The 4 Best Practices for Medicaid Member Engagement

As we enter a digital age of healthcare, Medicaid plans must be willing to embrace new tools and technology to reach diverse member popluations. Effective member engagement is vital as state health agencies motivate plans to build initiatives that address their members' unique healthcare needs, no matter how challenging. For states that tie financial incentives to these health outcomes, the pressure is even higher.

Employ the right best practices and start engaging Medicaid members in new and effective ways to ensure plan success.

1. Use Rewards Strategically

Implementing a rewards and incentives (R&I) program is one of the best ways to empower and activate Medicaid members and encourage health improvement. But not all rewards programs are created equal, and it’s important to keep the unique needs of Medicaid members in mind.

Consider the following questions when choosing a rewards and incentives program:

• Do members need digital rewards, physical gift cards, or both?
• What types of incentives motivate members?
• Are the rewards local and accessible for members?
• Can a program support flex cards?
• Do state regulators have guidelines for rewards?
• Does a program support analytics and performance metric tracking?

The Medicaid plans with the most successful R&I programs allow members to choose the rewards that make sense for them, instead of boxing them in with an all-or-nothing selection. Financial incentives can be particularly impactful for Medicaid members because they allow people to make a personal choice for what they need, such as groceries, fitness trackers, or a new blood pressure monitor. Ultimately, the right rewards program will incentivize members in a way that fits their lifestyle and motivates them to reach their health goals—and that’s what keeps them coming back again and again.

2. Deliver Coordinated Outreach

Incentives work to drive action but only when plans effectively reach and engage the member. If members do not know the reward exists, it’s not going to affect their behavior.

The most effective way to inform members is through clear communication that feels intentional and personalized to each individual member. Achieve this level of targeted communication by collecting data that identifies languages spoken, best times for outreach and preferred communication methods.

In addition, the cornerstone of any Medicaid member engagement and rewards strategy should be a digital platform that consolidates and coordinates all outreach in one place. This requires the aggregation of the right data points to paint a complete picture of a member’s health and lifestyle situation.

From there, plans can consolidate interventions into less frequent outreach to prevent member abrasion and help them focus on the high-priority activities. A digital engagement solution that aligns outreaches from every focus area can help Medicaid plans address member needs more efficiently and effectively.

Across all efforts is the golden standard of quality over quantity. Sending targeted, personalized messages at the right time within the right context of an individual’s health and life builds trust with members. This does not have to be done manually or at the expense of valuable staff. Use data-driven technology to build personalized, digital communications that reach members much faster than traditional modalities such as phone calls and paper mail. By cutting down on lag times from manual processing, digital engagement tools can deliver coordinated communications to the member at the right time.

3. Engage Households

Another way plans can engage more Medicaid members is by simplifying suggested healthy activities to engage parents, guardians and heads of households. Allowing a guardian or responsible party to review all of the activities for themselves and their children or dependents in a single view helps streamline engagement activities. This information helps deliver consolidated messaging and reduce member abrasion by engaging households as a whole, rather than sending a single message for each individual.

What makes this capability possible is data. To create the household view, focus on analytic tools that capture multiple sources of data for children and non-familial dependents, aggregate it in one place and then automate personalized messages that encourage households to complete healthy activities such as well-child visits or immunizations. The right data is critical to identifying noncompliant members and driving them to the right actions and programs.

4. Drive Health Equity with Data

For many people, the pandemic deepened the gap in access to care. Food insecurity has become an even greater burden for those who were already experiencing hardship prior to the pandemic, which directly impacts health outcomes and cost. 

Additionally, many community resources and government programs have become reliant on technology to coordinate services such as food programs and transportation, creating additional hurdles for those without internet access. Identifying and addressing social determinants of health (SDOH) continues to be critical to improving member engagement in Medicaid populations.

It all starts with data.

At a minimum, the three types of data we recommend all plans include in their engagement efforts are:

• Clinical Data: Consolidating electronic medical records and claims data enables plans to follow up with members about their experiences and support future appointment scheduling and transportation needs.
• Non-Clinical Data: Streamlining information from community resources, health trackers, and socioeconomic data helps to complete a longitudinal member record inclusive of situational information and SDoH.
• Self-Reported Data: Using health risk assessments and member experience surveys to identify barriers to care enables plans to rapidly evaluate population health needs and connect members with the appropriate resources.

A data-driven member engagement strategy enables plans to easily identify issues and provide members with the support they need. This requires a technical platform capable of ingesting and organizing all available data points about members, which then informs microtargeting to deliver relevant and timely information to connect members with the right resources and care. When conducted with omnichannel outreach that includes digital and physical channels, plans can maximize engagement for members in any scenario.

Evolve Member Engagement

Navigating healthcare is challenging in today’s environment. State health agencies continue to evolve quality programs with new health equity initiatives and drive Medicaid plans to higher standards. Plans need to move beyond point solutions and use coordinated engagement strategies to close care gaps, boost quality scores and improve member experiences.

By consolidating outreach with Healthmine's digital suite, Medicaid plans can continuously engage diverse populations to achieve strong health outcomes and quality scores. Our solution guides members to the next best healthy activity through rewards-driven, personalized care plans that account for preventive care, chronic disease, pre-natal, postpartum and child-specific activities. Plans can leverage a wide range of channels to meet members wherever they are in their journeys while overcoming digital literacy challenges.

Access a comprehensive solution for improving Medicaid member engagement when you partner with Healthmine. Reach out to us at any time.