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Medicaid Member Engagement Strategies That Work

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Three Essential Approaches for Effective Medicaid Population Engagement

Today's Medicaid programs and managed care organizations (MCOs) need to improve costs at the same time as they improve quality and outcomes for vulnerable populations. However, connecting with and encouraging members to take needed health-related next steps can be complicated.

Factors that contribute to this challenge include invalid and frequently changing contact information, low health literacy, lack of childcare, and access to transportation. This complexity demands a specialized member engagement approach that can address the specific needs of the Medicaid health plan population.

At Carenet Health, we typically recommend three essential strategy components for effective Medicaid community engagement:

Let's take a look at each one.

Proactive Outreach to Medicaid Members

To boost member communication, health literacy, care management, compliance, patient satisfaction and outcomes, you'll need solid pre-emptive outreach. And that outreach needs to be carried out by contact support teams who understand this specific population's needs and barriers to care.

Those teams should be trained in demonstrating empathy and understanding, using motivational conversation tactics and working with individuals to uncover their obstacles to getting the health and wellness information and care they need.

There are a few specific healthcare areas that your proactive Medicaid strategies should focus on here to give you the best ROI and member activation rates. (Activation rates are numbers that quantify how many of your health plan members take predetermined, specific actions after being contacted.)

Proactive outreach strategies should focus on:

  • ED Avoidance - Emergency room (or emergency department) avoidance is one of those targeted areas. With this kind of upfront engagement, you can reach out to frequent flyers and low-acuity ED users and help them transition to more appropriate and less expensive care options. This should be a key educational initiative.
  • Member Onboarding - Another critical area of upfront communication is member onboarding. This is often your best chance of contacting some members of your Medicaid population because you have very recent contact information, and that information can change frequently when a member is experiencing housing and job insecurity or stops and starts with different mobile phone carriers. Use your member onboarding/welcome engagement to tackle as many needs as possible. Educate members about the importance of well child visits, immunizations and other services, as well as the availability of resources such as a Nurse Advice Line and virtual care coordination that require no transportation access. Combine health risk assessment completion with your welcome communications.
  • Perinatal and Well Child Communications - Two other important areas of Medicaid member engagement efforts include perinatal and well child exam communications. Connect with those members who are expecting a child and identify indicators of high-risk pregnancies and offer targeted, timely interventions that can ultimately improve health outcomes for both parents and infants. Explain the importance of well child visits and regular check-ups. Discuss the importance of a consistent provider-patient relationship and assist with appointment scheduling via three-way conference calls.

Learn more about how your organization can benefit by leveraging Carenet solutions to address:

On-Demand Telehealth Care Available to Members 24/7

Since you likely offer 24/7 access to on-demand virtual care, be sure your Medicaid members know about the different types (nurse advice lines, online behavioral health crisis lines, remote patient monitoring), and that they understand how easy it is to use, and what types of issues it can be used for.

For example:

  • Communicate that it's free and convenient
  • Prominently display on member benefit an appointment cards
  • Publish it on all consumer explanation of benefit (EOB) documents
  • Plan automated reminder communications / emails

See a full list of additional ways to increase telehealth communication awareness among Medicaid members here, and check out these Carenet virtual care solutions:

Around-the-Clock Support for Plan Members

Medicaid plans should also consider the benefit of member support services that never close. Think about that individual who works two jobs and gets home from the last one at 2 a.m. That's the only time he or she may have to connect with you. Translation services, of course, are important and should be just as available as your 24/7 support: after normal hours, on weekends and holidays.

These after-hours support teams should be able to handle everything from benefits eligibility questions to transportation coordination to referrals to providers and programs.

How to Engage Medicaid Members Through Outreach Channels

Once you've outlined your care, support and outreach plans, you need to consider what channels you'll use to reach your Medicaid audience. Automated voice messaging is a nice tool to have in your toolkit, especially for reminder messages, and text messaging can often reach members who can't be reached any other way.

However, it's also important to remember that healthcare is a highly personal matter, and rarely are minds changed about things like making a needed appointment (that can be tinged with fear and anxiety) via only an email or other digital patient communication. One-to-one human connections are still the best and most powerful way to have those conversations with meaningful results.

Carenet Health recommends 3 essential strategy components for effective Medicaid community engagement:

Carenet Health recommends 3 essential strategy components for effective Medicaid community engagement proactive outreach 24/7 on-demand telehealth around-the-clock support for plan members

Want to talk more about health plan engagement? Carenet works with a large number of Medicaid plans. CONTACT US TO SET UP TIMES TO DISCUSS MEMBER ENGAGEMENT FOR HEALTH PLANS.

We also have more information in our ebook: An Engagement Success Formula for the Medicaid Population: Improving Activation, Outcomes and Costs.

1. Encyclopedia of Quality of Life and Well-Being Research


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