Understanding your members’ risk is as crucial to delivering high-quality care as it is to your plan’s financial performance. However, as every plan can attest, CMS risk adjustment can be a challenge, especially if your members are not actively engaged in their heath or with the health care system.
That’s why, today, we’re releasing the results from our new case study, revealing how we develop member engagement solutions to identify risk—and appropriately capture risk revenue.
What makes our engagement solutions unique is our use of propensity modeling and analytics. We leverage this data to implement a hyper-targeted CMS-HCC identification and CMS risk adjustment strategy—segmenting a plan’s member population based on risk score and propensity to activate.
In this case study, taking a targeted approach allowed us to establish marketing focus, developing segment-specific communication and activation strategies, such as rewards and incentives. The goal? To engage members and drive high-value activities—such as health risk assessment (HRA) completion or primary care visits to assess risk.
Not only did we see great results from this solution—including improved risk identification that leads to better care for members—but it proved highly cost-effective as well, all because we focused on the members who would have the largest impact on plan performance.
Download the case study to see the full results, and learn how our solutions identify and appropriately capture additional risk revenue for your plan. Or, contact us to learn more about how we tailor rewards and engagement solutions to your member population using the latest in behavioral health science and health care data analytics.
NovuHealth is the health care industry’s leading consumer engagement company. Combining performance analytics, behavior science and comprehensive technology solutions, our rewards and engagement programs enable health plans to increase high-value member activities—improving member health and driving plan performance. Visit us at novu.com.