Community Health Choice increases activation,
closes diabetic care gaps with NovuHealth

A NOVUHEALTH CASE STUDY

Challenge

Community Health Choice, Inc. (Community) is a non-profit HMO based in Houston that serves 350,000 members across 20 Texas counties, including many underserved Medicaid and Health Insurance Marketplace patients.

As Community’s marketplace membership grew each year, so did the number of members with diabetes. In 2017, the staff crafted a strategy to improve health outcomes for at-risk marketplace members. Wanting to motivate routine self-care and management among the diabetic population, they decided to implement a rewards and incentive program to increase member activation and completion of diabetic health care activities.

Community needed a partner with experience building solutions for underserved populations, one with multi-lingual and omni-channel communication capabilities that was also HITRUST certified and had a strong privacy program in place to handle protected health information.

Solution

NovuHealth designed a rewards and incentives program, branded Community Rewards, focused on four key HEDIS diabetic measures: A1c testing, A1c control, eye exam (retinal) performed and medical attention for nephropathy. Leveraging its deep experience in consumer marketing, behavioral sciences and proprietary predictive analytics, NovuHealth focused on 3,000 eligible members and tailored its program to meet the express needs of those members. The company offered members a variety of reward options, and selected communication channels based on member preferences—offering email, direct mail, online or a live agent.

That focus was crucial, according to Melanye Otto, Community’s director of quality improvement. “Targeting a specific, defined group of members was a key factor in the program’s success,” she said.

Another key was integration. NovuHealth integrated the program with Community’s patient portal to create a seamless member experience. Additionally, the program was designed to complement existing disease management initiatives. For example, nurses who contacted patients as part of Community’s Care Management Program promoted the rewards program during those calls. Ann Engelhorn, RN, Community’s leader for disease and care management, said, “The fact that NovuHealth’s program complemented our Care Management Program so beautifully contributed to the success of both programs. We were able to reach members we hadn’t before.”

Results

Pam Hanson, Community’s director, provider call center, set an activation goal of 10% and utilization goals of 7-12% at the start of the program. NovuHealth’s program surpassed those targets well before the end of the year, ultimately achieving a 30% activation rate and a 17.6% utilization rate. “With NovuHealth, we saw success from Day 1,” she said. “We saw a definite spike in activity any time they reached out to our members, and we’ve been very pleased with the results.”

That activity drove other impressive outcomes. Nearly 60% of activated members closed at least one diabetic gap. In total, more than 2,000 previously non-compliant, hard-to-reach members closed more than 6,700 diabetic care gaps through the program.

Another positive outcome came in the form of patient responses. “Member feedback was overwhelmingly positive,” said Community’s Sandra Rose, MHA, MSN, RN, who supervises the Care Management Program. “They loved that they had a choice in how they could receive their rewards.”

Hanson recalled one member, who initially contacted the call center with a complaint about a different program. “She stopped in the middle of the conversation to tell us how much she loved the Community Rewards program,” Hanson said.

That positive impact on members is translating into a stronger, more differentiated image for Community, said Otto. “Our members appreciate the service we’re providing with this program. That improves our overall reputation in the market.”

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NovuHealth is the leading healthcare consumer engagement company, offering rewards and incentive programs that improve consumer health and plan performance. NovuHealth applies proven loyalty and data science strategies and leverages its deep industry and regulatory expertise to motivate high-value consumer activities. Headquartered in Minneapolis, NovuHealth has worked with nearly 40 health plans and served more than 15 million consumers across all 50 states.

“With NovuHealth, we saw success from day one. We’ve been very pleased with the results.” –Pam Hanson, Provider Call Center Director