MarketPoint-Star Monthly Member Talking Points –November

The Monthly Member Talking Points are provided as supplemental messaging for MarketPoint agents in their normal flow of outreach to members for health plan support and retention goals. The Stars messaging provides monthly topics related to national monthly health awareness topics and actions toward Star measure compliance. Talking points are provided as supplemental guidance for agents in support of their conversations with members. Actions include the following member guidance:

• Encourage compliance with specific monthly Stars measures (refer to Actions below relating to measures).

• Promote engaging with appropriate provider.

• Support member in finding a primary care physician (PCP), if they state they don’t have one.

• Encourage members to contact Humana (Agent or Customer Service) to support measure compliance or member issues, as appropriate.

Measure / Lead-in statement / Actions
Screening reminders
Breast Cancer Screening / “October is/was Breast Cancer Awareness month. Just a reminder an annual screening is a benefit covered under your plan. Please talk to your doctor about making an appointment.” / If appropriate, encourage member to talk to their doctor about breast cancer screening.
Flu Vaccine / “It’s flu season” Members should get an annual flu vaccination – if you received yours prior to July 1st you will need one to protect you this flu season. / Encourage member to have flu vaccine, assist where needed with finding location. Flu shots are a covered benefit – $0 cost at participating pharmacies and retail clinics. Many PCPs also offer flu shots but a copay may apply.
Checking in on member’s experience
Medication Adherence
Getting Needed Prescription Drugs
Care Coordination / “Are you getting your prescriptions without any trouble?”
“Be sure to take your medications as prescribed or talk to your physician if you have any problems doing so.” / Encourage member to share a list of medicationswith their doctoror take all medications to doctor visits.
Encourage member to talk with their doctor if they are not taking their medications as prescribed.
Getting Needed Care
Getting Appointments and Care Quickly / “Do you currently have a primary care physician?”
“Are you getting all your doctor appointments scheduled without any trouble?” / If appropriate, assist member with finding network doctors.
If appropriate, refer member to customer service regarding access to care issues.
Ask members to always contact Humana directly with any questions or to change their demographic information (address, phone number, etc.)
Closing – use standard MarketPoint guidelines for closing call.