As the CBA enters our 10th Anniversary year, we continue to engage with our members on ways to further protect their Catholic health plan experience. Our initial effort was to identify the areas within the Summary Plan Description (SPD) language requiring updates to best reflect our protections.
However, this resulted in something unexpected. An opportunity to improve Catholic Identity and reduce risk to our members through stronger translation between insurance language and our faith.
In addition to CBA protection compliance, we identified the following issues that needed to be addressed withing our member health plans and took the lead in shaping change:
Covered services that conflict with our Catholic teachings.
Confusing language causing benefit loopholes and future risk.
Silent benefits or exclusions not being administered to the member’s intent.
A wealth of opportunity to improve Catholic identity.
These findings demand a new approach to how we evaluate our health plans and a growing sense of urgency and responsibility in addressing these findings timely.
Here is how the CBA has worked to address these and many more plan related issues.
Breaking through the Status Quo
In response, the CBA created a formal review process and Moral Compliance Scoring model. These processes analyze Catholic health plans in a way not being conducted today. Much like a Health Risk Assessment is conducted by employees to determine their initial health score, our Moral Compliance Score reviews health plans through a Catholic lens and helps to identify plan language, benefits, and exclusions which should be addressed.
The Moral Compliance Score leads to a structured conversation with our membership leaders and their business partners on the findings, educates on the possible improvements and addresses potential risks associated with the plan language as it exists today.
The Results Demonstrate Room for Improvement
Our Moral Compliance Score model has identified a clear opportunity for improving the Catholic health plan experience within today’s insurance plans. We will demonstrate below how plans today are scoring.
Our scoring model is based on the best possible score of a 100%.
The average Moral Compliance Score for all organizations achieve between 68% – 75%. Below are some examples of how particular group types have scored in this process.
73% – Diocese
56% – Catholic Charities
71% – Catholic For-Profit Business
64% – Other Catholic Ministries
Our highest scoring organizations had an initial average score of 86-89% and were achieved by and Catholic owned for-profit business space.
Has anyone achieved 100%?
Yes. Through our efforts in building the CBA Genesis Healthcare Program from inside an insurer, we have Catholic diocese and ministries who have achieved 100%.
What are groups achieving higher scores doing differently?
Groups with a higher-than-average Moral Compliance Score have applied adequate resources, built-in detailed project steps addressing their plan with intent, and added specific emphasis on ensuring their plans do not cover services that conflict with the teachings of the Catholic church. Next, they have taken necessary action to ensure their CBA protections are thoroughly embedded within their plans.
Leadership within these organizations expressed the daunting journey and history of plan language engagement projects and updates to secure the necessary changes which as a result reflect their higher score. Their persistence and engagement in these projects were the difference maker.
While these efforts are certainly admirable, CBA began to ask – how do we make these processes easier for our members?
It should not have to be this hard!
CBA’s first response was to work with our membership in the development of tools and resources that would help in easing the burdens of adding yet another project. One immediate step was to work with a plan review participant in building an easy-to-use Action Plan document that can be used to adopt, change, and track all our findings and recommendations in the form of a project management tool. This document is now included as part of our review process.
However, not all review participants had time to engage in this process due to other priorities within their organization. While this is certainly understandable, prolonging engagement in this type of activity, especially in today’s legal, political, and cultural environment, can have negative consequences.
In fact, one example has led to difficult discussions and possible legal challenges for one employer that may prove costly.
CBA again asked – how we can help?
Full-service solutions available in 2023
The CBA has expanded its Healthcare Benefits Consultative Services to include a full-service Catholic Consultant option dedicated to securing the CBA protections, eliminating faith-related benefit risks, and translating our faith into insurance language and faith-based benefits which improve a Catholic health plan experience.
The addition of our consulting expertise allows our member organizations to address these complex and urgent issues without having to take on yet another large and timely project. We have simplified this process and speak the same language as your insurance provider and consultants, while speaking fully Catholic.
Supporting a Catholic healthcare experience
We believe that we all have a responsibility to commitment to a detailed approach in helping to sustain Catholic healthcare into the future. This means moving beyond the typical acceptance of the insurance industry standards and accommodations to our faith related benefits and exemptions. We aim to eliminate these boundaries and bring a stronger Catholic experience to our membership.
Our formula is simple: Protect Understand Secure Test Form Direct
Protect – You and your carrier/TPA are protected by our CBA Protections
Understand – Through our medical review and moral compliance score help our membership and their business partners in understanding where within their plan to galvanize the language and services in support of a stronger Catholic experience.
Secure – CBA then works with you directly in securing CBA protections and adopted changes into their plans.
Test – CBA audits how claims are paid or denied according to the newly adopted changes.
Form – Help to form leaders and plan participants around Catholic identity and mission compliance within a plan and a Catholic health experience ensures a stronger, more sustainable faith-based health plan into the future.
Direct – Sharing and promoting local and national Catholic health providers of service driving a stronger Catholic experience and promoting the goal of sustaining Catholic healthcare into the future.
Our consultative approach is focused on addressing each of these areas through a commitment to building a new Catholic standard and experience for future generations. In today’s legal, political, and cultural environment it is critical to engage in the fortification of our Catholic health plan experience. This includes helping our business partners in understanding what that new model looks like.
Catholic Tools for Further Protection
CBA’s vision of the future is to innovate new Catholic solutions to move away from yesterday’s status quo and to build an experience that is more suited for the challenges of today. A part of meeting these challenges is to understand fully where the gaps are and the dangers they present. To help our membership, we have developed case studies demonstrating these dangers.
To learn more about these case studies and the many Catholic tools we’ve built to meet these challenges head on, please contact Jason Coon, Vice President of Healthcare Benefits Consultative Services today.
As the CBA enters our 10th Anniversary year, we continue to engage with our members on ways to further protect their Catholic health plan experience. Our initial effort was to identify the areas within the Summary Plan Description (SPD) language requiring updates to best reflect our protections.
However, this resulted in something unexpected. An opportunity to improve Catholic Identity and reduce risk to our members through stronger translation between insurance language and our faith.
In addition to CBA protection compliance, we identified the following issues that needed to be addressed withing our member health plans and took the lead in shaping change:
These findings demand a new approach to how we evaluate our health plans and a growing sense of urgency and responsibility in addressing these findings timely.
Here is how the CBA has worked to address these and many more plan related issues.
Breaking through the Status Quo
In response, the CBA created a formal review process and Moral Compliance Scoring model. These processes analyze Catholic health plans in a way not being conducted today. Much like a Health Risk Assessment is conducted by employees to determine their initial health score, our Moral Compliance Score reviews health plans through a Catholic lens and helps to identify plan language, benefits, and exclusions which should be addressed.
The Moral Compliance Score leads to a structured conversation with our membership leaders and their business partners on the findings, educates on the possible improvements and addresses potential risks associated with the plan language as it exists today.
The Results Demonstrate Room for Improvement
Our Moral Compliance Score model has identified a clear opportunity for improving the Catholic health plan experience within today’s insurance plans. We will demonstrate below how plans today are scoring.
Our scoring model is based on the best possible score of a 100%.
The average Moral Compliance Score for all organizations achieve between 68% – 75%. Below are some examples of how particular group types have scored in this process.
Our highest scoring organizations had an initial average score of 86-89% and were achieved by and Catholic owned for-profit business space.
Has anyone achieved 100%?
Yes. Through our efforts in building the CBA Genesis Healthcare Program from inside an insurer, we have Catholic diocese and ministries who have achieved 100%.
What are groups achieving higher scores doing differently?
Groups with a higher-than-average Moral Compliance Score have applied adequate resources, built-in detailed project steps addressing their plan with intent, and added specific emphasis on ensuring their plans do not cover services that conflict with the teachings of the Catholic church. Next, they have taken necessary action to ensure their CBA protections are thoroughly embedded within their plans.
Leadership within these organizations expressed the daunting journey and history of plan language engagement projects and updates to secure the necessary changes which as a result reflect their higher score. Their persistence and engagement in these projects were the difference maker.
While these efforts are certainly admirable, CBA began to ask – how do we make these processes easier for our members?
It should not have to be this hard!
CBA’s first response was to work with our membership in the development of tools and resources that would help in easing the burdens of adding yet another project. One immediate step was to work with a plan review participant in building an easy-to-use Action Plan document that can be used to adopt, change, and track all our findings and recommendations in the form of a project management tool. This document is now included as part of our review process.
However, not all review participants had time to engage in this process due to other priorities within their organization. While this is certainly understandable, prolonging engagement in this type of activity, especially in today’s legal, political, and cultural environment, can have negative consequences.
In fact, one example has led to difficult discussions and possible legal challenges for one employer that may prove costly.
CBA again asked – how we can help?
Full-service solutions available in 2023
The CBA has expanded its Healthcare Benefits Consultative Services to include a full-service Catholic Consultant option dedicated to securing the CBA protections, eliminating faith-related benefit risks, and translating our faith into insurance language and faith-based benefits which improve a Catholic health plan experience.
The addition of our consulting expertise allows our member organizations to address these complex and urgent issues without having to take on yet another large and timely project. We have simplified this process and speak the same language as your insurance provider and consultants, while speaking fully Catholic.
Supporting a Catholic healthcare experience
We believe that we all have a responsibility to commitment to a detailed approach in helping to sustain Catholic healthcare into the future. This means moving beyond the typical acceptance of the insurance industry standards and accommodations to our faith related benefits and exemptions. We aim to eliminate these boundaries and bring a stronger Catholic experience to our membership.
Our formula is simple:
Protect Understand Secure Test Form Direct
Our consultative approach is focused on addressing each of these areas through a commitment to building a new Catholic standard and experience for future generations. In today’s legal, political, and cultural environment it is critical to engage in the fortification of our Catholic health plan experience. This includes helping our business partners in understanding what that new model looks like.
Catholic Tools for Further Protection
CBA’s vision of the future is to innovate new Catholic solutions to move away from yesterday’s status quo and to build an experience that is more suited for the challenges of today. A part of meeting these challenges is to understand fully where the gaps are and the dangers they present. To help our membership, we have developed case studies demonstrating these dangers.
To learn more about these case studies and the many Catholic tools we’ve built to meet these challenges head on, please contact Jason Coon, Vice President of Healthcare Benefits Consultative Services today.