Readers Write: The Future of Member Support: How Intelligent Search Can Transform VAB Delivery

The Future of Member Support: How Intelligent Search Can Transform VAB Delivery
By  Andi Gillentine

Andi Gillentine, MS is VP of national accounts at Findhelp.

Value-added benefits (VABs) are services that are offered by Medicaid managed care plans above and beyond required Medicaid state plan services. They are extremely popular –  Medicaid plans in at least 48 states offer VABs — and historically poorly promoted and utilized.

How do we ensure improved utilization of VABs, which have the power to impact quality measures, quality of care, and overall health? By maximizing intelligent searching via closed-loop referral systems to surface the right programs to the right person at the right time, for both care managers navigating on a member’s behalf and members who are self-navigating.

About VABs 

While VABs are typically non-medical, they are often related to member wellbeing. Examples of VABs are car seats and bike helmets for children, extended dental and vision services, over-the-counter medication funding, and carpet cleaning. More and more commonly, these services are used to address health-related social needs (HRSNs).

In Ohio, for example, VABs are allowed for dental, vision, transportation, health and wellness programs (includes housing supports and medical meals), incentives to strengthen health and wellbeing (includes rewards for seeking preventative care), prenatal and postpartum incentives, application services, telehealth, and 24-hour medical advice lines. Each of the seven Medicaid plans in Ohio offers at least 30 VABs, with one plan offering nearly 50.

This wealth of benefits can help Medicaid members achieve improved health outcomes and quality of care that is measurable in HEDIS and other health quality measures, if the members are aware of the benefit and know how to access it, and if administering it is easy on the health plan. Unfortunately, this is often not the case.

Improving VABs Access and Awareness

Today, in most states, a Medicaid member seeking support would have to spend hours researching their health plan website or reading their plan’s member handbook. As any health plan member can attest, this is a challenging, time-consuming task, frequently made more challenging by engaging solely through a smart phone. Accessing VABs usually requires a call to a customer service representative, with potentially long wait times, and then a waiting period to receive the goods or services.

This high administrative effort to find and access benefits results in high costs for health plans. Many Medicaid members miss important preventive care appointments due to transportation issues, use the ED for non-emergent needs because they can’t afford medications, or lose housing or utilities. VABs can provide the resources and support to prevent these occurrences, but it’s not enough for support to just be available. Members need relevant recommendations and easy access.

In an ideal world, a Medicaid member would be able to go to one place, validate their insurance coverage, search for services that address their needs, and receive intelligent results that provide resources tailored to their specific situation, with the ability to self-refer to access these goods and services. This intelligent search needs to include all available resources from their community, county, state, and health plan’s VABs. No more hunting through multiple sites or staying on the phone for long periods of time just to put food on the table, get a ride to an appointment, or find a car seat.

Intelligent Search is the Answer

There are no technological hurdles to solving this problem. We have already solved it. We simply need to integrate these workflows at the right time and in the right place for navigators and Medicaid members, using interoperable social care platforms with intelligent search capabilities. Where a patient can walk in the doors of a safety net hospital and, because of the integrated social care information in their medical chart, tailored recommendations, including VABs, are automatically presented to  care teams. The care team may refer or recommend some of these resources to the patient and encourage the patient to self-navigate for additional benefits and support. Or where a health plan care manager, engaging with a chronically-ill, dual-eligible member, can assess need and eligibility for VABs and other integrated social care support and, with consent, directly refer the member to services.

One personalized, intelligent search for all services, in easy-to-access workflows for navigators and members. The future is already here. Let’s make the most of it.