Balto Health Agents: Enhancing Medicare Advantage Plans by Engaging Members on Supplemental Benefits

Introduction

Balto Health has emerged as an essential ally for Medicare Advantage plans by engaging their members with supplemental benefits. From gym memberships and rehabilitation services to at-home Continuity of Care (COC) and Annual Wellness Visit (AWV) appointments, Balto Health's experienced agents are at the forefront of educating members about these benefits and ensuring access. This commitment not only enhances the lives of Medicare beneficiaries but also contributes to improved STAR measure performance for CMS, impacting various star rating categories positively.

Educating Members on Supplemental Benefits

The journey begins with education. Balto Health agents work diligently to inform members about the full range of supplemental benefits available to them. By explaining the options in detail, from gym memberships that promote healthy living to rehabilitation services, at-home COC, AWV appointments, and meal delivery, members are provided with a clear understanding of the benefits that align with their individual needs and preferences.

Opt-In Process and Triage of Needs

Once members are informed, Balto Health agents obtain their explicit permission to opt into the selected programs. A comprehensive process follows where the agent triages the member's specific needs and requests. Whether it's aligning a member with a gym that caters to their fitness level, scheduling at-home COC and AWV appointments, or setting up meal delivery tailored to dietary requirements, the agents act as personal advocates to ensure that the services are a perfect fit.

Documentation and Integration with Client Systems

A crucial aspect of this engagement is meticulous documentation. All encounters and member preferences are carefully recorded onto the clients' systems, ensuring transparency and seamless integration with existing workflows. This detailed record-keeping not only fosters efficient service delivery but also provides valuable data that contributes to the continuous improvement of the programs.

Impact on STAR Measure Performance

The coordination and personalized attention offered by Balto Health have far-reaching implications for STAR measure performance for CMS. Several key star rating categories are positively impacted:

1. Member Experience: By educating members and tailoring supplemental benefits to their needs, satisfaction levels rise, positively affecting member experience ratings.
2. Care Coordination: The seamless scheduling of rehabilitation, COC, AWV appointments, and meal delivery demonstrates effective care coordination, another critical STAR measure.
3. Health Outcomes: Access to gym memberships and tailored wellness services lead to improved health outcomes, reflecting positively in this STAR rating category.
4. Access to Care: By ensuring that members are aware of and can utilize supplemental benefits like rehabilitation and at-home appointments, Balto Health enhances access to care, a vital component of STAR ratings.

Conclusion

Balto Health's comprehensive approach to engaging members with supplemental benefits represents a significant advancement in the support of Medicare Advantage plans. Through careful education, personalization, documentation, and integration, the process adds tangible value to the member experience while simultaneously elevating STAR measure performance for CMS.

The innovative collaboration between Balto Health agents and Medicare Advantage plans showcases a vision that goes beyond traditional healthcare offerings. It emphasizes a member-centric philosophy, where individual needs are met, and healthcare becomes a tailored, empowering experience. The impact on STAR rating categories is a testament to a model that integrates empathy, efficiency, and excellence, paving the way for a new era in healthcare engagement and satisfaction.