Strategy-driven growth: a Florida health plan employs a host of process changes and IT improvements to redirect its growth to a small business market.
Author: Health Management Technology

"Qualified lead" is a phrase most often whispered at healthcare IT trade shows. It is what every vendor in every exhibit hall across America wants from the flow and ebb of conference attendee traffic through the exhibit hall.

Pivotal Corp., based in Vancouver, Canada, gained more than a qualified lead at the 2004 America's Health Insurance Plans conference. It gained a customer and, it hopes, a developing and long-term relationship with a Florida-based health plan out to reinvent itself with diversified business growth.

AvMed Health Plans is Florida's largest not-for-profit health plan with offices in Miami, Tampa, Gainesville, Fort Lauderdale, Jacksonville and Orlando. For more than 20 years, AvMed was essentially an HMO serving a small Medicare and larger commercially-insured Florida population, totaling about 200,000 members. But times changed. HMOs are no longer a strong or utilitarian enough model to serve as the sole foundation of an enterprise's product line. ArMed management knew that.

Not long ago, senior executives at AvMed concluded that the company required a wider suite of products to keep pace with the burgeoning rise of double-digit cost increases, the consumer-directed health plan movement and demonstrated consumer preference for more control and flexibility within provider networks. In short order, it designed and brought to market numerous products, all of them featuring more open access to providers, more consumer flexibility and strong medical management capability operating in the background.