Drive behavior change, close gaps in care, and improve Star ratings

The Eliza for Medicare solution directly addresses key areas of the Center for Medicare and Medicaid Services (CMS) Star programs. Eliza's approach to improving Star measures not only captures members' responses, such as intent to have a recommended screening, but also uses Eliza's algorithmic propensity scoring to add a unique dimension of understanding. For example, it can reveal which members are likely to engage in healthy behaviors or which members are likely to leave the health plan next year. We apply these insights in actionable ways to influence better population outcomes and overall program results, and, most importantly, individual quality of life.

Delivering Results for Our Clients

QUALITY AND
COST MANAGEMENT

  • 27% improvement in gaps-in-care closure rates in less than three months
  • 23% increase in gap-in-care closures for diabetes care including eye exam and kidney disease monitoring
  • 32% increase in breast cancer screenings

REVENUE
MANAGEMENT

  • 5% increase in overall retention rate
  • 3% increase in dual-eligible retention rates
  • Decreased CTMs by an average of 44% with ANOC reminders

CONSUMER
EXPERIENCE

  • 15-20% increase in key HOS/CAHPS scores, raising key measures by 2-3 Stars
  • 4X increase in HRA participation year-over-year
  • 60% email opt-in

Eliza Medicare Programs

Welcome &
Onboarding

Preventive
Care

Chronic
Disease
Management

Medication
Adherence

Post-Hospital
Discharge

Emergency
Room
Avoidance

Satisfaction &
Outcomes
Surveys

Gap Closure

Retention

Health Risk
Assessments

CLIENT SUCCESS STORY:

Retention

 

CHALLENGE:
Create a positive member experience, increase engagement and improve retention using multi-channels

RESULTS:

  • Increased retention rate by 5%
  • Saved $625K by using email instead of mail

Year-End Gap Closure

 

CHALLENGE:
Improve clients' diabetes Star Rating from 3.5 to 4

RESULTS:

  • 4-Star threshold achieved, increasing potential Star bonus to $22M for the year

HOS/CAHPS

 

CHALLENGE:
Client had a 1-Star rating in 2014 for all CAHPS measures

RESULTS:

  • Client improved every CAHPS measure by at least 1 Star and some improved 2 to 3 Stars

Our Approach Video: Health Engagement Management

Eliza’s Health Engagement Management solution reaches individual healthcare consumers and initiates a personalized two-way conversation that motivates them to take action. It integrates a scalable, multi-channel technology platform, proprietary data sources, industry-leading analytics, and experience-driven program design services to deliver outcomes that matter. Watch this short video to learn more.

  • Working with Eliza, we've proven that delivering the right message to the right person at the right time measurably improves our members' experiences. Eliza's data-driven approach helps us improve outcomes while empowering our members to advocate for their own health.

    Client testimonial: Elizabeth Bainter, Director of Clinical Quality Improvement, PacificSource Health Plans
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