Choosing a HIPAA-Compliant Incentives Vendor? Read This First.



According to the CDC, six in 10 Americans have at least one chronic disease. These diseases, including diabetes, cancer and heart disease, account for 75% of US healthcare spending. That’s why it’s no surprise that many healthcare plan providers are using incentives to encourage members to take specified healthy actions—and boost HEDIS Scores and CMS Star Ratings at the same time.

To implement effective incentive strategies, Medicare, Medicaid and commercial plan providers need a HIPAA-compliant partner that offers both communications and rewards. Here are four more tips for finding the ideal vendor to handle your gap in care incentives.

1. Look for the right rewards

Your reward provider must offer a portfolio of customizable incentives that are relevant and meaningful to your members. For example, to help you meet Medicare and Medicaid requirements, you may want to curate filtered-spend Visa®or Mastercard®Prepaid Cards that can be used at merchants that support healthy lifestyles, such as pharmacies, athletic gear retailers, and natural food stores. Or, if you know that getting to the doctor’s office is difficult for a specific group of members, offer transportation gift cards.

The right reward portfolio also evolves to keep up with your needs and your members’ desires. Digital rewards delivered via email are growing in popularity—even with older generations. Recent research indicates that 79 percent of Medicare members own a smartphone; among those age 80 and older, 56 percent own smartphones. These incentives offer faster delivery to create a stronger connection between the action taken and the reward received.

2. Make sure you can offer smaller rewards

As part of vetting a new incentives partner, make sure you can choose to offer small rewards for individual steps. Programs that build member engagement through incremental rewards are often more successful, especially since Medicare programs are not allowed to reward outcomes (such as losing a certain amount of weight). Instead, offer lower-value incentives for reporting weight loss at regular intervals. Five-dollar merchant gift cards are a great choice, especially if they can be used at popular places such as Starbucks, CVS, Subway or Whole Foods.

3. Check out the communication options

For an incentive program to be effective, it needs to offer personalized, relevant and eye-catching member communications. One option that has proven successful for Medicare, Medicaid and commercial plan providers is a two-step greeting card strategy. These fully customizable mailings enable targeted campaigns that encourage members to earn preventative care incentives for activities such as health risk assessments, mammograms, colorectal screenings, A1C screenings, and more. Plus, these cards can be tailored to meet your program’s specific needs:

  • Created specifically to appeal to your target audience
  • Branded with your logo, colors, personality and tone
  • Personalized with your recipients’ names

After the desired action is taken, the incentive—either a filtered-spend Visa or MastercardPrepaid Card or a merchant gift card—can be delivered in a similar mailer. Remember, the right partner will be able to print and mail these campaign materials for you from their HIPAA-certified facility.

4. Investigate the analytics capabilities

Implementing a variety of targeted, personalized incentive campaigns is good—but understanding campaign results is actually the key to greater success. You need to be able to accurately track healthcare program engagement to help inform future strategies.

Ultimately, you also need to measure how your programs are moving the needle on CMS Star Ratings and HEDIS Scores. It’s no secret thateven as little as a half a percentage increase can lead to millions of dollars in additional revenue from the government.

So if you’re looking for a new HIPAA-compliant rewards provider, make sure you choose one with a full suite of customizable solutions. The right partner can help you manage your programs from end to end, saving you the headache of coordinating multiple campaigns with multiple vendors.


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