Making Consumer Incentives Work in a Care Management Program

The Illinois Department of Healthcare and Family Services (HFS) and McKesson developed an incentive program to encourage participation of eligible high-cost, high-risk Illinois Medicaid recipients in the Your Healthcare Plus care management program.

As part of the ongoing outreach activities, a re-contact letter is sent to members not yet actively participating promising a $10 Walgreens gift card if the member completes an assessment, thereby officially enrolling in the program. The letter also asks the member to verify demographic data.

The re-contact letters were sent multiple times over the course of many months. The results of the first year of the incentive program show that members who received the enrollment offer generated a 20% enrollment rate, while members who received a letter without the enrollment offer, generated a 13% response rate.

While the initial results were positive, HFS and McKesson are now refining the program further by adding an end date to the offer to improve tracking to create a sense of urgency; limiting the number of letters sent per member—identifying the point of diminishing return; and adding disclaimer language to discourage members from requesting multiple gift cards.

Meanwhile, a Texas commercial health plan that wanted to improve the enrollment in its asthma and diabetes care management programs used a $10 gas card as an enticement. The health plan sent two similar mailings to two groups of 1,200 members each:

• One group received program information and a letter letting them know that when they successfully enrolled in the program a $10 gas card would be sent to them.
• The control group received program information with no mention of the free gas card.
• The program lasted one month.

While the program enrollment numbers are small, the results of the incentive program showed that the gas card offer did have a positive impact on member enrollment.

Of the 10 people who enrolled in the asthma program during the 30-day incentive program, 70% came from the incentive group, the remainder from the control group. The story was much the same for the diabetes group. Of the 30 people who enrolled during the incentive period, 73% were from the incentive group, 27% from the control group.

The program demonstrated that those in the incentive group were 2.67 times more likely to enroll than control group members.

Finding Success
Success is measured with qualitative and quantitative assessments. We typically look at response rates, and retention or enrollment rates to find out how well the program is accepted by members. We also look at complaints, compliments, and anecdotal feedback received by staff members.

For specific chronic illness or other conditions that we want to impact, we'll drill down to get screening rates and HEDIS scores.

We also look closely at how well we're doing. How much does the program cost, including direct costs, such as creative development, print and postage, incentives, and call center support?

Across the board, we've found that successful member engagement programs have several things in common:

• The program is simple.
• Multiple channels are used to communicate with members.
• The message, whether it's joining the program or quitting smoking, is reinforced throughout the course of the program.