1. Derrick Dale CareOregon March 2004

2. Churning of Members Issues Care disruptionsCare disruptions Managing for stability rather than CrisisManaging for stability rather than Crisis Administrative expenseAdministrative expense –Multiple handling The MD OfficeThe MD Office The PlanThe Plan The StateThe State

3. Developing Approach Create Patient file earlyCreate Patient file early –Out-reach for Early intervention Welcome Call TriageWelcome Call Triage »Based on Eligibility Risk Adjustment and/or Premium Category (OR has 13 categories) –Medical Conditions first »Medical Questionnaire –Retention second »Eligibility date (State can provide file also) »Diary for follow up »Incentives »Call back

4. Medicaid Enrolled, But Before Entering MSO First Six Months Plan Experience Average Experience After Six months Average Premium First Year Plan Enrollment Early Intervention? Cost Pattern Early Intervention and Member Retention RetainMembersLonger

6. Retention Strategy MailingMailing –Send telephone card (for 30 minutes of time) Needs an activation numberNeeds an activation number –Call-in to get activation number »Inexpensive »20% return –Go through the renewal process and need Proactive Outbound Call (evening shift)Proactive Outbound Call (evening shift) –Timed 60 days before eligibility expires –Explain benefits of requalifing on time –35-40% connect rate after 4 attempts

7. Results After 6 month on Program –Many addresses and phone numbers incorrect –About 10-15% stay 3-4 months longer About 5% increase in enrollment –Plan Cost: Estimated $40-55 per retained member

8. Conclusion Helps continuity Saves hassle Off three months, then on again Retroactive eligibility Reinforces state approach Reaches and helps very few Need Plan/State to collaborate to reach 35-50%