Gaps in care represent missed opportunities for preventive screenings, chronic disease management, and overall health improvement. At Icario, we offer innovative solutions uniquely tailored to identify and close these gaps. Our focus is on delivering results that lead to better quality scores and health outcomes for each plan’s Medicare and Medicaid populations.
85%
of members who activate in our program close one or more care gaps
33%
churn improvement among members who engaged with Icario’s programs
63%
above the national average for annual wellness visits
As Star Ratings and quality metrics shift to reflect benefit utilization and health outcomes, clinical programs that close gaps in care are rapidly gaining importance.
Annual Wellness Visits (AWVs) are a crucial component for clinical programs focused on closing gaps in care. AWVs can increase member participation in preventive health action, provide earlier detection of chronic diseases, and offer more opportunities for important advanced care planning.
At Icario, we know that AWVs significantly impact quality scores, risk adjustment, and member satisfaction—our statistics prove it. Roughly 70% of Medicare members and 81% of Medicaid members complete an AWV before engaging in further high-value health activities.
Why Choose Icario for Gaps in Care Programs?
Icario’s long track record of success, combined with data from over 100 million member touchpoints, demonstrates our unmatched expertise in closing gaps in care. An approach that utilizes our personalized engagement platform, broad and deep data insights, and the latest in behavioral science has been proven time and again to drive more meaningful health actions, close gaps in care, and improve overall health outcomes.
Predictive Interventions
Icario incorporates leading-edge predictive behavioral science to identify gaps in care and pinpoint opportunities for targeted interventions. By combining whole-person data with the most advanced data analytics models, Icario can design interventions that predict and prevent gaps in care before they become a problem. Our proprietary engagement platform offers comprehensive feedback and reporting mechanisms to capture the most powerful insights and use them to improve results continuously.
Targeted Outreach
Approaching data from a whole person perspective gives Icario the edge in designing highly personalized, robust outreach programs. Our innovative, personalized approach to AWVs, health risk assessments, and other programs designed to close gaps in care builds trust. Authentic relationships between a plan and its members motivate more health action now and in the future.
Gap Closure Results
Our Gaps in Care programs have consistently delivered measurable results for health plans. By improving HEDIS measures and closing care gaps, Icario helps plans:
Achieve higher Star Ratings
Significantly increase member satisfaction
Drive better health outcomes for their members
Quality Improvement & Member Satisfaction
Medicare Advantage
Challenge
An award-winning mutual benefit corporation dropped from a 4-Star Medicare plan to a 3.5-Star plan. This prompted a company-wide focus on improving quality and enhancing satisfaction for its 4 million members. The plan’s primary objective was to close gaps in care on key measures, hoping to improve the plan’s Star Rating while also boosting member satisfaction and plan affinity.
Approach
The plan partnered with Icario to design a member engagement and incentive program focused on historically non-compliant members. Leveraging Icario’s deep experience in consumer marketing, behavioral science, and proprietary predictive analytics, the program included all 91,000 eligible Medicare Advantage members to create personalized, dynamic member experiences for thousands of historically non-compliant members with one or more open care gaps.
Results
Since its inception, Icario’s program has delivered a multi-year engagement strategy with significant ROI year after year. By focusing on high-value health activities, the new program has significantly improved both quality and member satisfaction metrics for this plan, inclduing 75% of respondents reporting the program improved their satisfaction with the plan, and 95% were likely to renew.
An award-winning mutual benefit corporation dropped from a 4-Star Medicare plan to a 3.5-Star plan. This prompted a company-wide focus on improving quality and enhancing satisfaction for its 4 million members. The plan’s primary objective was to close gaps in care on key measures, hoping to improve the plan’s Star Rating while also boosting member satisfaction and plan affinity.
The plan partnered with Icario to design a member engagement and incentive program focused on historically non-compliant members. Leveraging Icario’s deep experience in consumer marketing, behavioral science, and proprietary predictive analytics, the program included all 91,000 eligible Medicare Advantage members to create personalized, dynamic member experiences for thousands of historically non-compliant members with one or more open care gaps.
Since its inception, Icario’s program has delivered a multi-year engagement strategy with significant ROI year after year. By focusing on high-value health activities, the new program has significantly improved both quality and member satisfaction metrics for this plan, inclduing 75% of respondents reporting the program improved their satisfaction with the plan, and 95% were likely to renew.
100%
increase in breast cancer screenings
44%
increase in diabetes screenings
80%
increase in fall risk assessments
100%
increase in breast cancer screenings
44%
increase in diabetes screenings
80%
increase in fall risk assessments
Parent & Baby
Medicaid
Challenge
A non-profit managed care organization (MCO) wanted to close gaps in care for its expecting Medicaid members and new parents. The MCO needed to improve health outcomes by motivating eligible members to enroll and complete recommended prenatal, postpartum, and well-child visits.
Approach
Icario created an innovative digital-first member engagement solution to reach eligible Medicaid families, close gaps in care, and improve the plan’s results. Icario leveraged proprietary predictive analytics and behavioral science to design highly personalized messages to activate members and reward high-value health actions.
Results
Since its inception, the plan’s new Community Rewards Program has helped improve the health of the plan’s expecting members and new parents. Results of the program continue to be substantial—last year, the rewards program provided over $2.5 million dollars of impact, delivering an outstanding ROI of 506%.
A non-profit managed care organization (MCO) wanted to close gaps in care for its expecting Medicaid members and new parents. The MCO needed to improve health outcomes by motivating eligible members to enroll and complete recommended prenatal, postpartum, and well-child visits.
Icario created an innovative digital-first member engagement solution to reach eligible Medicaid families, close gaps in care, and improve the plan’s results. Icario leveraged proprietary predictive analytics and behavioral science to design highly personalized messages to activate members and reward high-value health actions.
Since its inception, the plan’s new Community Rewards Program has helped improve the health of the plan’s expecting members and new parents. Results of the program continue to be substantial—last year, the rewards program provided over $2.5 million dollars of impact, delivering an outstanding ROI of 506%.
17%
on-average utilization rate for prenatal and postpartum care
66%
of members who join the program complete at least one health action
1/3
of members who attend at least one well-child visit continue to do all 6
17%
on-average utilization rate for prenatal and postpartum care
66%
of members who join the program complete at least one health action
1/3
of members who attend at least one well-child visit continue to do all 6
Icario’s Approach to Closing Gaps in Care
Identifying Gaps in Care
Whole person data better informs health risk assessments and AWVs to identify care gaps across populations. This comprehensive approach helps target each member’s individual needs within diverse groups while offering plans a view of metrics across the entire member population.
Predictive Analytics for Omnichannel Outreach
At Icario, we leverage advanced predictive analytics and new approaches to propensity modeling to design the most effective outreach strategies. This includes specific tactics tailored to each member’s engagement likelihood and risk profile.
Rewards & Incentives
Strategic rewards and incentives are thoughtfully designed to motivate members to take healthy action. These might include scheduling annual wellness visits, completing health risk assessments, or taking other essential actions to improve each member’s health outcomes.
Population Reporting and Insights
Through comprehensive population reporting and deep insights, we can capture a holistic view of health across even the largest member populations. Superior health outcomes are achieved by addressing specific needs identified through ongoing data analysis powered by our proprietary engagement platform.
Smarter engagement starts here.
Discover how our platform drives health action and improves outcomes with personalized, data-driven solutions.
