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Top 5 Learnings From World Congress’ Medicaid Managed Care Conference

Not making a decision is a decision itself. Kicking off the conference, Glenn Pomerantz from Gateway Health Plan and chairperson of the World Congress Medicaid Managed Care Conference, spoke of the challenges facing Medicaid and plans that continue with the status quo, and the dangers of failing to adapt to a shifting managed care landscape. Instead, bold decisions must be made to affect the change needed to reduce costs, while improving quality and the member experience.

These are my five bold decisions after attending the conference and presenting alongside Jason Thomas, Corporate Director of Special Projects and Facilities at Trusted Health Plan:

1. Focus resources on the biggest drivers of health

I learned that while socio-environmental factors, and the behaviors they drive, account for approximately 60% of factors that impact premature death, only 4% of a health plan’s operational spend focuses on these areas.

2. Create benefits that matter to members

Social isolation has a huge impact on health and many vulnerable and elderly members. Yet despite this, plan products rarely focus benefits on these areas. What would be the impact of providing a service where a home visit was made to take a member out for a neighborhood walk every week? How much more would the member value that over typical plan benefits?

3. Use the communication channels that members use

In response to mPulse’s presentation with Trusted Health Plan that explored conversational text messaging solutions, Glenn Pomerantz of Gateway Health Plan commented, “If we are doing our jobs properly, every plan should be using this channel.”

4. Focus on building relationships with members

In mPulse’s presentation I talked about conversations being the foundation for relationships. Through the use of conversational AI, Medicaid plans can now have meaningful conversations with their members at scale. Using this approach, plans can ask questions to understand the needs and challenges of their members and provide tailored support that provide them with the experience and support they value most.

5. Bridge digital and community

Trusted Health Plan built its success around a brick & mortar wellness strategy. Yet they realized they needed to do more to improve member engagement. Jason Thomas highlighted how they were able to use text messaging to engage members on key areas such as, redetermination and Wellchild visits. They also used messaging to connect members to their community. Trusted Health Plan used text messages to promote and drive attendance at important local events that created a powerful bridge between their digital engagement and community-focused strategies.

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