OBJECTIVES: Targeting only high-risk members can lead to missed opportunities. That prompted Blue Cross and Blue Shield of Louisiana in 2019 to develop an impactability score that measures a member’s likelihood of being affected by intervention. Blue Cross further developed the score in 2021 by adding new and more granular score drivers (such as newly identified diabetes and out-of-control diabetes) and expanding the score to different intervention approaches. Blue Cross began applying these outreach efforts in January 2022 by prioritizing members with a higher score. This research evaluates the effectiveness of the modified outreach prioritization effort.

METHODS: Members targeted during the first quarter of 2022 were identified. Using a pre/post method, the index date was defined as the first month the member was actively engaged. The pre and post period were defined as 12 months prior to and 9 months after the index month (accounting for three-month claim run-out). The study cohort were members who were actively engaged in a Care Management program. The control cohort were members who were not engaged. Propensity score matching was used to address differences between the study group and control group, and the effectiveness of the program was evaluated using a difference-in-difference (DID) analysis.

RESULTS: Engaged members with higher impactability scores had around 14% more cost savings compared to not engaged members, while engaged members with lower impactability scores had around 56% less cost savings compared to not engaged members. In addition, since integrating the impactability score into outreach efforts, the engagement rate in Care Management programs has increased from 32% to 53% for members with high impactability scores.

CONCLUSIONS: Utilizing an impactability score to tailor outreach helps direct Care Management nurses to the right member, at the right time. This not only reduces costs but also increases engagement rates.