Unlike rivals like Aetna, Anthem, UnitedHealth Group and Humana, Centene is expanding into new markets and has been able to successfully manage the costs of sick uninsured Americans buying individual policies on the ACA’s public exchanges. Centene had nearly 1.1 million customers enrolled in plans purchased on the ACA’s marketplaces as of June 30 compared to 617,700 at the same time last year and is expanding into several new states.
Michael Neidorff, chairman and chief executive officer of Centene Corp., center, and Bernard Tyson, chief executive officer of Kaiser Permanente, left, wait to go through security near the White House in Washington, D.C., U.S., on Wednesday, Oct. 23, 2013. (Photo: Andrew Harrer/Bloomberg)
In Fidelis, Centene will buy an established player in New York’s Obamacare, Medicaid and Medicare Advantage markets . Fidelis had more than 1.6 million health plan members as of June 30 and nearly $5 billion in revenue for the first half of this year, the companies said.
The deal will turn Centene into a larger national player with $60 billion in annual revenue by next year assuming Centene's acquisition of the nonprofit insurer's assets closes Jan. 1, 2018. New York is the nation's second-largest managed-care market.
"Centene's and Fidelis Care's missions are fully aligned in terms of promoting health through high quality, accessible care and services for all and advocating for health policy that accords true dignity and respect for all people, especially the underserved," Niedorff said in a statement. "Through this transaction we can further enhance the well-being of Fidelis Care's members and continue to build linkages and systems for the coordination of care and services among healthcare, behavioral and social services while doing so at an appropriate level of cost." Marriott International, facing devastation from Hurricane Irma that stranded more than 600 of its hotel guests on St. Thomas, chartered a 177 foot, 30,000-ton ship from the Dominican Republic at a cost of $100,000 on September 7, and began coordinating with local authorities representing multiple government entities for permission for the ship to land and evacuate as many of these guests as possible.
In the face of hurtles related to weather, timing, and logistics, the viability of the rescue operation remained touch and go as the clock ticked down. But ultimately, as night fell on Friday, September 8, the ship was able to leave and take all 620 guests to safe harbor in Puerto Rico, where they were provided with accommodations at other Marriott properties at no charge, as well as money for food and vouchers for airfare.
Tim Sheldon, President of the Caribbean and Latin America for Marriott International, helmed the operation from his command center in Orlando, in coordination with a mainland-based Marriott crisis team. He describes a sequence of challenging events that could overwhelm almost any business entity striving to protect and care for its customers under such crisis conditions.
Micah Solomon: First of all, was it always a “given” for you as a company that you were going to take care of these guests in their hour of peril? I’ve read the disclaimer on the door of my hotel room a time or two, and I don’t recall that dramatic high-seas rescue coverage was part of that contract.
Tim Sheldon, President of the Caribbean and Latin America for Marriot International. There was zero debate here on this point. Taking care of people is central to our corporate ethos, and it’s what we do as a hospitality company, both day to day and in times of peril, including in previous storms: Cancun (Wilma) and New Orleans (Katrina) among others.
Solomon: What were the first steps you took when it became likely that your guests on St. Thomas were at risk?
Sheldon: As soon as it was clear that Hurricane Irma was heading toward the islands, we followed protocols we have in place to prepare for potential, severe storms.
The first step was to reduce the occupancy levels as much as possible via regularly departing vessels and planes from the island, in advance of the storm.
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Solomon: Was this successful?
Sheldon: Only partially, but quickly, the airport closed and regular ship transportation on St. Thomas dropped off, making our options extremely limited. At this point, 620 guests remained across three of our hotels on St. Thomas.
Solomon: Could these guests have “sheltered in place”?
Sheldon: There were two basic problems with this. First the hotels seemed to have sustained enough damage from Irma to make us concerned that Hurricane Jose, which was coming next, could further and more dangerously damage them. Furthermore, we weren’t sure we could supply and resupply the guests if they stayed.
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Solomon: So, it being clear to you that you had to get more than 600 people out, what were your next steps?
Sheldon: Operations and security teams evaluated any reasonable idea we could find for evacuating guests – including military planes, helicopters and boats.
The solution we came up with, on September 7, was to commission a ferry [the MV Kydon, a 30,000 ton, passenger/cargo ship 177 meters in length] to depart from the Dominican Republic, go on to Puerto Rico, and then depart from there on Friday, September 8 to collect our guests.
Solomon: Once you had the ship hired, did this rescue operation go essentially smoothly–“by the books,” as they say–or was it tick-tick-tick down to the wire, with it never being clear until the last moment whether this was going to work or not?
Sheldon: There was really no “book” for this, unfortunately, as everything had to happen extremely quickly. Conditions deteriorating on the island, paired with the news of the next hurricane, Hurricane Jose, being en route, gave us a very limited window. It was, there’s no way around it, a high-stress, minute-to-minute situation.
Solomon: What were some of the nail bite-inducing factors? Were there variables that didn’t resolve in your favor until the last minute?
Sheldon: We didn’t know until we were almost out of time whether the ferry could even leave Puerto Rico to come to St. Thomas; it wasn’t clear waters were passable or that we were going to get authorization from the US Coast Guard in time. And, even once the ship was under way, we didn’t know if the ferry would make it in time and if it would be allowed to dock (the owner of the dock in St Thomas would make that call).
Solomon: What about even getting the guests to the dock from the hotel, in the face of the damaged infrastructure?
Sheldon: On this front, the minister of tourism was helpful in finding appropriate transportation of guests–not easy, when the roads were all but unpassable due to hurricane damage.
What was harder was that, because of crowd control concerns on the part of the company that owned the dock, they would not allow people to collect there ahead of time—we had to time their arrival to be almost exactly at the moment that the boat was ready to accept them aboard.
Solomon: You say the local tourism minister was helpful at this point. But overall, were you sure you had secured the cooperation of the local authorities—that they would even let the people on the boat if they were able to get there?
Sheldon: We had to operate within very strict parameters to have the best chance of making them comfortable with this operation. Because of the governmental entities with power over exits and documentation on the island, part of what we had to do was to submit detailed guest information for the ferry manifest. (The authorities required legal names, ages, dates of birth, and medical information for every passenger they were going to allow to come on board). We got permission from our guests to release this and we gave a detailed manifest in response to this requirement.
Solomon: I’ve seen some troubling posts on social media about people who were, for whatever reason, not let on the boat. If so, who wasn’t letting them on the boat? Was this a Marriott decision? What more can you tell me about what was happening on the ground, on the ship, on the telephones—if you even had telephone communication at this point–
Sheldon: We did everything we could to help, ultimately to no avail. Approximately 35 people who were not Marriott guests, and therefore whose names were not on the detailed manifest required by the local authorities, arrived at the dock gates wanting passage off the island.
Solomon: Do you know who these 35 people were?
Sheldon: To our understanding, these were guests from other hotels and some local residents as well. Beyond that, we are limited our knowledge, but this had no effect on our desire to assist.
Solomon: What happened?
Sheldon: The security personnel employed by the dock company would not—and we asked them repeatedly–allow them through the port gates and boarding area, because they were not on the manifest we prepared in advance, as a requirement for the boat to depart for international waters.
The General Managers who run our hotels on St. Thomas tried to work with dock personnel to allow them to get on the ship—we certainly had room aboard, which makes this both frustrating and disheartening.
Solomon: Do you think that every entrepreneur and business has a similar responsibility for its customers? Or is this something unique to being in the hospitality/lodging business?
Sheldon: I believe that all businesses, in every industry, have a responsibility to their customers, their employees and their communities. But maybe the lines are more clearly drawn in the hospitality industry because of the nature of what we do day to day. People are trusting us every day to accommodate them safely and to make their experience our priority.
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