According to a recent GoHealth analysis of Member Care Assessments (MCAs), these health-related surveys represent a powerful tool to drive personalized care journeys and better health outcomes.
Over the past decade, healthcare organizations have been challenged by the lack of a cost-effective and timely means of identifying clinical and social needs early in their members’ health journeys. MCAs were born to identify these unmet needs. MCAs are surveys typically administered by health plans or insurance brokers to learn about members’ health needs and personalize engagement. This survey is often administered to Medicare and Medicaid enrollees. Used to trigger member engagement, MCAs often produce the following types of data:
- Physical Health-Related Conditions (emergency room admissions, chronic conditions,
alcohol consumption) - Social determinants of health (SDOH) (food insecurity, transportation needs, health literacy)
- Prescription and Pharmacy Access (pickup preferences, affordability, vaccinations)
- Extra Benefit Needs & Mental Health (dental, fitness, loneliness, anxiety)
MCAs – What They Aren’t
For the purposes of this whitepaper, the term MCAs describes the questionnaires used to screen members for a variety of SDOH and health preferences, which are used to activate member engagement. That said, the industry is still aligning on verbiage in this space. Specifically, the terms MCAs and health risk assessments (HRAs) are sometimes used interchangeably. GoHealth views HRAs as encounter-focused appointments, executed by a provider, which are often completed well after point of enrollment and can help inform risk adjustment.
Use Cases of MCAs
Primary – Member Engagement
The primary purpose of MCAs is to learn more about the member to inform how to interact and engage with him/her. Data captured from MCAs provides new insight into a member’s health and well-being, which is used to segment membership and drive meaningful, tailored engagement journeys that address the identified needs.
Ways to leverage MCA data to inform how to interact with members:
