Challenge
Engaging Medicaid Families for Necessary Care Before and After Birth
Adequate care for expectant parents and newborns is a major problem in the United States. Social determinants of health (SDoH) and other factors often prevent families from receiving necessary healthcare before and after the baby is born. For example:
- 1 in 7 infants in the United States in 2021 were born to someone receiving inadequate prenatal care, from a study by the March of Dimes.
- 40% of new parents do not attend a postpartum appointment, according to the ACOG.
- The CDC reports that 15% of newborns do not receive the recommended well-child visits in their first year.
Problem-Solving Partnership
Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO) based in Houston that serves 400,000 members across Southeast Texas. Many of Community’s members are Medicaid-eligible expectant parents and people with newborn children. In any given year, Community covers on average, nearly 30,000 Medicaid births.
Prior to engaging with Icario, Community understood the impact social determinants of health have on accessibility to prenatal and postpartum care and well-child visits. Community’s large member population of Medicaid families provided the plan with first-hand knowledge of devastating statistics:
Babies born to a mother without a history of prenatal care are 3x more likely to have low birth weight and 5x more likely to die than children born to a parent who received prenatal care (NCSL.org).
“Because there’s so much at risk with those measures, we wanted to make absolutely sure we were reaching everyone we possibly could.”
Pam Hellstrom
Chief Compliance and Quality Officer, Community Health ChoiceWith stakes so high for expectant parents and families with newborns, Community wanted to find a way to close gaps in care and improve health outcomes by motivating their members to complete the recommended prenatal, postpartum, and well-child visits.
Omnichannel Solution that Delivers Year Over Year
To meet this challenge, Icario’s health action experts designed the Community Rewards program, a member engagement and incentive program for expecting members and new parents. The program’s primary objective was to motivate members to enroll and complete their prenatal, postpartum, and well-child health actions within the HEDIS (Healthcare Effectiveness Data and Information Set) specified timeframes.
Icario leveraged deep experience in consumer marketing, whole person data, and proprietary predictive analytics to create an innovative member engagement solution to reach eligible Medicaid families. The Community Rewards Program is uniquely designed to close gaps in care and improve measure performance for the plan. Focused on rewarding the 8+ healthcare activities identified as part of these measures, the program includes a digital-first communication plan over 12 months, using highly personalized messages to activate members and reward high-value health actions.
The Community Rewards program includes:
- An innovative omnichannel approach that uses digital outreach like email and SMS, Interactive Voice, mailers, and other traditional outreach methods to meet the unique messaging preferences of each member.
- Personalized communications that go beyond closing gaps in care to engage each member in a purposeful, ongoing conversation with Community.
- Meaningful rewards that can be redeemed instantly after each activity, such as gift cards that help cover important expenses like groceries and diapers.
Results
Since its inception in 2018, the Community Rewards Program has reached over 147,000 eligible members, achieving extraordinary results, including:
17%
utilization rate on average for prenatal and postpartum care
66%
of members who join the program complete at least one health action
1/3
of members who attended one well-child visit continued to do all six
Key Takeaways
Our long partnership with Community continues to deliver value for the organization as we seek to find more ways to improve the performance of the Community Rewards program year after year.
We also strive to create even more effective messaging techniques to improve social determinants of health, including health literacy. The program offers a sophisticated language translation capability, creating equal experiences for non-native English speakers and ensuring language is not a barrier to engagement.
In addition to closing gaps in care and improving important measures for prenatal, postpartum, and well-child visits, the program continues to deliver strong financial value for Community: Last year the Community Rewards program provided over $2.5 million dollars of impact, an outstanding ROI of 506%.
These metrics all point toward the most meaningful result of our work—the Community Rewards program is improving the lives of parents and their babies. Icario’s mission is to move people to do things that are good for them. With Community, we’re doing just that.
