1. Molina Marketplace Broker Assisted Wellness Survey Agent Training

2. Training Agenda Molina’s Broker Assisted Wellness Survey Program Goal
Wellness Survey Data: Why is it Important?
The Impact of Risk Transfer Payments
Wellness Survey Process Overview
VUE Portal Step by Step Instructions
Survey Guidelines
FAQs
UAT Testing
SME
Requirement Review Design review
Approvals

3. Program Goal
As a pilot project, Molina Marketplace will partner with our brokers to assist with capturing Wellness Survey data from our new membership. The goal is to proactively engage with this new membership so that Molina can provide the best possible care for members. The Wellness Survey will be launched in all states.
Program Kickoff
April 2017!
Strengths of our broker network include:
UAT Testing
SME
Molina is currently one of the top 5 QHP’s, thanks in large part to our broker partners
59% of total Marketplace membership for 2017 was broker assisted*
The great relationship between brokers and members should lead to a higher conversion rate on the Wellness Survey
Requirement Review Design review
Approvals
*As of the conclusion of OEP

4. Wellness Survey Data: Why is it Important?
What is the ACA’s Risk Adjustment program?
Risk Adjustment is a health acuity based program that measures the health status of all members who have a plan on the Marketplace.
How does the ACA’s Risk Adjustment work?
Support is provided to carriers based on the overall health of their membership. In order to receive the appropriate level of support, it is important that Molina accurately capture this health data and provides it to CMS1.
The goals of Molina’s Risk Adjustment activities are:
To recognize the health issues of our members early on, so that we can provide appropriate care
COPD Program
Diabetes Management
Care Management
Provide CMS with accurate health data on our membership, so that Molina is provided with the appropriate resources to deliver the highest quality of care
UAT Testing
SME
Requirement Review Design review
Approvals
1 Data provided to CMS is masked, meaning member identity information is not provided

5. The Impact of Risk Transfer Payments
% of gross revenue
Savings impact of the 2018
Methodology
Risk Transfer Payment
Net Revenue
Improved HCC capture through HRA’s can significantly reduce Molina’s Risk Transfer Exposure
Changes in the Risk Transfer Methodology for 2018 will also improve Molina’s experience
Broker participation in the HRAs will have multi faceted impacts

6. Wellness Survey Process Overview
Broker contacts member
Broker conducts survey
Broker sends survey results to Molina via VUE
Molina reviews survey results
Molina schedules members for follow up, as appropriate
Brokers contact NEW members using the Molina developed outreach process
Survey will be hosted in the VUE Broker Portal. Brokers will only have access to their own book of business, Agencies will have access to their agency BOB
Questions are based on existing Wellness Survey questions, to maintain consistency with other Molina Surveys
Survey results will be reviewed, and next steps will be determined. Molina Corporate will share survey results with state health plans
Health plans will contact members to schedule follow up appointments, if needed
Requirement Review Design review
Approvals

7. VUE Portal Step by Step Instructions

8. Eligible Member Search
To see the members who are eligible for the survey:
Go to the Book of Business tab and select Insured details.
In the Search function, select yes on both the “Wellness Survey Eligible” and the “Show All My Agents” drop down menus.
Click the purple search button on the far right and all of the members who are eligible for the survey will populate below.
UAT Testing
SME
Requirement Review Design review
Approvals

9. Eligible Member Search
Select the member that you wish to complete the survey for, by clicking on the radio button to the left of their name
Click on Wellness Survey
UAT Testing
SME
A new screen will appear that shows the Subscriber Number in the far left column. It will also show if a survey has been completed for the subscriber previously. If this field shows “No” then the Wellness Survey link will be enabled. Click on Wellness Survey link.
Requirement Review Design review
Approvals

10. Wellness Survey The survey will open in the next window
The Spanish version of each question is right next to the English question
Questions with an * are required. The scroll bar on the right indicates that there are more questions below
UAT Testing
SME
Requirement Review Design review
Approvals

11. Question Types
Questions with text field boxes are not required and are free text fields (It is recommended)
Questions with radio buttons are multiple choice and only one answer can be selected
Questions with a square check box are multiple choice and more than one answer can be selected
UAT Testing
SME
Requirement Review Design review
Approvals

12. Question Types
There are some questions that will trigger a follow up question to be asked, if the initial answer is yes.
UAT Testing
SME
Requirement Review Design review
Approvals

13. Incomplete Question Prompt
If the survey is submitted without all of the required questions being asked, then a pop up screen will appear which will indicate which questions are still pending.
UAT Testing
SME
Requirement Review Design review
Approvals

14. Survey Submission
When the submit button is clicked, then a pop up will appear to confirm that you are ready to submit the survey. If Yes is pressed, then the survey will be submitted. If no is pressed, then you will be returned to the survey where you can make changes
UAT Testing
SME
When the survey has been submitted, the next screen will show that the Wellness Survey has been completed
Requirement Review Design review
Approvals

15. Survey Submission
Once the survey has been submitted, you will not be able to go back and edit the survey
If you click on the survey link, you will see the survey questions and answers will be grayed out
UAT Testing
SME
Requirement Review Design review
Approvals

16. Dependent Survey UAT Testing SME
If the subscriber indicates that someone else on their policy has one of the conditions mentioned during the subscriber survey, then they can complete a survey for the dependent by clicking the Add Dependent Survey link.
The Dependent ID field is not a required field, as the subscriber may not have that information readily available. Dependent name and date of birth are required fields
The dependent D.O.B can be entered manually, or by using the calendar function
UAT Testing
SME

17. Dependent Survey UAT Testing SME Requirement Review Design review
Once the dependent details are entered, the below screen will appear, which shows the subscriber number, and the dependent details that were entered. To begin the dependent survey, click on the Wellness Survey link that is on the dependent row.
UAT Testing
SME
The dependent survey will open, and is ready to be completed
Requirement Review Design review
Approvals

18. Survey Script
Script

19. Survey Guidelines UAT Testing SME Requirement Review Design review
The survey will be administered through the VUE Broker portal. Brokers will only have access to members in their own book of business.
The survey is open to NEW members who have an effective date of 1/1/17 or later. This survey is not open to renewal members.
The survey is open for 60 days from 4/19/17 through 6/17/17.
The main survey will be based at the subscriber level. If the subscriber indicates that a dependent has any of the health indicators on the survey, then the broker will have the ability to complete a survey for that dependent.
The questions and answers on the survey will be in English and Spanish.
If the member has a change in their metal tier, they are not considered eligible for the survey, unless they have a gap in coverage of more than 30 days.
If the member changes product, then they would be considered new members, and would be eligible for the survey.
All agencies and brokers have been trained on HIPAA confidentiality requirements with regards to handling member information.
UAT Testing
SME
Requirement Review Design review
Approvals

20. States where HRA is Offered States where HRA is NOT Offered
Member Incentives
If a member answers “yes” to any question, Molina will follow up with them to schedule an in-home health assessment
If the member completes the IHA, they are eligible to receive a $50 gift card (see table below)
To ensure the integrity of the survey, please only mention this incentive after a survey has been completed with at least one “yes” answer
States where HRA is Offered
States where HRA is NOT Offered
Texas
Florida
Utah
Michigan
Wisconsin
Ohio
California
Washington
New Mexico
UAT Testing
SME
Requirement Review Design review
Approvals

21. FAQs
1.       Will my client be denied services or no longer be eligible if they do not participate in the survey?             
       No, this survey is completely optional and will not affect their status in any way
2.       Will my client’s premium be affected by the answers on this survey??
       No, this survey will not have any effect on premiums, co-pays, or deductibles
3.       How long does this survey take to complete?
       The survey will take approximately 5 minutes to complete
4.       How many times should I attempt to call client?
       Please attempt at least 3 times, but you can attempt as many times as you would like
5.       Is this survey only for one state?
       No, this survey is for any of the 9 states you are contracted in and have clients.
6.       How long do I have to complete all the surveys?
       60 Days
      
UAT Testing
SME
Requirement Review Design review
Approvals

22. Molina Member Services Number
FAQs
7.       If, while conducting a Wellness Survey, a member asks about an issue they are having with claims,
invoices, providers, etc., who may we refer the member to for assistance?
Please advise the member to contact the Member Services Department for resolution
      
State
Molina Member Services Number
California
Florida
Michigan
New Mexico
Ohio
Texas
Utah
Washington
Wisconsin
UAT Testing
SME
Requirement Review Design review
Approvals

23. Amy DeMarco Broker Channel Manager, CA Marketplace (657) 243-7461
Questions
Amy DeMarco
Broker Channel Manager, CA Marketplace
(657)
UAT Testing
SME
Requirement Review Design review
Approvals