Improving Patient Adherence, Clinical Outcomes, and Experience in a Comorbid Medicaid Population
Wellth’s program for Mount Sinai Peak Health was focused on enrolling their highest-risk, nonadherent Medicaid patients diagnosed with Congestive Heart Failure, Cardiovascular Disease, Type 1 & 2 Diabetes, and COPD / Asthma. In addition, approximately 50% of the enrolled population had a behavioral health comorbidity and approximately 25% of the enrolled population had a substance use disorder comorbidity.
Patients enrolled into the Wellth program received up to 5 care plan reminders each day to check-in a picture of their medications and / or monitoring devices. Over the 70-day program, patients were eligible to receive a maximum of $75 in rewards for demonstrating full adherence to their care plan. $2 was deducted from the patient’s rewards balance for each day that any of a patients’ required care plan tasks were missed, leveraging the concept of Loss Aversion from behavioral economics to drive better adherence outcomes. As a result, the average adherence in the enrolled cohort at the end of the 70-day program was 85.1%, with 67.2% of enrolled patients achieving an average adherence of 80%+. Of the enrolled patients who had a diagnosis of Diabetes, the average A1c reduced by 0.47 points, from an average starting A1c of 9.6. At the end of the program, all enrolled patients were extended a standard member satisfaction question, which was: “How likely are you to recommend this rewards program and Wellth application to a family member or someone else?” From the results of this survey, Wellth achieved an extremely member satisfaction rate of 97%.