of a 5-star health plan
TRANSCRIPT
of a 5-Star Health Plan
of a 5-Star Health Plan Does it feel like the ground is shifting under you with gaps
widening among your members? It’s reported that 1 in 3
Americans delayed or skipped care due to the pandemic,
including 41% of adults with chronic conditions. The impact
of these missed appointments is real: one-third of those
delaying/skipping care reported worsening health problems
as a result.1 These gaps are also negatively affecting your
quality metrics, putting your Star Ratings and business at risk.
It is a big challenge but achieving a 5-Star Rating – and
keeping it – in today’s environment is possible.
Use these 5 proven strategies, gathered from over a decade of
work supporting MA plans before and during the pandemic, to
create a member experience that will overcome barriers and
get members to close critical care gaps.
lift in engagement when using consumer data
TO
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Use SDOH and Consumer Data to Predict Member Needs With large numbers of people avoiding routine and
preventive care due to COVID-19, clinical and claims insights
are sorely outdated.
Tap a partner like Welltok to start leveraging consumer
data and SDOH insights, things like proximity to outdoor
recreation areas, access to healthy food, and financial
security, among others, to help you better understand what
risks your members are likely facing today and in the future.
The result? You’ll get a current and forward-looking view
of which members are likely to experience mental distress,
develop a chronic condition, or skip a medication refill,
putting their health and your quality scores at risk.
20% 55%
WECAN
HELP
of all diabetes care gaps closed among 190K identified high-risk members
Personalize Outreach Based on Risk and Receptivity It’s essential for the member experience to feel personal,
which can only be done by offering them relevant programs,
and by using messaging and communications channels that
will resonate with them.
You can’t do this alone. Find a partner that can create
targeted outreach lists based on predictive insights about
which members are at risk, likely to be receptive and take
action based on your efforts.
The more relevant your offerings are, the more
engagement and ROI you will see.
48%
Use Multiple (and New!) Channels to Connect with Members Consumers are facing more and more informational “noise” in
all aspects of life, making it more difficult for your messages
to break through. To be heard, you have to move beyond
one-off, single channel campaigns and instead run integrated
multi-cycle, multi-channel campaigns.
Your peers agree, with healthcare organizations reporting
that digital channels like email and text proved to be
considerably more effective at driving consumer action. Text
messaging showed the largest gain in inspiring action with a
154% increase from 2019-2020.2 Furthermore, it’s an effective
channel to engage hard-to-reach populations and help
address health disparities.
300%
increase in effectivenesswhen using four or more
outreach channels
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Drive Action with Incentives Sometimes simply educating and inviting people to
participate isn’t enough to motivate them to take action.
Offering a smart incentive that matches the time and effort
needed to complete the desired action – like offering a $5-25
reward for getting an annual flu shot – can tip the scales and
get your members to close all types of care gaps.
Staying on top of CMS policy changes can be hard,
especially when you are incentivizing Medicare
members across all parts. Partnering with someone
like Welltok will ensure you design and implement
CMS-compliant incentive programs.
Top Gift Cards Among MA Members
Walmart, Amazon, Publix, and Meijer
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Keep a Steady, Not Overwhelming, Drumbeat Going
With members expecting a consumer-grade experience, a “one and done”
approach isn’t going to cut it. Gartner agrees that plans need “deep engagement
at the member and provider levels, along with payer tools to orchestrate health
outcomes and communications.”3
Use technology to make it simple for you to conduct targeted, multi-cycle, multi-
channel campaigns that will resonate with – not overwhelm – your members.
For example, get members to close preventive screening gaps by coordinating
outreach across multiple channels:
An email and post card to educate
about recommended screenings
IVR (automated calls) to deliver
barrier-breaking messages that
will overcome fears about coming
back in for appointments
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Closing gaps is good for your members, quality measures and business.
Want to explore these tips further?
Email [email protected] to
set up a strategy call with one of
our member engagement experts.
improvement in colon cancer
screenings achieved with culturally
tailored, multi-channel campaigns
56%
1. 1 in 3 Americans Delayed, Skipped Medical Care During Pandemic,HealthDay, Feb 17, 2021 2. Email, SMS Text Soar as Effective Healthcare Consumer Engagement Channels in 2020, Reflecting Urgency of COVID-19 Communications, Engagys, February 2020
3. U.S. Healthcare Payer CIOs Boost Medicare Advantage Star Ratings Using Engagement Hubs and Insights, Gartner, February 3, 2020
Text messages to send
appointment reminders