Challenge
Boosting Quality and Satisfaction in an Increasingly Competitive Market
Blue Cross of Idaho is the state’s oldest health insurer with nearly one-quarter of the state’s population enrolled in its traditional, PPO, and managed care programs.
After receiving a relatively strong 3.5 Part C Star Rating, Blue Cross of Idaho Medicare had aspirations of creating greater market differentiation in order to attract new members and increase its market share.
Recognizing the need for a more strategic approach to quality improvement, member engagement, and member satisfaction, Blue Cross of Idaho initiated an enterprise-wide improvement initiative. As a key part of that effort, the plan turned to us to develop and implement an engagement program that would demonstrate results while also delivering a positive return on investment.
Solution
A More Targeted Approach to Quality Improvement and Member Satisfaction
Previously, Blue Cross of Idaho employed a variety of member engagement tactics, but they didn’t have a coordinated engagement strategy specifically designed to improve quality and member satisfaction. So although the existing tactics were helping, the plan wasn’t able to measurably attribute the impact they had on results.
The plan engaged Icario to design a member engagement strategy that could measurably improve quality and satisfaction while also demonstrating a positive ROI.
The result was a member engagement program called Healthy Rewards, which focused on the quality measures that mattered most to plan performance while building a stronger connection between the plan and its members. While all members were eligible to participate, the Healthy Rewards program provided strategic communications to historically non-compliant members to motivate them to complete high-value health actions (for example, osteoporosis screening and rheumatoid arthritis management).
Healthy Rewards launched to 20,000 eligible Medicare Advantage members. It not only delivered a more robust, personalized member experience through a variety of channels, including email, inbound and outbound interactive voice, and mail—and also used an optimized communications cadence to help members keep their health top of mind.
“Having a rewards and incentive program has had a significant influence on Stars improvement.” — Royce Scoresby, Director, Senior Markets at Blue Cross of Idaho
Results
Higher Star Rating and Bonus Revenue with a 7:1 ROI
In just six short months, the Healthy Rewards program not only met, but exceeded initial program goals. Along with the plan’s other enterprise-wide improvement initiatives, Healthy Rewards improved quality scores, enhanced member health, and boosted the plan’s bottom line.
Impressive Participation and Gap Closure
The number of targeted members who chose to participate in Healthy Rewards was 2x higher than the initial program goal, proving that members see value in a program that meaningfully engages them in their health.
On average, nearly 50% of participating members, most of whom were historically non-compliant and generally unresponsive, completed all of their assigned health actions. In total, participants completed nearly 2,000 high-value health actions, such as monitoring physical health, flu shot, and improving physical and mental health.
Increase in Measure-Level and Overall Star Ratings
Thanks to the Healthy Rewards program and other enterprise-wide initiatives, Blue Cross of Idaho saw its Part C Star Rating jump from a 3.5 to a 4.0 in Star Ratings, putting the plan in a far more advantageous position financially and competitively.
At the measure level, Blue Cross of Idaho moved up a full Star in four Part C measures and maintained its Star Rating in six Part C measures —all of which were part of the Healthy Rewards program.
The plan also improved its compliance rating in nine of the ten Part C measures included in the program, demonstrating that more eligible members were closing more care gaps.
Positive Impact on the Plan’s Bottom Line
The half-Star Part C increase from 3.5 to a 4.0 helped drive an overall Star increase from 4.0 to 4.5, which not only helped Blue Cross of Idaho become more competitive, it also came with a significant increase in quality bonus payment (QBP) value—to the tune of $3.7 million.
What’s more, because the Healthy Rewards program prioritized the measures and members that would get Blue Cross of Idaho to the next Star cutpoint (instead of including all measures regardless of importance which increases costs but not performance), the program demonstrated a remarkable 7:1 return on investment.
7:1
return on program investment
50%
of participating members completed desired health actions
2x
higher participation rates from initial goal
Key Takeaways
Maintaining Momentum for Continued Success
The Healthy Rewards launch exceeded Blue Cross of Idaho’s expectations, prompting the plan to sign on for another year. Knowing member engagement is a long-term investment and not a one-and-done initiative, Blue Cross of Idaho looks forward to building on the success they realized and continuing a partnership with Icario to further optimize their engagement strategies.
