Hallmark Health Plan Pulse Check: July 2024
Joe Dahlkemper
Leads Member Engagement Strategy | Stars | CAHPS | HOS | HEDIS | Retention | Health Equity
Welcome to July’s Hallmark Health Plan Pulse Check: my monthly newsletter sharing the latest trends and effective strategies to enhance member retention. Below, you'll find insights from RISE Qualipalooza Conference and the 14th Medicare Star Ratings event.
Top Posts:
TOP-5 Takeaways from RISE Qualipalooza 2024:
1. Deep Dive into CAHPS Math
Heidi Salerno from Rex Wallace Consulting, LLC was exceptional in taking us on a deep dive intoCAHPS Math. Formerly the Sr Exec at Cigna Healthcare responsible for Stars and CX Outcomes, Heidi knows what she’s talking about. If you are looking to improve your CAHPS scores I highly recommend that you reach out to Heidi Salerno at RWC. Reach out: [email protected]
2. Data, Data, Data—From Getting it to Using it, and Everything in Between
Mike Foytik, VP, Payer Analytics & Innovation at Press Ganey provided enlightening content around numerous factors to consider with data:
?? Synthesizing multiple lines of business
?? Dealing with declining responses rates
?? Changing data collection modes
?? Questionnaire changes
?? Determining the source of changes in performance
?? Implementing effective improvement strategies
3. The Equitable Care Journey: From Data to Closed Care Gaps
CVS/Aetna’s Julia Bietsch, Chief Nursing Officer and SVP, Clinical Operations and Mike Kester, PMP, Exec Dir of Health Care Quality Management presented insights and impressive results from thoughtful and innovative approaches taken to improve results. They shared how they used algorithms to better identify specific member segments. And provided insights into their outreach and engagement strategy. Finally, they gave input from experiences with their Care Model Intervention.
4. Tips from Consultants Ana Handshuh, CHC and Melissa Newton Smith
?? CMS loves HOS. Embrace HOS. When we embrace HOS, we reduce MLR.
?? HEI replaces reward factor in 2027 based on 2024 and 2025 performances. Currently 75% of 5-star plans do not qualify for HEI.
?? Stars is 100% political. $16 billion pot of dollars for incentives. HEI is totally a
Democratic construct. SDOH is safe under both Dem and Rep administrations.
Get in touch: [email protected], [email protected]
5. Understanding Boomers
Alexis Abramson, PhD was keynote speaker and has dedicated over 25 years to the ‘Business of Aging.’
?? Q: What’s the number one influence for boomers in making a purchase? A: Word-of-mouth. 89% of boomers that are asked, give a recommendation.
?? The MA 65+ audience is NOT one-size-fits-all. Know the various demographic segments and communicate accordingly.
?? Relationships drive purchases. Here are six critical components:
- Build Trust & Communicate Effectively
- Personalize
- Deliver Exceptional Service
- Show Appreciation & Engage
- Show Support
- Highlight Benefits
This conference is focused on quality of care and improving member experience. Kudos to Kevin Weigel at RISE for pulling together this important annual event with impressive and knowledgeable speakers and exhibitors.
领英推荐
Members of health plans like Horizon BCBS NJ love to receive and use their Hallmark Cards #MemberWellness calendar all year long. Here is an example with unique wellness messages and reminders specific to each month.
Please send me a message if you’re curious about our beautiful 2025 designs and want to learn more about how to incorporate this engaging mailing into your member engagement strategy.
Here are my top 5 takeaways from the 14th Medicare Stars, HEDIS, Quality & Risk Forum June 4-6, 2024 in Costa Mesa, CA.
1?? Navigating the Health Equity Index: Brendan Generelli leads Stars & Quality at Blue Cross & Blue Shield of Rhode Island.
Brenden is an expert in understanding HEI, its calculation methodology, and what health plans can do to qualify for HEI rewards. He shared his experience in discovering the best way to navigate the health equity index, elevate healthy outcomes, and safeguard star ratings. His presentation was timely and relevant.
2?? Optimize Medicare Stars Unique Performance Levers
If you want to better understand how to Optimize Medicare Stars Unique Performance Levers, I recommend that you get in touch with Rex Wallace or Jessica Muratore at Rex Wallace Consulting, LLC. RWC is a strategy consulting firm with deep experience in Quality Improvement. They help clients improve #Stars by leveraging industry best practices, creating more meaningful engagement, and developing cultures of #quality. Rex and Jessica can be reached at [email protected] and [email protected].
3?? Leveraging your CTM (Complaint Tracking Model) and Appeals Measures to Boost your Stars Rating Scores
Moraima Rios, DrPH is the Medicare STARS Program Director at MCS Puerto Rico. With 272K MA members, MCS is the leading #healthplan in Puerto Rico. Moraima shared her smart and effective approach to measure and manage CTMs, which contributed significantly to MCS becoming a 5-Star plan.
4?? Enhanced Member Outreach Strategy through Interdepartmental Collaboration
Three executives from Blue Shield of California presented how they collaborate. They shared in depth the favorable results they are attaining by aligning these 6 internal departments:
?? Marketing Communications
?? Risk Adjustment
?? Medicare Member Outreach Team
?? Product
?? Data Analytics
?? Case Management
5?? Beyond Risk: The Importance of Dual Advocacy
Jennifer Callahan, COO at ATRIO Health Plans presented Social Care Program Goals and Social Care Program Challenges. Jennifer then outlined her integrated solutions that drive ROI.? Much was learned from her insights around the impact of #HealthEquityIndex.
Kudos to Roz Applebaum, VP Conferences at Strategic Solutions Network for bringing in experts from health plans to present best practices on current hot topics!
Centene Corporation and Wellvana's multi-year primary care deal for Medicare Advantage members marks a significant step towards enhancing access and quality of care. Exciting times ahead for the healthcare landscape! #MedicareAdvantage
Read more here:
I'd love to know: Which of these three designs for Hallmark's 2025 #MemberWellness Calendars is your favorite?
To talk more about the latest health plan member engagement strategies, send me a message on LinkedIn. I’d love to connect.
Thanks for subscribing, and stay tuned for next month’s Hallmark Health Plan Pulse Check.