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Eliza Corporation's Medicaid Solution Saves $2.4 Million in Revenue and Delivers 10:1 ROI for a National Managed Care Organization

Active Monitoring combines HEDIS and member-level interaction data to track progress and provide data visualizations that actively identify gaps in care

DANVERS, Mass. and ORLANDO, Fla., Feb. 26, 2014 /PRNewswire/ -- At HIMSS14 Annual Conference and Exhibition this week, Eliza Corporation ("Eliza"), the pioneer and recognized leader in Health Engagement Management, announced the "Eliza for Medicaid" member management solution suite that addresses key clinical and operational measures for Medicaid populations. 

Eliza Corporation.

Demonstrating the power of Eliza for Medicaid, one of the nation's leading Medicaid Managed Care Organizations ("MCO") struggled with high levels of member attrition.  The MCO turned to Eliza for strategic analysis and solutions.  Eliza's engagement analysis uncovered that over 30 percent of the MCO's members let coverage lapse -- simply because they failed to complete the required recertification process.  The administrative oversight left eligible members without healthcare coverage and threatened the MCO's productivity, costs and revenue goals.  In order for the Medicaid MCO to improve its position, it needed to find a solution to reduce attrition by improving recertification rates.  During a pilot period with the MCO, Eliza for Medicaid delivered:

  • 5% lift in recertification rates vs. a control group
  • $2.4 million in saved revenue
  • $1.35 million reduction in related re-enrollment expenses
  • 10:1 return on investment ("ROI")

"Consistent engagement of Medicaid populations is a perpetual challenge for health plans, since Medicaid members are notoriously difficult to reach.  In addition, Medicaid members have increased likelihood of chronic conditions.  In fact, an estimated 45 percent of Medicaid beneficiaries with disabilities are diagnosed with three or more chronic conditions. With the changes that health reform has brought to Medicaid – including the potential for millions of additional people eligible for services – Medicaid population engagement challenges have escalated," said John Shagoury, President and CEO of Eliza Corporation.  "Given the significant business and financial consequences that are compounded by Medicaid population realities, we remain intensely focused on helping our customers renew and retain members, close gaps in care, hit key thresholds, and safeguard associated health and financial outcomes."

Active Monitoring and Microtargeting Identify and Close Gaps
Based on the award-winning Eliza Star Year in the Life solution, the Medicaid solution applies Eliza's unique health data assets to help customers develop and implement strategic multimodal communication programs that:

  • Increase health literacy among hard-to-reach, underserved populations in a range of languages
  • Close clinical gaps in care for chronically ill patients
  • Promote primary care physician ("PCP") relationships to limit Emergency Room visits and increase preventative care utilization
  • Improve the recertification process
  • Gather insights (e.g., language preference, text, email) for future communications
  • Connect  people with supportive resources

Leveraging Eliza's Active Monitoring and Micro-targeting tools to offer even greater quantifiable value to customers, Eliza for Medicaid combines Healthcare Effectiveness Data and Information Set ("HEDIS") with Eliza member-level interaction data to track progress and provide monthly visualizations that 'actively' identify gaps in care.  Active Monitoring also adds a data layer -- derived by an Eliza proprietary algorithm -- to identify members that would benefit most from Micro-targeted outreach to close remaining gaps in care and to meet goals. 

For more information about the Eliza for Medicaid solution suite and other health engagement offerings, visit http://info.elizacorporation.com/medicaid or email [email protected].

About Eliza Corporation
Eliza Corporation ("Eliza") is devoted to making people happier, healthier, and more productive. The pioneer and recognized leader in Health Engagement Management, Eliza draws from more than a billion interactions with people about their health, and blends business intelligence, technology, and communication expertise to improve care experiences, reduce costs and advance population health. Each program is powered by Eliza's engagement-based analytics and population segmentation, and delivered via our patented speech recognition technology, rich web and multi-modal delivery platform (including automated calls, emails, text messages, mail, social and mobile interactions). These programs consistently yield the best outcomes in the industry in terms of increased engagement, health and wellness measures, and sustainable ROI. Eliza was founded in 1998 and is headquartered in Danvers, Massachusetts. For more information, please visit www.elizacorp.com.

All product and company names herein may be trademarks of their registered owners.

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