Health Risk Assessments and Medicaid

Health risk assessments encourage health promotion — the process of enabling people to increase control over their health and its determinants, and thereby improve their health.

A primary goal of healthcare organizations is to keep their population as healthy as possible. They do this, in part, by asking individuals questions about their health and lifestyle in a survey called a health risk assessment. Health plans and providers use the information gathered in a health risk assessment to forecast utilization and costs and develop personalized care plans for their members and patients.

Many health plans find it challenging to reach and activate Medicaid members to complete a health risk assessment within 90 days of enrollment, the CMS-required timeline for completion by new enrollees since July 1, 2017.

A health risk assessment can deliver insightful information to identify and manage risk during those critical initial days of enrollment, allowing health plans to address the needs of new members early in their tenure. An immediate transfer to plan resources upon identification of chronic conditions, ongoing treatment, or barriers to care, enable increased member control over their health and risk mitigation for the plan. HMS®  Eliza recommends engaging members within 30 days of enrollment with a welcome and onboarding outreach that incorporates a health risk assessment.

Here are five best practices to consider when launching a health risk assessment:

  1. Actionable member-level data: Utilize member responses to flag and follow-up with high-risk members in a timely manner.
  2. Multi-channel: Engage members through the most relevant channels (automated calls, email, SMS, web, live agent). If they are unable to complete the survey on the phone, follow-up with their preferred digital channel.
  3. Member experience: Use appropriate messaging that resonates and motivates members to take action.
  1. Configurable and customizable: The Eliza® health risk assessment solution utilizes an NCQA-compliant survey that assesses physical and mental health as well as of social determinants of health and can include flexible modules that provide inputs to your business intelligence (BI) modeling or direct information to your care managers. Eliza can also configure plan or state-required surveys for deployment via automated calls and digital channels. 
  2. Culturally appropriate: Reach members in their preferred language and ensure that translations are not simply one-for-one, but tailored using a culturally adapted approach.

Eliza® has proven experience engaging hard-to-reach populations. In less than three months, an Eliza client increased health risk assessment participation almost four times over the entire previous year. Another plan experienced a 60 percent completion rate.


For more information on how Eliza can help you with your HRA needs, contact us at 844.343.1441 or eliza@hms.com

 

 

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