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How Medicare and Medicaid Providers Can Offer Powerful Incentives


Partnering with the right rewards provider can encourage plan members to take proactive steps toward improving their health.

Medical icons

According to the CDC, six in 10 Americans-hundreds of millions of people-live with at least one chronic disease such as cancer, diabetes or heart disease. Chronic diseases

account for

75% of the money the U.S. spends on healthcare.

In an effort to curb these seemingly exponential costs for healthcare plans and consumers alike-and to help curb the impact of these diseases-many health plan providers are exploring ways to proactively encourage people to take action by receiving preventative care.

Gaps in care and awareness

CMS estimates that nearly 60 million people are on Medicare, and Medicaid.gov reports that 66 million people receive its services. But

research found

that 60% of Medicare Advantage members surveyed say their health plan doesn't encourage actions to improve health, and only 25% say their plan provides personalized incentives.

A HIPAA-compliant and HITRUST-certified rewards partners can help health plans more actively engage members by using incentives to encourage proactive behaviors that may improve overall health, reduce symptoms of chronic diseases, and boost health plan satisfaction. Driving positive engagement can also help raise STAR ratings and HEDIS scores, which often impact how consumers select their healthcare payers and directly impact healthcare plans’ bottom lines.

Closing the gaps

Not sure where to begin when managing an incentives program? That’s what a reward provider is for. Effective reward providers can help you close gaps in care and build awareness about how people can live healthier lifestyles.

Here’s how:

  • Offering customized incentives. Consumers engage more with personalized and relevant rewards-and the healthcare industry is no exception. Tailored rewards and promotions resonate with members and can drive plan participation-and the right portfolio evolves as members’ tastes change. Reward providers can help you create programs that customize incentive choices for each individual based on their personal preferences; for instance, digital cards can be emailed to members who do not want a physical card mailed to them. Rewards partners are capable of customizing specific incentives that help you meet Medicare and Medicaid requirements-such as curating cards to merchants that support healthy lifestyles like gyms, athletic wear retailers, and natural food stores. Rewards partners can also tailor specific transportation reimbursement rewards for those who need help getting to the doctor’s office.

  • Delivering rewards quickly and seamlessly. Once an action is completed and the supervising health plan officials have confirmed a reward has been earned, your reward provider should be able to deliver incentives quickly. This helps shorten the gap between when members take desired actions and when they are rewarded for doing so; it also keeps the lines of communication open. And it’s important that rewards are easy to redeem. If recipients have a hard time using their incentive or don’t know where they can use it, their frustration may hinder future outreach efforts.

  • Communicating relevant information. Communication is a critical component of engagement and participation. Many healthcare plans are not equipped to communicate with plan members regularly and at an individual level about specific steps they can take toward better health. Reward providers can enable targeted campaigns that encourage people to complete preventative care activities such as health risk assessments, mammograms, colorectal screenings, A1C screenings, and more.

  • Leveraging analytics. An effective reward partner should have access to analytics that track healthcare program engagement. Data insights help measure how many people convert on calls to action. When incentives are offered, analytics can track which incentives resonate best and help inform future reward strategy. Monitoring and using analytics also help health plans measure whether they are moving the needle on their STAR ratings and HEDIS scores; even a little as a half a percentage increase can lead to millions of dollars in additional revenue from the government.

  • Offering support in multiple languages. Our country‘s population is diverse, and your customer service center should be prepared to help members who don’t speak English. The best reward providers offer customer service support in hundreds of languages from a U.S.-based center.

The costs to help Americans manage diseases are rising to the detriment of healthcare plans and members. By using a reward provider to offer effective incentives and help your business proactively drive behavior, you can create a ripple effect that helps reduce the spread of chronic diseases, lower healthcare costs, and increase peoples’ satisfaction with your program.

Bill Warshauer is vice president, sales , Hawk Incentives, a Blackhawk Network Business.

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