Improving Health Outcomes

Client: AmeriChoice Health Plans (NY, NJ, MA)

Summary


AmeriChoice Health plans have approximately 133,000 Medicaid and Medicare members, many of whom are racial/ethnic minorities. As part of its growth plan, management had a three-fold objective:

  • Decrease customer attrition through the development of targeted programming
  • Decrease medical expenses due to misuse of health services
  • Integrate member related information between payor and provider to improve service

Process


M. Davis and Company, Inc. designed and administered a health assessment survey to provide information needed to create the foundation for future planning. The survey was administered to over 25,000 members, during a fifteen-month period, via Computer Assisted Telephone Interviewing. Interviews were conducted in English, Spanish and Russian. The survey/assessment was a “proprietary” design and MDAC developed all necessary computer programming and processes for the Health Assessment Data Management System and provided the client with online, real-time access to both the data and a dashboard of reports.

 Results


The following results were achieved:

  • Compliance with mandatory reporting requirements
  • Preliminary snapshot of the health and financial risks of new customer populations
  • Development of the historical baseline for negotiating capitation rates
  • Reduced the health plan’s financial exposure by initiating better management of high risk health plan members identified during the survey process

“Health Risk Assessments”

M. Davis and Company, Inc.
Main Office
3000 Market Street Suite 202, Philadelphia, PA 19104
Phone: 215.790.8900 Fax: 215.790.8930

Satellite Office
1391 Pennsylvania Ave SE, Unit 335, Washington, DC 20003

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