Medicare Advantage Engagement Achieves 38% Readmissions Reduction—and Boosts Star Rating
Providing the Medicare population with the right care in the right setting at the right time is increasingly a challenge. But failure to do so can have a significant impact on outcomes, Star ratings and incentive revenue. Also challenging is engaging with those...
Best Practices for Effective 5-Star Medicare Advantage Member Engagement
Medicare Advantage (MA) health plans and stand-alone Part D plans (PDPs) are increasingly focused on the Centers for Medicare & Medicaid Services (CMS) Stars system. Plan leaders want that 5-Star status and the per member per month bonus revenue and other benefits...
How to Improve Your Health Plan’s ER Diversion Strategy
Health plans need to lower ER costs, no matter what type of populations they serve—from Medicaid and Medicare to private, commercial plan members. Non-urgent ER visits cost the U.S. $4.4 billion annually, and ER costs, according to a new CDC report, have doubled in...
Innovative Approach to Patient Experience Delivers 5:1 ROI
As fee-for-service payment models continue to transition to value-based ones and consumers demand more exceptional experiences from their providers, innovative patient engagement models will become even more critical. In our latest case study, we examine what...
Two Things Medicare Advantage Plans Can Do Right Now to Tackle Social Determinants of Health
When we think of healthcare consumer engagement today, especially for Medicare populations, we typically think of ways to help close critical care gaps—reaching out with reminders, scheduling appointments, helping select providers and more. These are essential...
Medicare Member Engagement Approach Delivers $37.5M in Revenue
One of the country’s most prominent Medicare Advantage plans turned to Carenet for help with increasing member adherence to HEDIS-related health measures. In addition to closing gaps in care to improve clinical outcomes and reduce costs, the client wanted to...
How Are You Using Telehealth to Close Behavioral Health Gaps?
When it comes to ensuring follow-up care for individuals diagnosed with alcohol or other drug (AOD) dependence, health plans across the board are falling short. In fact, according to the 2016 HEDIS results, among the Medicaid, Medicare and commercial populations,...