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1 Engagement & Incentive Programs that Improve Health & Lower Costs

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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) [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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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

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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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

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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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 of 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 of 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 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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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 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

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THANK YOU FOR YOUR TIME