ADAPT Utilizing Innovative Member Engagement Programs to Educate, Involve and Empower your Members

Transcription

1 ADAPT Utilizing Innovative Member Engagement Programs to Educate, Involve and Empower your Members PRESENTED BY: Augusta Kairys, Senior Vice President, Medecision Kimberly Tuck, Plan President & CEO, Home State Health Geralynn Boone, Director, MLTSS Operations, Horizon NJ Health September 22, 2016

2 Medicaid Health Plans of America mhpa2016 Conflict of Interest Disclosure: Faculty/Planning Committee/Reviewers/Staff Participating speakers in Utilizing Innovative Member Engagement Programs to Educate, Involve, and Empower your Members have no conflict of interest to disclose relative to the content of the presentation.

3 Augusta Kairys Senior Vice President, Medecision This is a Section Break Title Slide Kimberly Tuck Plan President and CEO, Home State Health Geralynn Boone Director, MLTSS Operations, Horizon NJ Health

4 Kimberly Tuck Plan President and CEO, Home State Health

5 Innovative Member Engagement Strategies Enhanced Member Experience Fieldbased staff Community engagement Cultural competency training Locally active Innovative programs Clinical Expertise Integrated technology 5

6 Highlighting Successes Well-Care Reward Program Member Incentive Pilot Program CentAccount Member Incentive Program

7 Home State Health and STL Medical Supply Health+Care Rewards Program GOAL: EPSDT / Well-Child Checkup Improvement

8 Home State Health and STL Medical Supply Well-Care Reward Program Program Goals and Objectives Primary Goal Secondary Goal Tertiary Goal 10% increase in EPSDT visits for the study population Capture enhanced member data and demographic information Provide members with contact information for health providers and valuable community resources

9 Home State Health and STL Medical Supply Atchison Holt Nodaway Andrew Buchanan Platte Worth Gentry DeKalb Clinton Clay Jackson Cass Bates Vernon Barton Jasper Newton McDonald Harrison Daviess Caldwell Ray Well-Care Reward Program Program Overview Lafayette Johnson Henry St. Clair Cedar Dade Lawrence Barry Mercer Grundy Livingston Carroll Pettis Benton Hickory Polk Greene Stone Putnam Sullivan Linn Saline Chariton Dallas Christian Cooper Morgan Camden Webster Taney Schuyler Adair Macon Howard Randolph Moniteau Miller Laclede Boone Cole Wright Douglas Scotland Ozark Knox Shelby Monroe Pulaski Clark Lewis Audrain Callaway Osage Maries Texas Marion Phelps Howell Ralls Montgomery Gasconade Crawford Dent Pike Warren Shannon Oregon Lincoln Franklin St. Charles Washington Iron Reynolds Carter Ripley St. Louis Jefferson St. Francois Madison Wayne Ste. Genevieve Butler Bollinger Perry Stoddard Dunklin Cape Girardeau Scott New Madrid Pemiscot Mississippi 2,910 members throughout Missouri selected to be included in the program 1,000 members selected from each region of Missouri (West, Central and East) Member Criteria Ages 0 5 were selected from the West & East Regions Ages 0 6 were selected from the Central Region No EPSDT claims for 2015 Approximately 300 members had been with the health plan for less than 30 days

10 Home State Health and STL Medical Supply Well-Care Reward Program Program Outcomes

11 Home State Health and STL Medical Supply Well-Care Reward Program Program Outcomes 111 new phone numbers registered were previously not on file with the health plan 61% of the members provided a new phone number 52% of members that registered via text message requested their Primary Care Physician s contact information

12 Home State Health and STL Medical Supply Well-Care Reward Program Program Participation Month Registrations % of population September % October % November % December 7 6.2% 60 Total Registrations % September October November December

13 Home State Health and STL Medical Supply Well-Care Reward Program Program Participation 8.74% Well-Care Reward Registered % of population 25.14% Burt s Bees Essentials Kit % $10 Subway Gift Card % Disney Coloring Book % Minion s Play-Doh Kit % 45.36% 20.77% $10 Subway Gift Card Burt's Bees Kit Minion's Play-Doh The Coloring Book

14 Home State Health and STL Medical Supply Health+Care Rewards Program Pilot Summary

15 CentAccount Member Incentive Program

16 Highlighting Successes CentAccount Rewards Home State Health Gives You More with CentAccount! It Pays to Stay Healthy We want you to know how rewarding it is to take control of your health. There are many easy actions you can take to keep you and your family healthy. CentAccount is a program that provides dollar rewards loaded onto a CentAccount rewards card. You earn rewards by completing these healthy behaviors. After you complete one of the healthy behaviors, a CentAccount card will be mailed to you. New rewards will automatically be added to the card when you complete additional healthy behaviors.

17 Highlighting Successes CentAccount Earned Rewards by Reward Type 43,281 members earned rewards

18 Multiplatform Member Engagement

19 er Incentive program for 100% statewide FQHCS time assistance with PCP appointment setting Multiplatform Member Engagement ive outreach, PCP coordination & case management rs: Share high-risk member conditions & care gaps with PCPs Mobile App Technology: Member Portal: creenings, 24/7 hotline, active case management Member Concierge: ancial awards for healthy behavior Health Coaches: Primary Care Coordinators: y: Care management techniques designed StartSmart for Your Baby: od and reduce the risks of pregnancy CentAccount: ialized care planning for hydroxyurea identification eases member engagement Members have access to mobile applications Interactive member tools to stay up-to-date on health needs Real-time assistance with PCP appointment setting Health screenings, 24/7 hotline, active case management Share high-risk member conditions & care gaps with PCPs Care management techniques designed to extend the gestational period, and reduce the risks of pregnancy Expanded financial awards for healthy behavior

20 Geralynn Boone, RN, BSN, MSM Director, MLTSS Operations, Horizon NJ Health

21 Mobile Technology

22 Hot Topics in the News GlobeNewswire Geriatric Care Services Market Home care services expected to fastest growing segment of Geriatric Care Services Sector: MRRSE

23 How can we insert value-based pay in home care? get actionable insight out of the home? make home care workers part of the care team? minimize fraud, waste and abuse? reduce administrative costs for the provider? increase audit readiness for the health plan and provider?

24 Goals of program Empower the aide: Contributing member of the care team Early identification of changes in condition: Early intervention to improve health outcomes and reduce risk of admission Close gaps in care: Impact HEDIS/STARS Minimize fraud, waste and abuse: Validation of visit

25 App Features Check In

26 App Features Care Gap Closure

27 App Features Change in Condition

28 App Features Care Plan

29 App Features Check Out

30 Results

31 Medicaid Readmission

32 Readmission Framework Measure effectiveness of intervention program comparison with control and other interventions Identify best interventions Calculation of program return on investment (ROI) A. Member Identification Define 30 Day readmission Predict readmission risk membervisit level Identify drivers of readmission risk D. Program evaluation & effectiveness B. Design of intervention programs Define interventions Design test and control population Decide evaluation measures and duration of the study C. Execution of intervention Execute intervention strategy home visits, follow-up calls, telemonitoring, patient education, etc. Track all interventions

33 Member View Detailed Report

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35 Augusta Kairys Senior Vice President, Medecision Thank you Kimberly Tuck Plan President and CEO, Home State Health Geralynn Boone Director, MLTSS Operations, Horizon NJ Health