For government-sponsored health plans, the health risk assessment (HRA) is not only a critical tool to identify a member’s needs through risk stratification but a program requirement. Completion rates for HRAs are reported or counted in various quality rating programs, ranging from Medicare Stars for Special Needs Plans (SNP) to state health department report cards for Medicaid and Medicare-Medicaid Plans. While the calculation methodology varies between the various programs, the consistent element is that the member must answer enough questions for the HRA to be considered complete.

Plans often struggle to increase HRA completion rates as the targeted population tends to be more transient, less educated, and less food secure. This means plans must solve for multiple issues to achieve their goals of HRA completion rates and better population health management.

Leveraging Digital Technology

Traditionally, plans have relied on the familiar physical mail and phone calls for HRAs. Some plans deploy an additional initiative by sending staff, equipped with paper HRA copies, into the community for members to complete. These are high-cost, inefficient, and burdensome strategies.

Transitioning to digital engagement allows for a more scalable, effective, and timely approach to reach members in a way they prefer. With digital communications like email, a plan can tell within a week if a member has reviewed message contents or clicked on the link to a digital HRA. With physical mail, plans are guessing after a week if a member has received the information.

Once a member receives a paper version of the HRA, they must answer the questions, and mail the completed assessment back to the health plan for processing. This is difficult and time-consuming for a member (and plan).

Digital HRAs reduce the effort for the member— clicking responses and hitting ‘submit’ is less time- consuming. Digitalized HRAs are easy to complete in multiple settings compared to paper versions, which are often misplaced. Overall, digital HRAs are faster to distribute and result in higher completion rates. With only 90 days to ensure a member completes an HRA, time is of the essence.

Right now, there is an increase in Medicare and Medicaid plan members getting digitally connected. According to 2019 Pew Research, 71% of Americans who earn less than $30,000 per year own a smartphone. 53% of those aged 65-plus own a smartphone, and internet use of seniors was measured at 73%. Research from Deloitte in 2018 revealed that 86% of adult Medicaid beneficiaries own smartphones.

This was the starting point at the beginning of 2020 – then came a surge for digital: COVID-19. It has been reported that COVID-19 has catapulted seniors into a more digital lifestyle driven by telemedicine and connecting with family members via teleconferencing. It is likely to surmise that more Medicaid members have increased digital connectivity, too.

Plans can seize the moment and have a comprehensive connection program that digitally connects with Medicare beneficiaries and Medicaid members to help increase the completion rate of HRAs.

Accelerate Completion Results with Rewards

Additionally, pairing a member incentive strategy along with the digital HRA can significantly increase completion rates. Rewards can be physical or digital gift cards to a variety of local and national vendors such as Amazon, Walmart, Starbucks, and Apple. When offering an incentive with the use of digital HRA, our client experience has shown an increased completion rate of over 3 times versus not offering incentives in the first year.

At HealthMine, we offer the ability to supplement or enhance your plan’s capabilities with a HITRUST core solution of member engagement and rewards, clinical expert engine, robust analytics, client services, and technical support. Our HealthMine Digital HRA Module supports an NCQA approved Health Risk Assessment that can be linked to our clinical data engine. We can generate risk scores for populations in real-time, processing information from completed HRAs. HealthMine can return the data to a plan securely and promptly.

For more information on how to plug into the digital surge and drive HRA completion rates, feel free to contact me at

James Haskins is Director of Government Programs at HealthMine, Inc. with 13 years’ experience in Healthcare Effectiveness Data Information Set (HEDIS), Medicare Star Ratings, Medical Record Review, and Data Analytics.