Case Studies

Member PCP Appointment Scheduled

Most Medicaid health plans have a large percentage of their member population that is hard to reach with no means of communicating with them. As a result of bad phone numbers, emails and mailing addresses on file, plans can no longer communicate with their members. With limited communication, a member’s health care suffers from diminished preventive care and important medical prescriptions not being prescribed or refilled.  This situation is negatively compounded in non-human costs as well, with pricey emergency room and hospital visits increasing, which significantly impacts Health Plan’s efficiencies, objectives and results.

HRA Completion

Medicaid health plans face many challenges delivering quality services to their members. Transitioning plans to managed care models can lead to member confusion. Previously uninsured members can be particularly overwhelmed by new plans and utilize Emergency Rooms as primary care centers. The demographics of this population often include unstable housing and frequently changing contact information (phone and address) which is not communicated to the health plan. Assessing health risks and providing plan benefit information to members is an important component to member engagement

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