The increasing pressure of moving towards value-based care models coupled with recent changes in policies and an increase in funding for Medicaid services under federal initiatives has made Medicaid engagement more important than ever.
Engaging patients in their own care is often key to improving health outcomes and reducing costs within this framework. Since Medicaid patients often have complex healthcare needs and higher rates of chronic diseases, providing opportunities to improve patient engagement practices among this population is critical.
Like many new project undertakings success hinges at the intersection of clinical excellence and financial stewardship which drives the following question…
How do we strategically increase the engagement of high-risk Medicaid patients in a way that will bring us results without exhausting our staff , budget, or resources?
The answer just might be Caret Health, an innovative and relatively new health-tech company taking a unique hands-on approach to remote care intervention that drives remarkable outcomes and ROI through strategic targeting of highly weighted measures amongst a subset of your highest-risk highest-cost patients.
Effective Medicaid Patient Engagement presents a unique set of challenges these barriers often complicate the implementation of care programs limiting their success.
Frequent moves and/or changes in contact details not always present in pati ent records, including addresses and phone numbers, can severely disrupt communicati on eff orts and conti nuity of care.
Issues such as unstable housing, limited access to transportation, and food insecurity significantly hinder consistent healthcare access and adherence to treatment plans.
Many Medicaid patients have had little to no access to healthcare education, which can impede their understanding of medical advice, treatment plans, and the importance of ongoing care management.
Many Medicaid patients suffer from multiple chronic conditions, requiring coordinated management across various healthcare settings and providers.
Lack of access to technology or limited digital literacy can prevent patients from utilizing telehealth services or digital health tools effectively.
Looking at these challenges we can begin to see that efficiently connecting with Medicaid patients through remote care channels poses a complex puzzle that demands a synchronized, strategic response. These are individuals who frequently confront multifaceted health and socio-economic challenges, a situation that calls for a model of care delivery that not only anticipates needs but also innovates in service delivery.
Language barriers and low health literacy make it difficult for patients to understand their health conditions and the necessary steps to manage them.
Healthcare providers may not always be aware of cultural influences that affect a patient’s health beliefs and behaviors, potentially leading to decreased patient engagement.
Caret takes an approach like no other. Most companies are passively aggregating data and handing off a list of problems for care teams and providers to solve (In the time they most likely do not have).
Caret Health's blueprint for patient engagement takes a proactive, hands-on approach that seamlessly integrates actionable data with personalized patient care by using a centralized care team to conduct outreach so their customers are not burdened with extra work, drastic workflow changes, or resource drain.
Caret does the heavy lifting by offering outreach through their multi-disciplinary team of HIPAA and Cultural Sensitivity trained agents and clinical staff . This ensures operational efficiency that efficiently bridges gaps without placing additional burdens on existing care structures.
Providers are kept informed through monthly reports that can be sent manually or integrated with the customer’s EHR. The only time a provider is contacted outside of these reports is in the event of a risk escalation that has been vetted by the care team. For example, Caret received an alert notifying the care team of a high BP reading. After speaking with the patient and having them retest it is suspected that medication adjustment may be needed.
Each patient who enrolls is equipped with remote patient monitoring kits which include a Pulse Oximeter, Blood Pressure Cuff , and Scale. In some cases, heart rate monitors and glucometers are also provided. The care team educates each patient on the devices walking them through how to use them. In the event a patient has their own device that they are already comfortable using, the Care Team works with them to educate them and set them up for the program with those devices.
Caret uses a multi-stack method where each patient’s journey is tailored to their unique needs. Each patient’s technology literacy, communication method preference, language needs, and education level are assessed in initial outreach attempts. Custom engagement is then tailored to encourage the best possible outcomes.
Caret’s secure database tracks and transcribes each outreach call. These transcriptions are analyzed by proprietary Ai to assess and grade each interaction ensuring the approach is constantly optimized. The Ai has also been trained to pick up and flag any key language that may indicate larger health problems or SDOH issues allowing our care teams to escalate and address these issues in a timely manner.
Caret’s Tasking Engine analyzes this information and strategically directs efforts towards interventions with the highest probability of success and ROI, ensuring that value-based care translates into measurable quality improvement outcomes, cost of care reduction, and ROI as efficiently as possible.
Achieving initial communication and an agreement to participate from Medicaid patients can be challenging, particularly if updated contact information is not on file. This is why Caret does the most starting with multiple attempts to reach each patient at strategically diverse times through phone calls, customized voice and SMS messages, and mailed information pamphlets. For patients whose contact information was invalid or are still unable to be reached aft er a predetermined time window Caret will work through continuity of care to find the last provider the patient visited, to see if they have updated contact information for the patient.
In current contracts, Caret has successfully enrolled over 33% of master list patients in remote interventions.
To help patients build a healthy habit around checking their vitals Caret deploys strategically timed adherence reminders through app notifications, SMS reminders, and phone calls. Messages are designed to ensure patients feel valued and empowered to keep up with their health.
Roughly 60-65% of all enrolled patients engage in vital submission each month.
This equates to over 20% of the initial master list (Industry standard is about 0-10%).
New patient enrollment is ongoing and less than 3% of enrolled patients churn from the program each month.
You may be thinking why did Caret start with such a difficult population? The truth is they didn’t. Caret initially started this approach working with Medicare Advantage patients where their success was even more impressive. As a diverse company where employees from all backgrounds have joined hands to build the best product possible the company deploys a deeply rooted passion for diversity, equity, and patient care which means helping high-risk patients across all barriers, including Medicaid.
In a time where many hospitals and health plans are struggling with too much to do and not enough time or resources to do it, finding solutions that are affordable and easy to implement may feel like searching for unicorns. With the right support, achieving Medicaid Patient Engagement results that translate into outcomes is possible. Whether your ultimate goal is to drive quality improvement or reduce cost of care,
Caret can work with you to build a tailored program that drives results and ROI without additional PCP or operational burden.
Caret Health's commitment to transforming healthcare delivery underscores its role as a catalyst for change in addressing the complex healthcare needs of underserved communities.
By partnering with organizations like Caret Health, policymakers and healthcare leaders can continue advancing initiatives that promote health equity and improve outcomes for all individuals, irrespective of immigration status.
