multiple third-party reference data sources to integrate into a singular system or process for validation.

Avoid revenue leakage

Addressing such things as discrepancies in having the same customer on multiple rosters or incorrect COT assignments, can help avoid loss of revenue through double dipping and incorrect discounts. With an automated process, red flags like these are caught earlier.

The goal is to construct a process that fits into the organization’s revenue management process, customer and contract portfolio. By using an automated approach to membership management, there is less time spent reactively manipulating and organizing datasets, and more time proactively managing the business relationship with group purchasing organizations and wholesalers for a more seamless approach to contract management.  

Tags: data quality, data governance, revenue cycle management, revenue leakage, agility, data validation

  

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