GiftCard Partners Blog

It is important for program administrators, healthcare providers, and personal caregivers to take vested interest in proactive care towards Medicare and Medicaid members with chronic diseases. Keeping members healthy is beneficial for the entire care team, preventing health complications for members can reduce costly hospital visits for both the member and the program’s payors and providers. 

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.

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. 

Medicaid and Medicare payers and accountable care organizations (ACOs) strategize all year about how to get members to attend their annual health screenings. However, due to employment commitments, lack of transportation, fear of contracting COVID-19, and even lack of education on the importance of yearly screenings, many members need to be incentivized to schedule and attend annual screenings and preventive care check-ups.

The rate of people with chronic health conditions is growing and, unfortunately, people often have more than one condition. Half of adult Americans have at least one chronic condition, and more than two thirds of Medicare patients have two or more, according to a 2019 Premier analysis of emergency rooms across the country.