Northern Health Plan Upgrades Health Assessment 300,000 Medicaid, Medicare, and Commercial members
Northern Health Plan Upgrades Health Assessment 300,000 Medicaid, Medicare, and Commercial members
About The Health Plan
- 330,000 Members
- Medicare, Medicaid, & commercial
- Client since 2015
Challenge
Obtaining the required NCQA accreditation for the plan’s existing health assessment would have exceeded their allotted budget and constrained resources.
Solution
PDHI’s NCQA WHP 5 certified Medicaid questionnaires for adults and children were customized to accommodate regulatory requirements. The cost to deploy the ConXus Platform was a fraction of the expense to attain a certified in-house solution for their assessment.
To support their internal teams, this client employed the full force of PDHI’s Completion Support services to include:
- Multilingual live agents for their diverse population
- Paper forms to maximize completion
- Phone, email, text, and mail to reach members
Real-time reports are used by program administrators to analyze results, target program communication, identify members for earlier interventions with care management, and provide feedback to State regulators and HEDIS adjudicators.
Results
PDHI’s ConXus Platform and Completion Support services delivered personalized multi-touch and multi-channel outreach allowing the plan to achieve a 53% completion rate for its Medicare members in 2019.
During its most recent NCQA review, the client was awarded accreditation for its adult health assessment. The state also approved the pediatric assessment.
Health risk assessment results are delivered daily to the client care management system for use by care coordination.