REDWOOD CITY, CA – The developer of a national over-the-counter healthcare benefits payment platform now being used for Medicare Advantage members has unveiled a new platform for Medicaid, giving the beleaguered state-run program a means of controlling costs and cutting waste.
The OTCMedicaid card platform, developed by the Redwood City, Calif.-based Medagate Corporation in partnership with InComm, is designed to help Medicaid programs provide and administer OTC benefits for members. The platform enables Medicaid members to use branded, re-loadable, pre-paid cards on OTC Medicaid-eligible items while pushing incentives (including cash rewards) to members who engage in selected preventive health activities.
"It's becoming all about incentives," said Devin Wade, Medagate's CEO. "States are getting very interested in preventive health screenings and other rewards and incentives. Early detection saves money as well as saving lives."
Medagate launched its OTCNetwork national restricted-spend payments platform some 18 months ago and is integrated in front-of-store point-of-sale (POS) terminals at more than 35,000 retail locations, including pharmacies, grocery stores and Family Dollar stores. The platform first gained success with its
OTCMedicare services, and Wade said the company is looking to expand that program even as it looks for more commercial uses.
Among the early adopters of the OTCMedicaid Card is the Health Plan of San Mateo. The California health plan began offering incentives to its 52,000 Medicaid members in northern California this month, using the platform to push routine health screenings.
"A core area of focus for our plan is encouraging our women members due for mammograms and Pap tests to participate in these potentially life-saving health screenings and exams in a timely way," said Mary Giammona, MD, medical director at The Health Plan Of San Mateo.
"The OTCMedicaid card gives us the ability to offer incentives that can be used only for OTC Medicaid-eligible items like vitamins, first aid products and OTC medications upon completion of health screenings and well visits – a strategy we believe will not only improve health outcomes, but also reduce our overall program costs,'' added Ron Robinson, the health plan's director of financial and administrative services.
Wade said the template for Medicaid is much different than that followed by Medicare. Medicaid programs "are really about healthy behaviors," he said, and look to engage, incentivize and reward members for actions that improve their health-related lifestyle and reduce avoidable medical issues. To that end, Wade said he would like to get more markets and grocery stores involved in the program to promote healthy eating habits.
Wade said the platform also helps Medicaid programs improve their Health Effectiveness Data Set (HEDIS) wellness scores, a key indicator of a program's success and a tool for determining reimbursement.
"Medicaid Programs are facing increased scrutiny around their ability to demonstrate success in improving member health and satisfaction, based on their HEDIS scores," he said. "Our new OTCMedicaid platform enables Medicaid Programs, like The Health Plan Of San Mateo, to influence member behavior and improve health outcomes, ultimately impacting HEDIS scores."