Motivating People to Self-Care for Diabetes Management

Community Health Choice, Inc. (Community) is a non-profit HMO based in Houston that serves 350,000 members across 20 Texas counties, including many underserved Medicaid and Health Insurance Marketplace patients. 

As Community’s marketplace membership grew each year, so did the number of members with diabetes. In 2017, the staff crafted a strategy to improve health outcomes for at-risk marketplace members. Wanting to motivate routine self-care and management among the diabetic population, they decided to implement a rewards and incentive program to increase member activation and completion of diabetic healthcare activities.

Community needed a partner with experience building solutions for underserved populations, one with multi-lingual and omnichannel communication capabilities, that was also HITRUST certified, and had a strong privacy program in place to handle protected health information. Community found that partner in Icario.


Implementing Meaningful Rewards and Incentives for Health Action

We designed a rewards and incentives program, branded Community Rewards, focused on four key HEDIS diabetic measures: A1C testing, A1C control, eye exam (retinal) performed, and medical attention for nephropathy. Leveraging its deep experience in consumer marketing, behavioral sciences, and proprietary predictive analytics, we focused on 3,000 eligible members and tailored its program to meet the express needs of those members. The company offered members a variety of reward options, and selected communication channels based on members preferences—offering email, direct mail, online, or a live agent.

That focus was crucial, according to Melanye Otto, Community’s director of quality improvement. “Targeting a specific, defined group of members was a key factor in the program’s success,” she said.

Another key was integration. Icario integrated the program with Community’s patient portal to create a seamless member experience. Additionally, the program was designed to complement existing disease management initiatives. For example, nurses who contacted patients as part of Community’s Care Management Program promoted their rewards program during those calls. Ann Engelhorn, RN, Community’s leader for disease and care management, said, “The fact that Icario’s program complemented our Care Management Program so beautifully contributed to the success of both programs. We were able to reach members we hadn’t before.”


Icario’s Program Exceeded Both Activation and Utilization Goals

Pam Hanson, Community’s director, provider call center, set an activation goal of 10% and utilization goals of 7-12% at the start of the program. Icario’s program surpassed those targets well before the end of the year, ultimately achieving a 30% activation rate and a 17.6% utilization rate. “With Icario, we saw success from Day 1,” she said. “We saw a definite spike in activity any time they reached out to our members, and we’ve been very pleased with the results.”

That activity drove other impressive outcomes. Nearly 60% of activated members closed at least one diabetic gap. In total, more than 2,000 previously non-compliant, hard-to-reach members closed more than 6,700 diabetic care gaps through the program. 

Another positive outcome came in the form of patient responses. “Member feedback was overwhelmingly positive,” said Community’s Sandra Rose, MHA, MSN, RN, who supervises the Care Management Program. “They loved that they had a choice in how they could receive their rewards.” 

Hanson recalled one member, who initially contacted the call center with a complaint about a different program. “She stopped in the middle of the conversation to tell us how much she loved the Community Rewards program,” Hanson said.

That positive impact on members is translating into a stronger, more differentiated image for Community, said Otto. “Our members appreciate the service we’re providing with this program. That improves our overall reputation in the market.”