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 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. Approaches include identifying risk for, and closing, gaps in care like cancer screenings or medication refills, and boosting Star Ratings by getting seniors continuously engaged in their health.

New technologies, advanced analytics and multi-channel engagement offer Medicare plans an opportunity to boost engagement and personalize year-round quality interventions. For example, by leveraging both traditional data (claims and clinical) and consumer data (e.g., purchasing and voting habits), plans can accurately predict members at-risk and identify opportunities to make an impact. Then, by adding in multi-channel engagement approaches, plans can ensure seniors are engaged using their preferred communications channel (e.g., mobile, direct mail, automated voice and live agent), and that they 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. “Plans will benefit the most from quality solutions that are built to systematically understand and activate all types of seniors in a scalable and personalized way. “

Partnering with regional and national Medicare Advantage plans, Welltok has driven measurable and specific quality improvement results with its Medicare Quality Solution, including:

  • Diabetes care: 48% improvement in gaps in care closure
  • Medication adherence: 85% improvement in medication refill rates
  • Cancer screening: 56% improvement in the rate of colorectal cancer screenings

Welltok’s Medicare 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. It leverages 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 also attract new ones.”

Learn more about Welltok’s Medicare Quality Solution.