Decision Point for Medicare Improve Star by engaging the right members using a data-driven pop health approach


One of the most complex challenges facing Medicare plans is delivering positive outcomes across key, disparate health and clinical measures, while communicating with members efficiently and personally.

Our approach is based on predictive analytics, member segmentation and personalized communication.

We predict member behavior in any area or measure where you need to move the needle, or across all areas or measures.  We target members in need of outreach, segment the members based on their barriers and motivations, and determine the right channel for outreach.

If we’re tackling multiple measures and domains, our population health management approach prioritizes communications to areas where the member needs the most help to lower member abrasion and improve efficiency.



Results & Outcomes

Decision Point’s Medicare approach produces results. Our clients:

Keep more members:

  • Member engagement efforts led by our models resulted in 20%-25% improvement in disenrollment rates annually;

Reduce hospital readmissions:

  • Our models have identified more than 70% of readmissions by targeting less than 5% of members, and reduced readmissions by 25% annually;

Improve Health Outcomes Survey (HOS) metrics:

  • Targeting members for field case management that are high risk for mental and/or physical decline that are also high risk for admissions and/or readmissions results in a 10% improvement in member reported HOS outcomes

Improve member compliance with screening, medications and care recommendations (i.e. HEDIS):

  • Compared to control groups…
  • Over 10%-15% higher breast cancer screening rates
  • 8% – 20% better member performance on comprehensive diabetic care measures
  • 15% higher medication adherence rates for diabetes members


Contact Decision Point today to learn more.

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