Opportunity‍

A leading Nonprofit health plan with over 2 million members needed to drive completion of Health Risk Assessments (HRAs) for its Medicare members as part of a CMS 90-day compliance requirement. The challenge was to engage members, particularly those with chronic conditions, to complete the digital HRAs and use the data to close care gaps, ensuring compliance with CMS and improving health outcomes.

Action‍

Ushur deployed an AI-powered, multi-channel outreach campaign to encourage HRA completion. Using SMS with a secure link to Ushur’s Invisible App, a user-friendly and HIPAA-compliant digital channel for information exchange and two-way communication, the health plan was able to better guide members through the process. Leveraging predictive analytics to action insights from HRA responses, the health plan was able to prioritize members who were most at risk due to chronic conditions. The completed data was seamlessly integrated into the health plan’s care management platform to drive gap closure and preventive care outreach.

Impact

‍The collaboration resulted in a number of key successes that supported both regulatory compliance and improved care for members. Key takeaways include:

• Higher HRA Completion: Drove a 97% jump in completions with each text reminder and a 740% increase with email follow-ups for Medicare Advantage members.
• First 90-day compliance: Implemented a digital, omni-channel approach for delivering HRAs that drove a 25% completion rate within a four week period.
• Improved Care Gap Closure: Identified and addressed care gaps, particularly for chronic conditions, while boosting preventive care efforts, contributing to higher STARS and HEDIS scores.‍
• Streamlined Data Integration: Enabled seamless HRA data integration into care management systems for more guided, data-driven care.

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