Engagement & Incentive Programs that Improve Health & Lower - - PowerPoint PPT Presentation

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Engagement & Incentive Programs that Improve Health & Lower - - PowerPoint PPT Presentation

1 Engagement & Incentive Programs that Improve Health & Lower Costs 2 Panelists Suzanne OHara Matt Onstott Director, Business Development Deputy Medicaid Director InComm Healthcare & Affinity NM Human Services Department,


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Engagement & Incentive Programs that Improve Health & Lower Costs

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Panelists

Suzanne O’Hara Director, Business Development InComm Healthcare & Affinity (formerly Medagate) sohara@incomm.com 484-947-1653 Deborah Stewart President & CEO Finity Communications, Inc. dstewart@finity.com 503-808-9240 Matt Onstott Deputy Medicaid Director NM Human Services Department, Medical Assistance Division Matt.Onstott@state.nm.us 505-827-6234 Catherine McCarron Director, Accreditation and Clinical Programs Health Partners Plans cmccarron@hpplans.com 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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MEMBER INCENTIVES

SUZANNE O’HARA

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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

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  • Separate programs for specific target populations

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  • Member completes action

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  • Member receives traditional gift card

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  • Member takes card to retailer

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  • 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

  • f Health and Human Services or any of its agencies.
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EFFECTIVE ENGAGEMENT

DEBORAH STEWART

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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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Health Intelligence Closed-Loop System

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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

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  • ne2one 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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Diabetes Management LifeTrack

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Diabetes Management Incentive Tracking

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Step-Up Challenge

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Step-Up Challenge Mobile Trackers

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Step-Up 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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CENTENNIAL REWARDS PROGRAM

MATT ONSTOTT

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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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Sample Participant Track Page

 My Reward Points  Points Progress Detail  Link to Spend Points

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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

  • f Health and Human Services or any of its agencies.
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BABY PARTNERS PROGRAM

CATHERINE MCCARRON

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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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Baby Partners Incentives Maximum incentive: $100

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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

  • f Health and Human Services or any of its agencies.
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PROGRAM RESULTS

DEBORAH STEWART

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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

  • f 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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Improved Outcomes

 20% increase in

postpartum office visits

 10% increase in baby

check-ups

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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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DIABETES MANAGEMENT INCENTIVE PROGRAM

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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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HEART HEALTH INCENTIVE PROGRAM

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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

  • f 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) sohara@incomm.com 484-947-1653 Deborah Stewart President & CEO Finity Communications, Inc. dstewart@finity.com 503-808-9240 Matt Onstott Deputy Medicaid Director NM Human Services Department, Medical Assistance Division Matt.Onstott@state.nm.us 505-827-6234 Catherine McCarron Director, Accreditation and Clinical Programs Health Partners Plans cmccarron@hpplans.com 215-991-4434

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THANK YOU FOR YOUR TIME