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Panelists Suzanne O’Hara Director, Business Development InComm Healthcare & Affinity (formerly Medagate) [email protected] 484-947-1653 Deborah Stewart President & CEO Finity Communications, Inc. [email protected] 503-808-9240
Matt Onstott Deputy Medicaid Director NM Human Services Department, Medical Assistance Division [email protected] 505-827-6234 Catherine McCarron Director, Accreditation and Clinical Programs Health Partners Plans [email protected] 215-991-4434
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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.
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Incentives in Medicaid
Historical Drivers
Improve HEDIS Score
Complete Specific Actions
Expanded Drivers
Shape Buying Decisions
Educational Opportunity
Impact Utilization
Long-Term Behavioral Changes
Condition Management Engagement
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Typical Incentive Program Structure
1 • Separate programs for specific target populations
2 • Member completes action
3 • Member receives traditional gift card
4 • Member takes card to retailer
5 • Member purchases any item in store
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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
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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
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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.
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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
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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 Condition Management LifeTracks
Wellness Activities & Challenges
Personalized Health Goals & Alerts
High-Risk Population Incentive Programs
Targeted Engagement Marketing Campaigns
Text Message Campaigns
Targeted Engagement Kits
Incentive Reward Text Messages
Text Message Alert
Fresh Fruit Challenge Kit
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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
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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.
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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
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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
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Reward Redemption Options
Restricted-Spend Card
Healthy Catalog
Deluxe Art Set Basketball Locking Medicine Box
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Sample Participant Home Page
Learn About the Program Reward Program Alerts Reward Program Checklist Reward Program Progress Reward Spotlight
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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.
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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
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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
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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
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Pregnancy LifeTrack Portal
Personalized Content Wellness activities Monthly health
awareness campaigns Monthly raffle prize
drawings Online incentive tracking Web health alerts
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Closed-Loop Pregnancy Tracking
Encounters Communications Rewards Health Improvement Complications of Pregnancy Cost Savings
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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.
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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
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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
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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.
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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.
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Preliminary Results
Improved quality measure compliance
Reduced ER visits Reduced Inpatient
admissions
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The Heart Health 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.
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Preliminary Results
Improved quality measure compliance
Reduced ER visits Reduced Inpatient
admissions
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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.
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Q&A
Suzanne O’Hara Director, Business Development InComm Healthcare & Affinity (formerly Medagate) [email protected] 484-947-1653 Deborah Stewart President & CEO Finity Communications, Inc. [email protected] 503-808-9240
Matt Onstott Deputy Medicaid Director NM Human Services Department, Medical Assistance Division [email protected] 505-827-6234 Catherine McCarron Director, Accreditation and Clinical Programs Health Partners Plans [email protected] 215-991-4434