Align Quality and Risk to Improve Engagement and Health Outcomes

In 2025, health plans face significant hurdles in harmonizing budget restraints, increased regulations for risk adjustment, Star Ratings, member communications and intensified market competition. It is imperative for health plans to invest in effective and cohesive member engagement strategies to synthesize expenditures and drive the financial and clinical outcomes needed for long-term success.

Key takeaways:

• Pinpoint members in their preferred channels, leveraging comprehensive data analytics compiled from years of historical performance with millions of previous members.
• Build integrated risk and quality member outreach campaigns that optimize budget, simplify member outreach, improve choice of service to primary care providers, virtual care or in-home assessments, and improve the member experience.
• Engage, motivate and incentivize the hardest to reach members through the implementation of behavioral science-backed best practices and personalized, omnichannel communications.
• Improve, boost and discern the signal from the noise in a compliant and coordinated approach across the continuum.
• Understand how the partnership between ComplexCare Solutions (CCS) and Healthmine will support plans in achieving their 2025 goals to integrate and optimize vendor resources, reduce costs, increase revenue and improve the member experience.

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