Value Points // Client Info Flashcards
Low Return Rates, Customer Service, Limited budget
Multi-channel outreach programs, claims billing to use medical cost vs. administrative budget
Already contracted with another vendor
Bandwith - the capacity to make a change
What if you could reach more members, improve your quality metrics, and not need to use an adminstrative budget to fund your GIC program?
Status Quo is to fund Gaps in Care lab testing with a limited expense budget. Funding through claims, and contributing to MLR, significantly increases our client’s ability to close their member’s gaps in care.
If we can bill through claims it’s like house money. If we invoice them, it is budget. Everyone has limited budgets. They reach many more people when we bill through claims which is what we do. No need to worry about budget
Example: A regional medicaid healthplan client, formerly testing members with expense, was limited to 5,000 kits. By running through claims, this client expanded its reach to 250,000 members.
2 Disappointing return rates and member lab completion; 80% of kits shipped to members never come back.
Omni-Channel nurturing campaigns and confidence in our engagement support to share risk with our clients.
Example: Effective member engagement - we drive a higher rate of return than competitors. (The industry ships a lot of kits out but 85% aren’t returned, we do 50%+ better than the industry norm)
3 Convenience Barrier (Scheduling, commuting) to member completing an on-site lab test
Kits shipped to member’s door, activated by nurturing campaigns and supported with Client Relations
Example:
Anonymous Consumer (Health Plan Members) Testimonials
11 months ago
I think this is the first instructional video I’ve ever watched that didn’t bore me. Great video guys.
6 months ago
This was such a great, creative video to help those understand how to do the tests properly. Trust me, many patients mess this up no matter how easy the directions describe. But, this video is very accurate to do the test properly. DO follow the directions carefully and properly.
1 month ago
I was nervous I was gonna have to fill a whole tube of blood thank god. So simple and painless. Anyone that feels the way I did I promise its so quick and easy and doesn’t hurt at all, like a mosquito bite and so worth it for your health in the long run
Dumb it down
We help HealthPlan companies’ members obtain better quality of care. HealthPlans are required to submit “report cards” which means more screening and tests for their members on a yearly basis so by delivering test kits to their homes, the HealthPlan company stays in compliance and improves their members’ health too
They get measured on quality metrics (by govt, or for commercial businesses)
Ex: for patients with diabetes - A1C measures blood hemoglobin, something measured in home kits, instead of scheduling visit, traveling there and waiting at an onsite lab, we have the test kit arrive to your house making it much easier and more convenient to get the test done.
Help HealthPlan clients close Gaps in Care without the scarcity constraints of an expense budget AND activate/convert more of their member’s quality behaviors by responding to their #1 need (Convenience & Simplicity).
A client, formerly funding kits with adminstrative expense, was limited to 5,000. By running through claims and medical expense, this client expanded its reach to 250,000 kits.
https://vimeo.com/987252793
Value proposition
- MTL removes the barriers members face in scheduling a lab visit and arranging transportation while empathetically empowering our healthplan client’s members with confidence and trust.
- Effective member engagement - we drive a higher rate of return than competitors. (The industry ships a lot of kits out but 85% aren’t returned, we do 50%+ better than the industry norm)
- Health plans have to go through external quality measurement programs yearly. (HEDIS) “improve HEDIS and star rating quality metrics by closing more gaps in care” This score rolls up to their ability to get bonuses. Higher the score, higher the financial incentives - HEDIS = Healthcare Effectiveness Data and Information Set (HEDIS)
- We are so confident in our methodology that we are willing to go at financial risk with our customers (we are willing to pay penalties if we don’t achieve certain return rates) aka we are confident we will hit 25% and if not we will engage in financial penalties
Status Quo
The lack of simplicity, convenience, trust and patient-level relevance have traditionally served as significant barriers Healthplan Members face when their Healthplans attempt to influence clinical quality improvement efforts. These barriers create disappointing results in closing gaps-in-care quality measures.
Why CHANGE?
Status Quo Gaps In Care closure efforts produce disappointing, deteriorating results and are ripe for modernization and optimization. Imagine the power of data-driven, consumer-level engagement insights amplified with the convenience and simplicity of lab-quality collection delivered to your door.
Why NOW?
Increased member expectations for convenience, coupled with Advances in data science, behavioral science and virtual health adoption create an opportunity for HealthPlans to transform their gaps in care quality efforts and significantly improve these quality measures for the benefit of their members.
Why YOU?
- Driven by MTL’s core values of Innovation and Partnership, we saw a substantial opportunity to transform gaps-in-care quality improvement, a market plagued by antiquated consumer journeys and sub-optimal performance.
- For MTL clients this is a very simple and upgraded replacement to their existing quality platform, enhanced by shared savings opportunities.
- MTL, with its state-of-the-art, high-complexity clinical laboratory, is passionate about opening access to clinical testing where geographic, financial, and stigma barriers create gaps in the delivery of healthcare.
How does your differentiator benefit the client?
1) Member Preference; CONVENIENCE. As the OG of in-home lab testing, MTL offers the ability to lab test in the comfort of member’s homes addresses their #1 barrier (scheduling and commuting to an onsite lab).
(2)With the option of funding quality efforts through claims (and contributing to their Medical Loss Ratio requirements), the Healthplan client is no longer constrained by an expense budget which may limit their ability to effectivly activate and convert their member’s lab testing behaviors contributing to Gaps in Care Closure.
3) Risk Based Contracting Models; share in the upside gains in gap closure .
(3) White Labeling; we will white label (communicate with members on behalf of the healthplan client, operating under their branding guidelines), unlike our primary competitors.
Tips and Ideas
Supported by data-driven nurturing campaigns, Healthplan members are equipped with trusting expectations and clear next steps delivered through their preferred communication channels.
Imagine the power of data-driven, consumer-level engagement insights amplified with the convenience and simplicity of lab-quality collection delivered to your door.
Is your plan interested in reaching more members while saving money by transitioning to medical expense?
Interesting Stats
Our Labs analyze more than 2.5M at-home collections every year.
We study the return and rejection data and have learned what works (and doesn’t).
We know how to identify and nurture valuable behaviors at the healthcare consumer level while satisfying their core needs of trust, simplicity and convenience.
On average our healthplan customers see a 50%+ improvement in return with our end to end program.
Something Free
We often find our Healthplan client’s incentive platform is not optimized to activate and convert their member’s lab completion behavior. Free Consultation - We “heat map” your incentive platform and identify optimization opportunities for your incentive budget.
Who is not a fit?
Small plans < 50K members, state Medicaid and traditional Medicare (government vs. contracted payers)
Main Competitors
Everlywell, Let’s Get Checked = market leaders, most well known (we are less well known than them)
- We will white label and they won’t
- Our willingness to bill claims to allow medical expense vs. budget
- Both companies focus on Direct to Consumer and use GIC as a way to expand their reach to consumers
