Rise

Our recent analysis of a national health plan's Medicare Advantage (MA) population compared outcomes for plan members who received an IHE to members who receive annual wellness visits with their Primary Care Provider (PCP) and to members who neither received an IHE or an annual wellness visit (unengaged with primary care). The findings validate that beyond accurately capturing members health conditions and closing gaps in care, the IHE brings greater, untapped value health plans can leverage to optimize the time clinicians spend with some of their highest need members.

Positive member experiences are important for health plans to successfully address areas of focus such as assessing member engagement levels, Stars performance, and membership retention and growth. IHEs can open the door to a delightful member experience through an unrushed, whole-person evaluation of the member's health, which includes a physical exam, social determinants of health screening, diagnostic and preventive screenings and identification of gaps in care such as diabetes.

IHE results are shared with members and their PCP. Members are either encouraged to seek appropriate follow-up care with their PCP or, if not connected to a PCP are assisted in finding one. Our analysis showed that members who received an IHE were more likely to seek primary care services compared to those who did not have an IHE. Our research also shows that the majority of MA members who received an IHE are willing to receive additional in-home health services including more diagnostic and preventive screenings.

Topics at a Glance:

• Positive member experience has a strong, long-term link to value for both members and health plans
• In-home health evaluations can supplement the members relationship with their PCP, or facilitate connection with a new PCP
• Completion of diagnostic and preventive screenings during the IHE adds significant value for health plans and their members
• In-home point-of-care screenings create opportunities to close multiple care gaps and impact Star measures