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Chronic conditions pose significant challenges to individuals and healthcare systems alike. Back in 2021, a leading health plan client was concerned that their members were not getting adequate care for their chronic conditions, posing potential risks to member health and the plan’s financial operations. Facilitating patient education, empowerment, and care coordination was a top priority for the health plan but their current Customer Experience partner’s contact program was incurring substantial costs without delivering adequate impact.
The health plan wanted to limit the negative impact on plan’s financial performance, CMS incentive payments, as well as CMS Star Ratings and promote positive care outcomes. They decided to partner with ResultsCX to tap into our proven CXM expertise and solutions.
We collaborated with the health plan to design a comprehensive solution targeting members with pre-existing conditions to improve care utilization and member outcomes.
Our team remains committed to building upon the success of the program deployed in 2021. We continue to expand the scope of the engagement and drive continuous improvements to achieve even better outcomes.
Between 2021 and 2023, the holistic omnichannel solution has consistently surpassed targets for scheduled member appointments, promoting member wellbeing and safeguarding client’s CMS Star rating.
Year 1: 2021 – 2022
Year 2: 2022 – 2023