Member engagement is a powerful tool for Medicaid plans and managed care organizations (MCOs). When members are actively engaged, everyone involved benefits.
Increased engagement compels members to focus on high-value activities, making them more likely to take actions that prevent serious or chronic conditions. This leads to healthier members and populations, improved health outcomes, stronger plan performance and a better overall health care system.
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That said, many Medicaid members deal with real social factors that impact care and make it challenging for plans to engage. Social determinants, such as unstable living conditions or uncertainty about where the next meal or paycheck will come from, are concerns that often take precedence over dealing with health care.
Medicaid engagement programs need to factor in the social determinants of health (SDoH) that affect members. Understanding and acknowledging uncertain circumstances helps plans and MCOs communicate with their members more effectively.
Here is a brief look at seven smart strategies Medicaid plans can take to actively engage members.
1. Understand your Medicaid population. The first step to effective member engagement is to understand the population you serve.
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Medicaid enrollees make up a diverse group with varied and complex needs and circumstances. Many of these factors may be out of their control, such as access to healthy food, living conditions and job opportunities. Identifying the real-world issues of poverty, lack of transportation and other factors they face is a first step in designing a program that can be effective at reducing their risk of chronic disease.
Plans can use health risk assessments as a launching point to understand and engage with members by including SDoH as well as other data. In addition, a positive initial interaction between a patient and physician can help dispel fear, making members become more comfortable seeking out care when they need it.
2. Offer incentives members consider valuable. Research has shown that incentive programs that reward members for taking part in various health-related activities improve plan participation. Incentives come in various forms. It could be monetary, such as a $25 or $50 gift card, or it could be more service-oriented, such as free classes, counseling or gym access.
Increased participation in healthy activities helps prevent serious or chronic conditions and leads to improved outcomes and healthier communities. For example, encouraging a member to visit the dentist regularly reduces the risk of painful and costly oral conditions down the road.
3. Embrace mobile technology and text messages. These days, nearly every adult has a cell phone, and that’s not overstating it. In the U.S., 95 percent of adults own a cell phone, according to Pew Internet, including 92 percent of those living in households with incomes below $30,000 annually.
This makes text messaging one of the best ways to engage with member populations. It’s particularly useful for communicating with individuals who might be in unstable living conditions. Their address may change frequently, but their phone number probably will not.
Plans have previously used text messaging to keep members up-to-date on upcoming appointments or to remind them when to take prescribed medications—which are effective and inexpensive applications. This type of correspondence helps keep members thinking about their own health while also driving them to take action.
4. Increase your visibility. To help members become aware of the services and benefits available to them, it’s imperative for you to go where your members are. Instead of waiting for enrollees to come to you, take a more boots-on-the-ground approach and engage with members in physical locations they’re likely to be in.
In one example, Medicaid care managers from a number of states have visited locations such as transit hubs and parks in an effort to arm Medicaid enrollees with any resources or information they may need.
Assisted-living facilities, dialysis treatment centers and support groups are other potential locations where plans can engage with Medicaid enrollees.
5. Utilize community partnerships. Strong partnerships with other community organizations can help increase credibility for all parties involved. Medicaid plans in a number of states across the U.S. are partnering with local non-profit organizations to build relationships and provide benefit information to appropriate populations. These types of collaborations can lead to events or services that benefit Medicaid enrollees, while offering yet another reminder for them to stay active and involved in their own health.
In one recent example, Passport Health Plan, which administers Medicaid benefits in Kentucky, teamed with the American Heart Association and SOAR (Shaping Our Appalachian Region) to distribute CPR Anytime kits in rural areas of the state. The groups targeted families and at-risk groups most likely to benefit from CPR training.
6. Help improve low health literacy. According to the Center for Health Care Strategies, nearly 36 percent of U.S. adults have low health literacy. That number is even higher among those eligible for Medicaid.
That deficiency can be viewed as an opportunity to educate a large slice of members who may not know which questions to ask—or who to ask in the first place. A more educated base of members is more likely to actively participate in their own health.
In Colorado, the Medicaid program Health First Colorado offers a Medicaid Nurse Advice Line that staffs registered nurses 24/7 to answer questions, help with chronic conditions and direct members to the right place in case of medical emergency. By making it easy for members to get personalized advice that they understand, members learn and gain confidence in addressing their health needs.
7. Never end your search for creative solutions. As times change, the most effective tools to improve member engagement will continue to evolve. For example, 20 years ago, text messaging did not exist but is now a very effective way to communicate with Medicaid populations.
The healthcare industry is no stranger to its share of changing variables, so Medicaid plans should be prepared to optimize their engagement strategies as trends across the industry—and among enrollees—shift.
Engaging people can improve their health, but to do that they need to understand what benefits are available to them. Medicaid members are traditionally hard to reach because they’re so heterogeneous, and they often tend to deal with social factors that can negatively impact their health. However, understanding your audience and tailoring your communications to the individual can improve access and result in better care, and eventually, better health.
Photo: Getty Images, Paul Bradbury
