As CMS moves forward with the implementation of a Star quality rating system for Medicaid plans, and more and more states liberate their rules around wellness incentives, the stage is set for health plans to maximize their performance (and their ROI) through the use of rewards and incentives programs. Rewards and incentives programs for wellness activities are proven to drive desired healthy behavior among participants, resulting in improved HEDIS measures, optimized risk adjustment revenue and increased member engagement.

1—Define Business Objectives

Defining what your program looks like and setting clear expectations for how success will be measured will help focus your marketing and reporting efforts. Establish the highest impact goal to act as the base for your overall program design.

2—Utilize Customer Segmentation

The broader Medicaid membership is comprised of distinct, diverse and hard-to-reach audiences. Focus your efforts on activating and engaging segments of non-adherent members to drive incremental performance. Non-targeted programs cost over 50% more for less impact on HEDIS measures.

3—Identify Health Behaviors

Select and prioritize behavior change opportunities based on where the measures sit, how far they need to move, and whether they can be impacted by a Medicaid rewards program. Members that are shown 2-3 achievable activities at a time are twice as likely to participate than those shown 5 or more.

4—Choose the Right Reward Type and Value

Determine the right value for your wellness rewards—what’s needed to achieve goals and optimize economic return. Through our research, we’ve discovered that a $25 incentive drives the majority of behavior, and a member who redeems once is twice as likely to do a second earning activity. Debit cards and pre-paid mobile minutes are popular rewards for the Medicaid audience.

5—Employ Multi-Channel Communications

Medicaid members migrate across channels, so give them multiple avenues to engage, creating a seamless cross-channel experience. Pay particular attention to mobile engagement—50% of smartphone users have an annual income of less than $30,000.

6—Foster Ongoing Engagement

Encourage continuous member engagement by leveraging new and existing channels, and tapping into the consumer lifecycle. We’ve seen a 1.7x increase in gaps closed for members who are engaged in deeper digital features.

With these strategies for your Medicaid rewards program in mind, your health plan can improve incremental performance and overall quality measures.