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Don’t Try to Change Your Medicaid Members Behavior

As a health plan, getting members to act on compliance requirements is a costly and time-consuming affair. It’s a key focus for Medicaid plans because non-compliance results in revenue loss and corrective action. Since member participation is voluntary, many Medicaid plans have tried different approaches to meeting this requirement. Incentivizing behavior change among their members has become the most popular route that many have taken – but this is far from the best option. The secret to boosting compliance lies in changing how Medicaid plans approach this problem.

What are the types of actions that Medicaid plans have trouble getting their members to complete? The most common difficulties include members failing to complete:

  • Renewals in time
  • Activities for quality measurement
  • Health risk assessments

The traditional approach for solving these difficulties focuses on changing member behavior. This typically includes sending mail or making a phone call to remind members to complete the necessary action. These antiquated methods no longer work because phone calls from unknown numbers are not answered and mailers are mostly trashed.

Rather than pushing a member to take an action, it’s far more effective to remove the barriers preventing them from acting in the first place. Modifying and updating contact and completion methods deliver significant results. If your plan is looking for real, actionable steps that drive results, keep in the mind the following.

Technology is an asset, not a liability, for Medicaid plans. Rather than wasting time or money calling or sending mailers to members, text or email them a link. Giving them quick access, and the ability to complete at their leisure, leads to significantly higher completion rates on assessments. It removes the pressure of taking a call and having to spend 30 minutes asking and answering questions. Further, when members complete assessments on their own, it reduces data entry errors as well.

A large Medicaid plan implemented changes like these and saw their completion rates double. Before, it was under threat of corrective action. By replacing clinical with common terms, setting clear expectations on times to complete assessments, and designing the platform for mobile devices, the barriers for members to act were removed. 35% of assessments were done at night when it worked best for members. Plus, assessments were completed six times faster. This case study shows how behavior change alone does not work – instead, align your processes with member preferences and seek to remove obstacles preventing action.
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Topics: healconnect