When Current Efforts Don’t Cut It

As an award-winning not-for-profit mutual benefit corporation, this innovative health plan provides health, dental, vision, Medicaid and Medicare coverage to 4 million members across California. When they came to Icario for assistance, the plan had dropped from a 4-Star Medicare plan to a 3.5-Star plan, prompting a company-wide focus on improving quality and enhancing member satisfaction.

“It was clear our current efforts, which included member education, live call center agents, an in-home health program, and a care gap campaign, weren’t enough,” said K.R., MPH, Manager of Medicare Member Engagement. “There was a sense of urgency from leadership—it was an all-hands-on-deck situation.”


An Omnichannel Program That Delivered A Dynamic Member Experience

This health plan partnered with Icario to develop a member engagement and incentive program. The primary objective was to drive care gap closure on key measures to improve the plan’s Star Rating, but they also hoped to boost member satisfaction and affinity with the plan. 

With those goals in mind, Icario designed a member engagement solution that was available to all and focused on historically non-compliant members with open care gaps and prioritized measures like flu shots, diabetic eye exams, and colorectal cancer screenings. It was offered to all Medicare Advantage members as the Appreciation Program. 

Leveraging our deep experience in consumer marketing, behavioral science, and proprietary predictive analytics, we included all 91,000 eligible Medicare Advantage members and focused on creating a personalized communications experience for the 14,455 historically non-compliant members who had one or more open care gaps.

“Before Icario, we didn’t have the ability to personalize member communications,” said K.R. “They enabled us to create a more robust and dynamic member experience. We now communicate with members not just through mail, but also Interactive Voice, email, and an online platform. It’s a true omnichannel strategy.”


The Power And Impact Of A Multi-Year Engagement Strategy

Improved Quality

Members who participated in the program completed 23,401 high-value healthcare activities, compared to just 5,002 previously—a more than 300% increase. Several factors contributed to the uptick, including: 

  • Launching the program earlier in the year 
  • Introducing the interactive voice channel 
  • Co-promoting the program with the health plan 
  • Creating a more personalized member experience 
  • Program participants also completed several healthcare activities at a higher rate year over year, including the following:
    • 100% increase in breast cancer screenings
    • 44% increase in diabetes screenings
    • 80% increase in fall risk assessments

Improved Member Satisfaction

The Net Promoter Score survey measures customer loyalty and is highly correlated to customer experience. The average NPS for health plans was 18. This health plan’s NPS for the Medicare Advantage line of business was an already-impressive 59, and after working with us for a full year, the score rose to 65.2 with a sample size of 1,955 respondents.

Additionally, in a survey that measured the impact of the Appreciation Program on overall member sentiment toward the health plan:

  • 75% of respondents said the program improved their satisfaction with the plan
  • 95% of respondents said they were more likely to renew because of the program
  • 10% increase in NPS score

Key Takeaways

The Value Of An Experienced Partner

As CMS cut points shift, it can be challenging just to maintain your Star Rating, let alone increase it. This plan saw the value in a partner like Icario who could help them stay ahead of the curve instead of falling behind. 

And speaking of value, based on a model built to value incremental gap closure, Icario’s engagement program is projected to deliver a quality bonus payment value of approximately $6 million—or a 6x return on investment. 

“As a plan, you can’t do the same things year after year and expect the same results,” said K.R. “We’re always looking at how we can improve our program, and Icario has been great about continuously bringing us fresh ideas and strategic initiatives.” 

In fact, our client has been so pleased with the value the partnership has delivered that they’ve signed on for an additional year, saying they look forward to some of the exciting new program additions.