Senior male interacting with virtual health application to manage his chronic disease.

Reaching Medicaid populations is difficult. Keeping them engaged is an even greater challenge. 

During the recent AHIP webinar “Deeply Engaging Difficult-to-Reach, Chronically Ill Populations to Improve Quality,”  clinical and quality leaders from MedStar Family Choice shared how emocha Health’s digital medication adherence program helped members improve adherence to asthma medications.  As a result, the Maryland Medicaid plan’s Asthma Medication Ratio (AMR) HEDIS quality measure improved enough for the plan to avoid a disincentive penalty payment in member year 2020 and improved even further in 2021. 

The results were so strong, in fact, that MedStar has fully opened eligibility for the program and is now piloting the emocha program for diabetes patients. 

Three key takeaways:

  1. Members want digital health
    Traditional quality improvement practices did not sufficiently move the needle for engaging MedStar’s members with persistent asthma. However, as Dayne Maust, Manager, HEDIS and Quality Analytics at MedStar noted:“People can use, and want to engage with, digital healthcare. This includes the Medicaid population, who have historically been ignored in these sorts of advances… the rate emocha reaches members is as good as or better than internal programs. …Digital health is clearly what members want.”
  2. Digital medication adherence can have a huge impact on quality metrics

    The state of Maryland’s Value-Based Payment Program offers rewards and disincentives for hitting quality metrics.  In 2019, MedStar came to emocha to improve its AMR scores and avoid a penalty. After just 90 days of offering emocha’s video Directly Observed Therapy (video DOT) to members with persistent asthma, there was a measurable shift into neutral.  With ongoing efforts, the plan’s score has continued to trend upwards.Seventy percent of members who completed just one week of video DOT had a positive AMR metric vs. 52% of patients in the control group. Of those members who stayed with the program for 10 weeks, 78% met the plan’s AMR goal.
  3. Members liked the program, found the materials helpful, and would recommend it to others:

The top benefits of the program were:

  • Educating members about how to properly take medication and the importance of taking medications regularly
  • Providing members with an action plan and a Comprehensive Medication Review
  • Helping members establish routines 
  • Offering members frequent support

Such support is an essential component of emocha’s program because engagement between people, not technology, is what drives health outcomes. 

What’s next?

The pandemic and advances in technology have altered how members prefer to receive communication. Therefore, how we deliver care also needs to change, MedStar’s Maust said. Based on the success MedStar achieved with emocha’s program for asthma, it has begun to pilot a program for members with diabetes who have an A1C of 8.0 to 8.9. 

Maust also sees emocha’s program as a possible tool to increase adherence for members taking an expensive series of medications that require strict adherence, such as those for Hepatitis C or HIV.