5 warning signs your rewards & engagement program may be delivering negative ROI

5 warning signs your rewards & engagement program may be delivering negative ROI

Engaging members in their own healthcare is paramount today, and your plan likely already has a rewards and engagement program to motivate them. You recognize that members want a simple, seamless, personalized, and rewarding experience—and that’s an essential insight for your plan’s success.

But simply checking the box and investing in a rewards and engagement program isn’t enough if it isn’t effectively and efficiently driving results.

In fact, if you’re not measuring your program’s success or including the right measures and members—you could be actively throwing money away.

Here are 5 warning signs your rewards program may be delivering negative ROI—failing to boost performance and improve member health in a measurable, attributable, cost-efficient way.

#1: You include as many measures as possible.

When choosing measures for a rewards program, many plans take a “kitchen sink” approach, focusing on every possible rewardable measure. “Why not try to improve on as many measures as possible,” you may think.

In this case, more isn’t always better. The problem with taking a broad approach is that you may be wasting money on low-priority measures rather than zeroing in on the measures that matter most and focusing your investment there.

Instead of rewarding too many measures, we suggest aligning program activities with plan and program objectives, such as improving quality and connecting members to plan programs and services to help improve their satisfaction. Identify which measures should be included to achieve those objectives, and set a strategy to improve or progress each measure to the next cutpoint—or maintain its current cutpoint position.

By focusing solely on the measures that will have the biggest impact on quality and member satisfaction, your program can deliver better results more cost effectively.

#2: You passively reward members for closing their care gaps.

In many cases, plans automatically enroll their members into a rewards program and mail out a gift card three months after members complete an activity. The problem with this “opt-out” strategy is that members often aren’t aware they’re even eligible for a reward, nor are they able to make the positive connection between behavior and reward.

While plans must invite all members to participate in a rewards program, a better, more cost-efficient approach is using an “opt-in” strategy that communicates more robustly and frequently to the members most in need of care, and then rewarding the members who choose to participate—helping to build the connection between behavior and reward that can lead to lasting change.

#3: You think personalizing communications means including each member’s name in the salutation.

We often see plans using mail merge to add members’ names into the salutations of otherwise generic communications and calling it a day on personalization. Or, plans sometimes take it a step further, and use member personas developed by marketing to personalize content.

Truthfully, neither of these tactics is enough to personalize your communications and reach members where they are. Different members have different open care gaps. Different members prefer different channels. And those preferences might change throughout the program.

It’s important to prioritize and communicate a member’s open care gaps depending on what is most important to their individual health and your plan’s performance.

In addition, a highly personalized and seamless member experience across multiple channels allows members to interact in whichever channel works best for them, at whatever time they choose.

Finally, personalized, relevant content—based on personas as well as third-party consumer data—is far more likely to resonate with members, prompting them to take the right action at the right time. This translates to measurable improvements in quality, as well as increases in member engagement and satisfaction.

#4: You offer a $25 reward for every activity.

A consistent reward value for all activities might seem like a reasonable way to motivate members to take action while simplifying program logistics on the back end. However, based on our experience with nearly 15 million members, we know there is an optimal reward value for each healthcare activity and the amounts vary.

To avoid overpaying or underpaying, it’s important to consider the ask you’re making of the member, and any barriers they might face in completing that activity. For example, for a colorectal cancer screening, which is more invasive and time-consuming, you should offer a larger reward than you would for a flu shot.

It’s also important to consider the value of that measure to your plan, and its ability to impact results, so you’re investing most in the high-value measures and spending every dollar as efficiently as possible.

#5: You don’t manage and adjust your program daily.

Once a rewards program has launched, a lot of plans simply let it run by rewarding members as claims data rolls in. In other words, they “set it and forget it.” However, actively monitoring, measuring, and adjusting your rewards strategy based on performance will yield far better and more cost-effective results.

Keeping an eye on how your program is doing on a daily basis allows you to be nimble and adapt so you can be sure your program is as successful as possible. Adjusting factors—such as which measures and members you’re focusing on, how many communications members are receiving (in what channels), and what reward amounts you’re offering—can help ensure you stay on track to meet program and plan objectives.

5 best practices for delivering positive R&I ROI

Now that we’ve summarized the 5 warning signs your R&I program could be delivering negative ROI, here are 5 best practices you can use to ensure your R&I program is on the positive side of the ROI equation.

Prioritize: Unlike programs that include every measure, align program activities with plan and program objectives, identifying and focusing on the measures and activities that can directly improve quality, enhance satisfaction, increase enrollment, and optimize costs.

Segment: Instead of passively rewarding members for closing their care gaps, consider using a strategy that requires members to affirmatively opt in, and rewarding those who choose to participate. In addition, use analytics and modeling capabilities to help you understand which members are most likely to take action. This will help your efforts to optimize plan performance.

Personalize: Some plans think personalization amounts to using the member’s name in the salutation. A better approach is to dynamically provide relevant activities and content in the member’s preferred channel, prompting them to take the right action at the right time as their healthcare journey changes.

Motivate: Different healthcare activities require different levels of member effort. Intelligent R&I programs align the reward value with the ask, and couple that with identified barriers, value to the plan and budgetary constraints, to ensure every dollar drives a positive ROI.

Optimize: Evaluating and adjusting your engagement efforts real-time based on member activities is the best way to ensure you’re creating a meaningful member experience and making progress toward your goals.

We follow these five best practices at NovuHealth, and they produce a measurable difference, including lower costs and positive vs. negative ROI, as you can see in the charts from one client program below.

This client’s current R&I program was costing nearly $8 million to run yet was delivering a negative 7.8% ROI. A more strategic program designed by NovuHealth was projected to only cost $1.9 million while delivering a positive ROI of more than 262%.

The moral of the story is just because you have a rewards program in place doesn’t mean it’s delivering on your objectives and using your dollars effectively. A better approach is designing a strategic rewards and engagement program that follows our five best practices (and avoids the warning signs) to deliver measurable, positive ROI.

Looking for more guidance on building a rewards program that’s attributable, measurable and truly moves the needle on performance? Contact us here with any questions.

About NovuHealth
NovuHealth is the leading healthcare consumer engagement company, driven to improve consumer health and health plan performance. NovuHealth motivates consumers to complete high-value healthcare activities by leveraging its sophisticated engagement platform, proven loyalty and behavioral science strategies, and deep industry and regulatory expertise. Headquartered in Minneapolis, NovuHealth has worked with nearly 40 health plans and served nearly 15 million consumers across all 50 states. Learn more at novuhealth.com.

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Helping AvMed Health Plans improve quality by activating the unengaged

Helping AvMed Health Plans improve quality by activating the unengaged

AvMed is one of Florida’s oldest and largest not-for-profit health plans, serving approximately 230,000 members across 30 counties. Since 2014, AvMed Medicare has received a 4-Star (or higher) overall quality rating, demonstrating their ongoing commitment to quality and member satisfaction.

Like many successful Medicare plans, AvMed knew that maintaining their 4-Star rating would be crucial but increasingly difficult, so they partnered with leading consumer engagement company NovuHealth to help ensure they stayed at or above the 4-Star threshold without falling back.

Download the case study to see how NovuHealth helped AvMed improve program participation, close more care gaps and increase digital engagement year-over-year since 2016.

DOWNLOAD THE CASE STUDY  <https://www.novu.com/corporate/resources/how-novuhealth-helped-avmed-health-plans-improve-quality-by-activating-the-unengaged data-recalc-dims="/>

About NovuHealth
NovuHealth is the leading healthcare consumer engagement company, driven to improve consumer health and health plan performance. NovuHealth motivates consumers to complete high-value healthcare activities by leveraging its sophisticated engagement platform, proven loyalty and behavioral science strategies, and deep industry and regulatory expertise. Headquartered in Minneapolis, NovuHealth has worked with nearly 40 health plans and served more than 25 million consumers across all 50 states. Learn more at novuhealth.com.

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5 proven strategies for boosting quality and satisfaction by year-end

5 proven strategies for boosting quality and satisfaction by year-end

We’re over halfway through 2019—how are you tracking against your quality and satisfaction goals?

If you’re confident about your in-year data…

That’s great! However, you won’t know until October where the cutpoints for each measure are going to land, or how you performed relative to other plans. By then, it could be too late to make the changes needed to optimize performance by year-end.

It’s also worth noting that some cutpoints tend to be more volatile than others, moving up and down by as much as 9 percent from year to year. Even if you’re on track in the measures that tend to see greater shifts, by the time October rolls around, there’s still a chance your projections could miss the mark.

We know of one large health plan that used sophisticated modeling to project where they’d land, and in some measures, their actual performance fell short by as much as 3 percent—which can be the difference between moving up or falling back.

Bottom line: even if you’re feeling good about your performance thus far, you still may need to implement some short-term strategies to ensure you meet your targets.

If you fell short last year or are not confident about your in-year data…

Now’s the time to pull out all the stops—especially if you’re struggling to achieve or maintain a 4-Star (or higher) rating.

Staying above that 4-Star threshold is more important than ever. Three out of every four Medicare members choose plans with quality ratings of at least 4 Stars, and that number continues to grow. Members have increasingly more options, and they’re moving to highly rated plans that deliver a high-quality experience.

If you need to boost performance by year end, it’s critical that you pull the correct levers. Some plans, upon realizing they’re behind, implement what we call the “kitchen sink” approach: rewarding all members for completing any healthcare activity. Not only is this expensive, it’s also inefficient. You don’t need every member to complete every activity to positively impact quality; you need the right members to complete the right activities.

Other plans employ what we call a “binary” approach, which is sending a breast cancer screening letter to members eligible for that screening, sending an A1C letter to members eligible for that screening, and so on. These campaigns are either on or off; there’s no in between. And there’s also no prioritization or personalization. You might see some incremental lift, but likely not enough to truly move the needle.

So, what should you be doing? If you’re not already practicing the 7 habits of high-performing health plans, those principles are a good place to start. But when time is of the essence, like it is from now until the end of the year, here are 5 proven strategies we recommend to our clients.

DOWNLOAD THE GUIDE  <https://www.novu.com/corporate/resources/5-proven-strategies-for-boosting-quality-and-satisfaction-by-year-end data-recalc-dims="/>

Need to boost quality and satisfaction but aren’t sure where to start? Let’s chat about how NovuHealth can help. Want to see if your member engagement strategy is sound? Take our short quiz to see how your strategy stacks up and where you need to improve.

 

About NovuHealth
NovuHealth is the leading healthcare consumer engagement company, driven to improve consumer health and health plan performance. NovuHealth motivates consumers to complete high-value healthcare activities by leveraging its sophisticated engagement platform, proven loyalty and behavioral science strategies, and deep industry and regulatory expertise. Headquartered in Minneapolis, NovuHealth has worked with nearly 40 health plans and served nearly 15 million consumers across all 50 states. Learn more at novuhealth.com.

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How NovuHealth helped 1 health plan significantly improve their Mom & Baby Medicaid engagement

How NovuHealth helped 1 health plan significantly improve their Mom & Baby Medicaid engagement

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO) in Houston that serves 400,000 members across Southeast Texas—many of whom are Medicaid-eligible pregnant women and their newborn children, who face challenges related to social determinants of health.

Recognizing the importance of prenatal, postpartum and well-child visits to the health of mothers and their babies, as well as a health plan’s bottom line, Community wanted to create a member engagement program to encourage more moms to complete those all-important healthcare activities.

Download the case study to see how NovuHealth helped Community engage and motivate more than 1/3 of program participants to complete their prenatal and/or postpartum care visits.

DOWNLOAD THE CASE STUDY  <https://www.novu.com/corporate/resources/improving-engagement-with-moms-to-be-on-medicaid-using-a-personalized-digital-first-solution data-recalc-dims="/>

About NovuHealth
NovuHealth is the leading healthcare consumer engagement company, driven to improve consumer health and health plan performance. NovuHealth motivates consumers to complete high-value healthcare activities by leveraging its sophisticated engagement platform, proven loyalty and behavioral science strategies, and deep industry and regulatory expertise. Headquartered in Minneapolis, NovuHealth has worked with nearly 40 health plans and served nearly 15 million consumers across all 50 states. Learn more at novuhealth.com.

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The quality paradox: Improving performance by motivating the unengaged

The quality paradox: Improving performance by motivating the unengaged

Most consumer loyalty programs—think Starbucks, Delta and American Express—reward their best, most engaged customers. The frequent fliers. The twice-daily mocha drinkers. The big spenders. For these brands, 20 percent of customers drive 80 percent of revenue, so it makes sense to focus on those who are most loyal.

For health plans, it’s a different story. 20 percent of members drive 80 percent of costs. And generally, these members are the unengaged and non-compliant. If your plan is only reaching the members who are already engaged in their care, you’re not addressing the members who are costing you the most.

To meaningfully impact performance, health plans must engage and motivate the unengaged. So, where can you start? First, make sure you’re focusing on the right populations. Don’t just reward those who are already engaged; focus on the members who aren’t engaged and aren’t compliant with their care gaps.

Then, customize your program design and communications. Most plans use a one-size-fits-all approach to member outreach and engagement, sending everyone the same postcard with the same generic message and reward.

A better approach is a segmented, targeted and personalized approach at the measure and member level. Identify the quality measures where you need to boost performance, focus on the non-compliant population and figure out exactly how many care gaps you need to close to reach the next cut point. Then, design and deliver your rewards program accordingly.

Download our co-presentation with AvMed Health Plans from RISE Qualipalooza to learn 5 strategies for motivating unengaged members to take action, and to find out how we helped AvMed improve performance by doing just that.

DOWNLOAD THE PRESENTATION  <https://www.novu.com/corporate/resources/the-quality-paradox-improving-performance-by-motivating-the-unengaged data-recalc-dims="/>

About NovuHealth
NovuHealth is the leading healthcare consumer engagement company, driven to improve consumer health and health plan performance. NovuHealth motivates consumers to complete high-value healthcare activities by leveraging its sophisticated engagement platform, proven loyalty and behavioral science strategies, and deep industry and regulatory expertise. Headquartered in Minneapolis, NovuHealth has worked with nearly 40 health plans and served nearly 15 million consumers across all 50 states. Learn more at novuhealth.com.

Read more