1 Engagement & Incentive Programs that Improve Health & Lower Costs
2 Panelists Suzanne O’Hara Matt Onstott Director, Business Development Deputy Medicaid Director InComm Healthcare & Affinity NM Human Services Department, (formerly Medagate) Medical Assistance Division sohara@incomm.com Matt.Onstott@state.nm.us 484-947-1653 505-827-6234 Deborah Stewart Catherine McCarron President & CEO Director, Accreditation and Finity Communications, Inc. Clinical Programs dstewart@finity.com Health Partners Plans 503-808-9240 cmccarron@hpplans.com 215-991-4434
3 Presentation Agenda Member Incentives: Suzanne O’Hara InComm Healthcare & Affinity Effective Engagement: Deborah Stewart Finity, Inc. Centennial Rewards Program: Matt Onstott NM Human Services Dept. Baby Partners Program: Catherine McCarron Health Partners Plans Program Results: Deborah Stewart Finity, Inc.
4 MEMBER INCENTIVES SUZANNE O’HARA
5 Incentives in Medicaid Historical Drivers Expanded Drivers Shape Buying Decisions Improve HEDIS Score Complete Specific Educational Opportunity Actions Impact Utilization Long-Term Behavioral Changes Condition Management Engagement
6 Typical Incentive Program Structure • Separate programs for specific target populations 1 • Member completes action 2 • Member receives traditional gift card 3 • Member takes card to retailer 4 • Member purchases any item in store 5
7 Incentive Program Challenges Low member engagement No link to claims to show behavioral change No link to engagement communications Manual reward distribution Manual spreadsheet reporting Difficult to provide organizational oversight Money spent on unhealthy items
8 Incentive Innovation Define purchases at SKU level Expiration dates for rewards Funds returned if not used Utilization reporting Funds spent, program activity, etc. Reporting at payer & state level Maintain individual momentum Product discounts serve as incentive without adding cost
9 Several of the projects described in this presentation were supported by Grant Number 1C1CMS331034 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.
10 EFFECTIVE ENGAGEMENT DEBORAH STEWART
11 Healthy Rewards Plan Design Rewards must be: Tied to behaviors that can be tracked Easy to understand & redeem Clearly communicated in multiple mediums Aligned with robust engagement Reinforced continuously via alerts & reminders Personalized to a member’s health status Served through a closed-loop technology platform
12 Health Intelligence Closed-Loop System
13 Multimedia Engagement Web: Announcements, Reminders, Alerts Mobile: Text Messages, Trackers, Apps Phone: Robo-Calls, Outbound Calls, IVR Email: Education, Reminders, Alerts Social Media: Tracking & Badges Print: Posters, Postcards, Kits, Direct Mail
one2one Communications Text Message Alert Condition Management LifeTracks Wellness Activities & Challenges Personalized Health Goals & Alerts High-Risk Population Incentive Programs Targeted Engagement Marketing Campaigns Text Message Campaigns Fresh Fruit Challenge Kit Targeted Engagement Kits Incentive Reward Text Messages
15 Diabetes Management LifeTrack
16 Diabetes Management Incentive Tracking
17 Step-Up Challenge
18 Step-Up Challenge Mobile Trackers
19 Step-Up Challenge Kit
20 Additional Incentive Options Virtual Achievements Social media sharing Catalog of Healthy Items Useful for rural locations Mail or phone orders Wellness Activity Raffles Participation-based Encourages ongoing engagement
21 CENTENNIAL REWARDS PROGRAM MATT ONSTOTT
22 The Centennial Rewards Program is operated under the New Mexico Human Services Department’s Section 1115 Waiver for the Centennial Care Rewards Program, implemented on January 1, 2014.
23 Centennial Rewards Plan Design Automatic enrollment: Portable between MCOs Portable in & out of Medicaid Points are “householded“ Most rewards are based on modified HEDIS measures Plan design & regulation is mandated at the state level
24 Centennial Rewards Activities 1. Annual Dental Visits (Adult & Child) 2. Asthma Medication Management 3. Bipolar Disorder Medication Management 4. Bone Density Test (Female; Age 65+) 5. Diabetes Management Tests 6. Prenatal Program Enrollment 7. Schizophrenia Medication Management 8. Health Risk Assessment 9. Step-Up Challenge
25 Reward Redemption Options Restricted-Spend Card Healthy Catalog Deluxe Art Set Basketball Locking Medicine Box
26 Sample Participant Home Page Learn About the Program Reward Program Alerts Reward Program Checklist Reward Program Progress Reward Spotlight
27 Sample Participant Track Page My Reward Points Points Progress Detail Link to Spend Points
28 The Baby Partners project described in this presentation was supported by Grant Number 1C1CMS331034 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.
29 BABY PARTNERS PROGRAM CATHERINE MCCARRON
30 Engagement Summary Identify pregnant members Invite members to participate Send incentive letters with instructions to register online Outbound engagement calls Web resources, tools, activities, and incentive tracking All communications, encounters, and rewards are tracked & linked to claims data
31 Identifying Pregnant Members Members who check “pregnant” on enrollment form Claims for pregnancy-related service Prenatal vitamin prescriptions Inpatient admission ER events with pregnancy diagnosis Referrals from providers, homecare agencies & pharmacies Referrals from schools, events, & educational sessions Referrals from HPP case managers
32 Member Support Resources Doulas available free of charge Community events and educational sessions Text4baby text message campaigns Pregnancy and postpartum handbooks Free EPT kits Transportation to OB, dentist, & behavioral health appointments Labor of Love: dental screenings
33 Baby Partners Incentives Maximum incentive: $100
34 Pregnancy LifeTrack Portal Personalized Content Wellness activities Monthly health awareness campaigns Monthly raffle prize drawings Online incentive tracking Web health alerts
35 Closed-Loop Pregnancy Tracking Encounters Communications Rewards Health Improvement Complications of Pregnancy Cost Savings
36 The Baby Partners project described in this presentation was supported by Grant Number 1C1CMS331034 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.
37 PROGRAM RESULTS DEBORAH STEWART
38 Baby Partners Results Summary Study Period: July 2012 – June 2013 1,979: Participants with deliveries 1,105: Participants qualified for inclusion in the evaluation of the program
39 Healthier Babies Odds of delivering a low weight baby was 14% lower for participants Participant babies weighed an average of 59 grams more than non-participants
40 Improved Outcomes 20% increase in postpartum office visits 10% increase in baby check-ups
41 Cost Savings ROI Highlights* $437.38 PMPM Average cost difference of babies born to participants vs. non-participants $1.5 million Savings for first 3 months post-delivery for babies born to participating mothers *Preliminary results.
42 The Diabetes Incentive project described in this presentation was supported by Grant Number 1C1CMS331034 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.
43 DIABETES MANAGEMENT INCENTIVE PROGRAM
44 Preliminary Results Improved quality measure compliance Reduced ER visits Reduced Inpatient admissions
Recommend
More recommend
