Listening to the Consumer Voice to Create a Robust Consumer Health System for Gateway Health

Gateway Health Plan is a multi-state Managed Care Organization (MCO) of Medicaid and Medicare physical health services. They are based out of Pittsburgh, Pennsylvania and have been in operation since 1992.

 

As a company with a mission to improve the health and wellness of the individuals and the communities they serve, Gateway Health Plan was looking to adapt by promoting consumer engagement to improve overall performance, as that is one of the most significant aspects of how health plans get paid. Customer engagement had a direct impact on the Star Ratings the plan received, which in turn determined the flow of consumers to their plan.

Gateway Health Plan needed a better way to glean in-depth knowledge of what was driving customer satisfaction and wanted to do so by utilizing the CAHPS Survey, which is the federal standard for consumer satisfaction. The goal was to develop a consistent process to gather consumer insight and integrate that input to align with the predictive models in gDNA® to develop better engagement. 

The XtraGlobex team worked with the Gateway Health Plan leadership in customer service, complaints and appeals, and quality teams. We devised cohesive regional groups of individuals with disabilities, elder consumers, as well as persons with complex needs and young mothers. We identified and met with the individual groups to gather data. This data enabled us to develop actionable steps to improve the quality of services, which we shared with the management team. 

As a result of the consulting work that XtraGlobex provided, Gateway continues to demonstrate improvement in the CMS Star Ratings based on consumer satisfaction and quality of consumer health. The increase in their CMS Star Ratings has increased the flow of consumers to the health plan, which has increased profitability.

This case is a strong example of the importance of organizations finding a way to listen to their customers and respond appropriately. How do you currently listen to your customers or organize customer response data to draw meaningful insights?

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