GiftCard Partners Blog

Healthcare organizations focused on improving health plan member engagement face a familiar challenge: members often do not complete the visits and screenings needed to close care gaps. Missed primary care visits, telehealth appointments, and in-home assessments limit the effectiveness of preventive care and chronic condition management programs. According to the Centers for Disease Control and Prevention, chronic diseases remain the leading cause of illness and healthcare spending in the United States, making consistent care engagement essential¹. Strategic incentives tied to specific clinical actions can help motivate members to follow through with the care they need.

As of January 2022 62.8% of eligible Americans have been fully vaccinated against COVID-19. This milestone is significant and essential to help protect the nation’s health. Unfortunately, studies show that vaccination rates for the low-income Medicaid population are lower than that of the general population.

Continually improving member engagement, care, and health outcomes are vital for the success of healthcare providers’ programs. Engaged members lead to reduced hospitalizations, readmissions, and improved Star Ratings. When members do not utilize plan benefits, miss appointments, and are unengaged, Star Ratings plummet resulting in a direct impact on the funding providers are able to receive. Low Star Ratings can also cause members to switch to higher star-scored healthcare plans.

As Medicaid and Medicare program administrators begin planning the ensuing year’s member programs, there is an increasing need to focus on member experience in order to maintain member populations and raise retention rates within provider networks.

Finding a strategy to keep Medicaid members engaged in healthy activities is not always easy. Medicaid members may have trouble with appointment attendance due to a lack of access to, or inability to pay for transportation; or, they are unable to take time off from work, which is often in arduous, blue-collar industries.