Webinar Recap: How Gateway Health is Influencing Medicaid and Dual Eligible Health Outcomes through Member Engagement

Gateway Health's, VP of Clinical Quality, Kara House joined Eliza for a WHCC webinar, "How Gateway Health is Influencing Medicaid Health Outcomes through Member Engagement."

View the on-demand version of the webinar here.

House discussed the challenges associated with engaging underserved populations, including incorrect phone numbers and bad addresses (often due to frequent moves), cultural barriers to care, comorbidities, and socioeconomic barriers to care such as food insecurity, unemployment, low health literacy and limited access to transportation. Gateway partnered with Eliza to better engage its membership and improve health outcomes. In addition to improving HEDIS rates and key administrative processes such as new member onboarding and retention, Eliza has helped Gateway improve member satisfaction and loyalty and open new communication channels.

Kara spoke about the positive preliminary HEDIS results they've seen for the Annual Dental Visit (ADV) and Plan All Cause Readmission (PCR) measures. Those reached by Eliza had an 8.3% increase in ADV rates and were 3.9% less likely to be readmitted within 30 days of discharge, than those not reached. Gateway also closed care gaps at the end of the year by utilizing Eliza's live agents to schedule over 1,400 appointments for more than a thousand members with primary care, vision and dental providers.

Moving into 2016, Gateway will leverage Eliza's behavior-driven analytics in a multi-year, multi-channel coordinated member engagement strategy. Historical claims data are layered upon consumer and engagement data to segment, target, and outreach the appropriate members at the right time, via their preferred channel, with communications that drive outcomes.

In 2015, we worked with a large Medicaid MCO to positively impact HEDIS rates, streamline the onboarding and retention processes, and assist in achievement of pay-for-performance goals. Over the course of one year, Eliza launched 21 multi-channel programs and 2.3 million outreaches to over one million members, resulting in:

  • 30-48% overall engagement rate, utilizing automated calls email, SMS and live agents
  • 10% increase in redetermination rates
  • 5% improvement in Continuous and Acute Phase anti-depressant medication adherence rates from the previous year
  • 5% improvement in diabetes Hba1c testing rates from the previous year
  • Over 1,700 well child visits scheduled to close gaps in care during the last three months of the year
  • Double the number of members with access to government-sponsored mobile phones

Special thanks to Kara House and Gateway Health for sharing your story. For those of you who missed it, a recording is available here. For more information about how Eliza can help better engage your Medicaid population, email us at eliza@hms.com, or call us at 1.844.343.1441.


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