Case Study
90 Days to Improved HEDIS Scores: How a Medicaid MCO Engaged Members, Boosted Adherence, and Improved its AMR Performance
In just 90 days, we (as emocha Health) helped a Managed Care Organization (MCO) boost its Asthma Medication Ratio (AMR) performance to avoid a penalty under the state of Maryland’s HealthChoice value-based payment program — resulting in substantial cost savings.
We first partnered with the MCO at a critical point. After years of attempting to improve its AMR scores by implementing quality programs and expanding pharmacy benefits, the MCO found that its members required a more clinical and educational approach.
The MCO’s ultimate need was to provide its members with a comprehensive solution for asthma care to promote better health outcomes, fewer emergency room visits, and higher member satisfaction rates.
In 2020, we partnered with the MCO to do just that.
Our video Directly Observed Therapy (video DOT) program supported the MCO’s members at every dose of medication and helped members form consistent medication habits while providing insight into and addressing adherence challenges, including drug problems, side effects or symptoms, behavioral challenges, and social determinants of health.
Beyond helping the MCO improve its AMR performance, we also helped the MCO achieve a high program satisfaction rate.
This success prompted the MCO to partner with us to also improve its diabetes A1C scores — another value-based purchasing target for member year 2021.
As our work with this particular MCO shows, our adherence solution is a wise investment for health plans tasked with prioritizing population health, raising the standard of care, and reducing spend on healthcare in today’s value-based economy.
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