Summary
This document is a guide that outlines strategies for proactive care gap closure in healthcare plans. It emphasizes the drawbacks of relying on fourth-quarter interventions, which can lead to increased costs and poorer health outcomes. The guide presents a systematic approach to identify and engage members who typically do not close care gaps or delay until the end of the year. It details methods for capturing member demographics, understanding barriers to care, and implementing effective communication strategies, including AI-supported appointment scheduling. Additionally, the document highlights a success story involving a Medicare plan that improved Annual Wellness Visits (AWVs) through targeted outreach, resulting in significant revenue gains. The guide concludes with performance metrics that demonstrate the effectiveness of these proactive measures, including higher connection and conversation rates compared to industry averages.
