CASE STUDY
Industry:
Health Insurance
Products / Services:
HRA360
Managing & Transforming a leading Fortune Five Health Insurance Organization based in the USA
Client Background
Client is a multinational managed healthcare and insurance company based in the USA. The client’s healthcare products and insurance services cater to an extensive customer base across United States.
Client Requirements
With large customer base, the client faced challenges in completing Health Risk Assessment due to incomplete and outdated member contact details. The traditional methods of completing HRA and low traction in non-native speakers resulted in low HRA completion rate, ultimately impacting Star ratings.
Engagement Highlights
99.2%
Successful HRA Completion Rate
99.84%
Success Rate in Member Connect
4+
Star Ratings increased
for most of the contracts
Solution Highlights
The BPaaS enabled platform provided digital and intuitive solutions to manage the existing process. This in turn improved the HRA completion rate due to member connect and in turn improved the star ratings.
Enhanced
Star Rating
Helped in improving Star ratings of the Health Plan’s measures having less than 3 Stars
Multilingual
outreach
Dedicated outreach for providing support for multi lingual Membership (English and Spanish)
Member
Validation
End to end validation and processing of accurate contact information of the Members prior to outreach
Risk
Stratification
Stratify existing Members based on risk score & models and easy prioritization
Configurable
Questionnaires
Member portal enabling Members to fill the HRA form online
CMS
Compliance
Helped in compliance with CMS regulations through audit trail & CMS compliance reports