DENVER, November 15, 2018 – Consumer awareness of quality measures like Star Ratings is on the rise, and a growing number of Medicare eligible consumers are choosing plans based on these measures. With the recent release of the 2019 Medicare Advantage Star Ratings, plans across the nation are strategizing to target or maintain specific areas to keep a competitive edge. Based on work with the nation’s leading Medicare Advantage plans, Welltok has introduced its integrated Medicare Quality Solution – designed to precisely identify risk for gaps in care like cancer screenings or medication refills, and boost Star Ratings by getting seniors continuously engaged in their health.
Welltok’s Medicare Quality Solution combines its leading SaaS technology with the latest cutting-edge advanced analytics and multi-channel engagement to personalize year-round quality interventions with members. Welltok uniquely leverages both traditional data (claims and clinical) with consumer data (e.g., purchasing and voting habits) to accurately predict members at-risk and identify opportunities for plans to make an impact. Seniors are then engaged with through their preferred communications channel (e.g., mobile, direct mail, automated voice and live agent), and are connected to personalized resources, support and incentives that drive action and outcomes.
“The disparity among the senior population is only growing – while some seniors are more tech savvy and prefer a purely digital experience, others still welcome a phone call or a postcard in the mail,” said April Gill, vice president of health plan market solutions for Welltok. “Our solution is built to systematically understand and activate all types of seniors in a scalable and personalized way. We’ve designed best practices that impact quality initiatives and lower risk profiles, improving Star Ratings and the member’s experience.”
Partnering with regional and national Medicare Advantage plans, Welltok has driven measurable and specific quality improvement results, including:
- Diabetes care: 48 percent improvement in gaps in care closure
- Medication adherence: 85 percent improvement in medication refill rates
- Cancer screening: 56 percent improvement in the rate of colorectal cancer screenings
The Quality Solution is designed to support one, a few or up to 30 quality measures, such as flu vaccinations, diabetes screenings or care coordination, based on the goals and objectives of a Medicare Advantage plan. Another differentiator of the offering is the use of proprietary consumer data on 275 million Americans, compiled from public and private sources over the past seven years. This data, including social determinants of health, adds a level of precision and targeting that results in an unparalleled, personalized experience that members want and expect from today’s plans.
Added Gill, “By implementing data-driven, targeted multi-channel campaigns to close critical gaps in care and engage members in the appropriate care and condition management programs or facilitate access to valuable resources, we are helping plans not only retain members, but attract new ones too.”