Medicaid & Medicare Management

Medicaid & Medicare Market Research

For four decades, GreatBlue has been helping healthcare organizations make data validated decisions. Having collected, analyzed and reported on quantitative and qualitative insights from hundreds of thousands of patients/members/providers our team is well equipped to assist healthcare clients with understanding and utilizing data to strategically move forward.

GreatBlue has conducted and reported on hundreds of thousands of completed healthcare related respondent surveys and scores of focus groups. This includes research conducted on behalf of hospitals, state agencies, non-emergency medical transportation services, insurance companies, dental providers, radiology providers, and more. We work closely with a diverse group of healthcare organizations and agencies of varying size and geographic locations helping them design custom research studies to fulfill their specific needs. From the local hospital serving one county, to statewide agencies overseeing thousands of patients and members, GreatBlue approaches each and every study with the same level of detail and attention.

Provider/Facility Satisfaction Assessment

These studies assess the satisfaction of providers and facilities within a healthcare network. Topics in these studies typically include overall satisfaction with the network, program offerings, benefits, and representatives, awareness of programs, rating the website or portal, and financial claims. The target audience typically includes primary care physicians, specialists, nurses, and office managers. Multiple methodologies of data collection are utilized for this type of study to maximize response rates received over time, and provide a variety of ways for providers to complete the survey. These include — 1) a paper survey mailed to the provider’s office, 2) digital survey link, and 3) telephone surveys. The results help healthcare networks improve their services and offerings to providers, develop materials to effectively communicate programs to providers, and implement changes to enhance the overall quality of service.

Health Risk Questionnaire (HRQ)

Understanding feedback from recently activated patients and members helps to strategically anticipate upcoming needs and guide the improvement of the care provided to them. Health Risk Questionnaires (HRQ) are essential to gather general feedback and opinions from patients regarding their health and well-being. Various healthcare related questions are included to provide a holistic viewpoint of their current healthcare state. Topics in the questionnaire include but are not limited to assessing current problems, conditions, or illnesses, use of medications, current healthcare providers (i.e. primary care physician, dentist, other specialists), physical/mental/behavioral well-being, and housing or quality of life concerns. These assessments are critical to understand the type of care or treatment patients are currently receiving and areas in need of improvement to enhance that care.

Wellness Reminder Calls

It is imperative to reach your members and patients to notify them of necessary as well as recommended healthcare visits for their well-being, or the well-being of family members. Wellness reminder calls are utilized to reach your member in a quick, efficient manner to remind them to schedule appointments and periodically visit their healthcare provider. Examples of wellness reminder calls may include but are not limited to the following:

  • Baby Reminder Calls — Importance for infants to receive periodic well visits in the early months of their lives to check on growth development and receive routine care (i.e. vaccine shots)
  • Child-Well Visits Reminder Calls — Similar to Baby Reminder Calls, this targets parents and guardians to remind them to schedule appoints for young children for wellness visits and the importance of routine care
  • Diabetes Reminder Calls — Importance for those with diabetes to schedule examinations and tests, develop a treatment plan, and ensure they are aware of the provider’s services and resources available for assistance
  • Hepatitis C Reminder Calls — Information regarding the infection, recommended testing and scheduling an exam, and ways to find a healthcare professional and other pertinent information
  • Prescription Reminder Calls — Reminder to refill prescription medications, offer assistance if needed, and connect to healthcare professionals if there are any immediate questions or needs

Mystery Shopper Study

The primary goal of a Mystery Shopper study is to evaluate the ability of a health plan’s members to obtain medical appointments. As a blinded study, telephone calls are conducted by researchers to determine ease of appointment setting, availability or lack thereof, acceptance of various insurance plans, and ability of the provider to accept new patients. The study also seeks to understand if self-identifying as certain insurance plan members has an adverse effect on the availability of scheduling appointments. The findings are then provided to the healthcare organization to assess which providers are offering appointments and accepting new patients.

Intensive Care Management (ICM) Study

The goal of this study is to evaluate member satisfaction of the care management nurse and its impact on helping improve self-directed quality of life. Often conducted on a monthly basis, this study tracks overall satisfaction with care management (i.e. helpfulness, friendliness, and knowledgeable), rating information and services provided by the care management program, usefulness of the information provided, and overall suggestions for health improvements.

PCMH / PCMH+ CAHPS Assessment

These mandated studies assess member satisfaction with providers, their services, experience and access to care, treatment, and overall response to behavioral health questions. This study collects data from thousands of members to compare and contrast findings amongst multiple providers within a given network. This assessment is often utilized as a tracking study to compare findings year over year and determine if satisfaction levels have improved over time. Results are utilized to act on near term initiatives and areas in need of improvement to support members and enhance their quality of care.


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