Get your money’s worth

When I was a kid, we would jump on those tiny merry-go-arounds outside of stores or those little goofy race cars in Toys R Us and my dad would shake them. Yes, it is true.

He refused to put the 25 cents in to move them mechanically.  He would just shake them and after a while we’d jump out.  It wasn’t worth the 25 cents to him.

Well, what would my dad (or your dad for that matter) say if he knew you were paying $300, $400, or even $500 for a member evaluation and not linking it to gaps in care to improve your HEDIS, STARS, and member plan of treatment, or using they to trigger medical management?  In a recent webinar we asked health plans the following questions:

 Question #1: Does your health plan use your member evaluation findings to do member outreach to reduce gaps in care? 

The Answer:      30% Yes

                              70% No

Question #2:  Do you utilize your member evaluation findings to trigger referral to complex, case, or disease management?

The Answer:      60% Yes

                             40% No

The member evaluation is a great way to collect clinical, demographic, administrative, and quality of care information. You are paying for it; make sure you are getting your money’s worth.  We hope next time we asked this question the answers are 100% Yes.

Note: CenseoHealth CEO Jack McCallum is speaking on September 13th on a webinar hosted by MCOL that addresses this topic even further.  Register here to join us for this event: Integrating Risk Adjustment and Quality of Care Initiatives