CONTRACT_ID	CONTRACT_NAME	YEAR	CONTRACT_REC_NUM	REWARDS_NAME	ACTIVITY_DESCRIPTION	EARN_DESCRIPTION	REWARD_VALUE	TRACK_PARTICIPATION	TOTAL_ENROLLED	TOTAL_REWARDS	
H0022	BUCKEYE COMMUNITY HEALTH PLAN, INC.	2019	1	BUCKEYE COMMUNITY HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, DIABETIC KIDNEY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, BONE DENSITY, INPATIENT MENTAL HEALTH FOLLOW UP, PCR OUTPATIENT VISIT 30 DAYS POST	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	12759	22765
H0028	CHA HMO, INC.	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	2206	288
H0028	CHA HMO, INC.	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	346375	1435539
H0028	CHA HMO, INC.	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	6674	1482
H0062	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	2019	1	SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	2109	3302
H0088	WELLCARE HEALTH INSURANCE OF NEW YORK, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	165	4
H0104	BLUE CROSS AND BLUE SHIELD OF ALABAMA	2019	1	care rmdrs clm stmt find doc/rx InHm Asmt edu mtg sveys care/disease mgmt pgms	$25 Visa gift card	Program utilization was estimated based on current plan enrollment. The reward amount was then determined based on an internal approved budget.	tracked via BCBSAL website utlizationcount is kept in Excel format	20490	20490	20490
H0104	BLUE CROSS AND BLUE SHIELD OF ALABAMA	2019	2	care rmdrs clm stmt find doc/rx InHm Asmt edu mtg sveys care/disease mgmt pgms	$25 Visa gift card	Program utilization was estimated based on current plan enrollment. The reward amount was then determined based on an internal approved budget.	tracked via BCBSAL website utlizationcount is kept in Excel format	20490	20490	20490
H0107	HEALTH CARE SERVICE CORPORATION	2019	1	Rewards and Incentives Program	Annual Wellness Visit, Fall Risk Assessment, Flu Vaccine, Blood Glucose A1c Screening, ColorectalScreening, In Home Assessment, Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening	Registered members earn Gift Cards total annual maximum rewards is $100. For members in this contract we used $25 gift card awards for all Healthy Actions, inclusive of Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening. Members that complete the Annual Wellness Visit recieve two rewards of $25, amounting amounting to a total $50 reward	Evaluated the cost  value of each service,  ensured that the  value of the award is less than that of the  service provided  while significant enough to drive the member to complete it	We track participation in the Healthy Rewards Program, via Weekly Registration reports, Healthy Action Activity Reorts and Reward Redemption Reports	8050	25146
H0111	WELLCARE OF GEORGIA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	3948	789
H0137	COMMONWEALTH CARE ALLIANCE, INC.	2019	1	 	 	 	 	 	0	0
H0148	BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN	2019	1	Blue Shield of CA Promise Appreciation Program	Annual Wellness Visit, Diabetes Blood Test (A1c), Eye Exam, Breast Cancer Screening, Bone Density Test, Colon Cancer Screening, Monitor Your Physical Health, Fall Prevention, Statin Treatment	Gift Card(s)	Vendor recommendation per industry standard	Vendor provides weekly program KPI reports	695	965
H0154	VIVA HEALTH, INC.	2019	1	 	 	 	 	 	0	0
H0169	UNITEDHEALTHCARE OF THE MIDWEST, INC.	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	16770	15119
H0174	WELLCARE OF TEXAS, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	30310	4885
H0192	AMERIHEALTH MICHIGAN, INC.	2019	1	Breast Cancer Screening	Mammography	Gift Card	Gift Card Face Value - $10.00 per enrollee per completed screening	Identify and track enrollees in need of the screening. Use claims data to verify screening completion.	664	115
H0192	AMERIHEALTH MICHIGAN, INC.	2019	2	Colorectal Cancer Screening	Colorectal Cancer Screening	Gift Card	Gift Card Face Value - $10.00 per enrollee per completed screening	Identify and track enrollees in need of the screening. Use claims data to verify screening completion.	779	82
H0192	AMERIHEALTH MICHIGAN, INC.	2019	3	Diabetes Screening HA1c	HgA1c testing	Gift Card	Gift Card Face Value - $10.00 per enrollee per completed test	Identify and track enrollees in need of the testing. Use claims data to verify screening completion.	1145	507
H0192	AMERIHEALTH MICHIGAN, INC.	2019	4	Diabetes Screening Nephropathy	Nephropathy testing	Gift Card	Gift Card Face Value - $10.00 per enrollee per completed test	Identify and track enrollees in need of the testing. Use claims data to verify screening completion.	1127	508
H0192	AMERIHEALTH MICHIGAN, INC.	2019	5	Diabetes Screening Eye Exam	Retinal exam	Gift Card	Gift Card Face Value - $10.00 per enrollee per completed test	Identify and track enrollees in need of the testing. Use claims data to verify screening completion.	1815	1320
H0192	AMERIHEALTH MICHIGAN, INC.	2019	6	Flu Prevention	Flu vaccine	Gift Card	Gift Card Face Value - $10.00 per enrollee who  received flu vaccine	Identify and track enrollees in need of the vaccine. Use claims data to verify screening completion.	3349	898
H0251	UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.	2019	1	HouseCalls Program	House Call	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued	32897	29322
H0270	WELLCARE HEALTH INSURANCE COMPANY OF AMERICA	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	86	15
H0271	SYMPHONIX HEALTH INSURANCE, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	18871	17507
H0281	ILLINICARE HEALTH PLAN	2019	1	ILLINICARE HEALTH PLAN	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, PCR OUTPATIENT VISIT 30 DAYS POST, INPATIENT MENTAL HEALTH FOLLOW UP, BONE DENSITY, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, BONUS REWARD FOR COMPLETING ALL REWARDS	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	8181	9498
H0292	HUMANA HEALTH PLAN OF OHIO, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	4979	45987
H0292	HUMANA HEALTH PLAN OF OHIO, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	115	41
H0294	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	5974	6149
H0302	MEDISUN, INC.	2019	1	 	 	 	 	 	0	0
H0321	ARIZONA PHYSICIANS IPA, INC.	2019	1	HouseCalls Program	House Call	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued	23522	21437
H0332	KS PLAN ADMINISTRATORS, LLC	2019	1	 	 	 	 	 	0	0
H0336	HUMANA HEALTH PLAN, INC.	2019	1	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	29	4
H0351	HEALTH NET OF ARIZONA, INC.	2019	1	HEALTH NET OF ARIZONA, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C TESTING, ANNUAL WELLNESS VISIT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	11352	18239
H0354	CIGNA HEALTHCARE OF ARIZONA, INC.	2019	1	 	 	 	 	 	0	0
H0422	UCARE HEALTH, INC.	2019	1	Community Education	wellness session, health related activity, wellbeing activity	session discount	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	499	1
H0423	METROPLUS HEALTH PLAN, INC.	2019	1	MetroPlus Rewards	New member PCP visit, diabetes retinal eye exam, diabetes HbA1c test, breast cancer screening, adult PCP checkup, colon cancer screening, flu vaccine, Step-Up walking challenge, member event, renewal learning module	Points-based program with members earning points and exchanging for items in a catalog.	No cash value. Ten points equals one dollar.	Participation is tracked by our rewards platform vendor, Finity. Participation is defined as members who are engaged at least twice via two different media and who complete a reward activity. Finity also tracks all member engagements as well as rewards earned and redeemed.	7383	6278
H0432	UNITEDHEALTHCARE OF ALABAMA, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	8136	7159
H0439	CIGNA HEALTHCARE OF GEORGIA, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	21824	4764
H0473	HUMANA INSURANCE COMPANY OF KENTUCKY	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	10160	30010
H0473	HUMANA INSURANCE COMPANY OF KENTUCKY	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	231	54
H0480	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	2019	1	 	 	 	 	 	0	0
H0504	CALIFORNIA PHYSICIANS' SERVICE	2019	1	Blue Shield of California Appreciation Program	Annual Wellness Exam, Diabetes Retinal Eye Exam, Diabetes A1C test, Breast Cancer Screening, Colorectal Cancer Screening, Flu Shot, Bone Density Test	Gift Card(s)	Reward amount calculated by vendor based on incentive program experience and industry standards	Vendor provides weekly KPI dashboards	4484	8196
H0523	AETNA HEALTH OF CALIFORNIA INC.	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening. Diabetic Eye Exams, Diabetic Kidney Screenings,  blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can activate the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more complaint in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	445	611
H0524	KAISER FOUNDATION HP, INC.	2019	1	Yes, Silver&Fit Rewards Program	Members are rewarded for meeting a threshold of fitness facility visits and/or physical activity.	Members may earn nominal rewards such as a Silver&Fit hat or collectable pin each quarter.	The value of the reward is the cost per unit. Silver&Fit Rewards are of nominal value.	Members are offered the opportunity to participate in the rewards program upon enrollment. Their participation is tracked through a field in the system that indicates whether they choose to participate or not.	8321	4530
H0543	UHC OF CALIFORNIA	2019	1	HouseCalls Program, Renew Rewards	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device).	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	37128	49306
H0544	BLUE CROSS OF CALIFORNIA	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	36	30
H0544	BLUE CROSS OF CALIFORNIA	2019	2	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	2551	2398
H0544	BLUE CROSS OF CALIFORNIA	2019	3	Rewards for Health Program	Depression Screening, Colorectal Cancer Screening, Breast Cancer Screening (Mammogram), Annual Physical Exam, New Member Physical Exam at CareMore Care Centers, Physical Activity Monitoring, Diabetes Care  Eye Exam, Fall Risk Management, Annual Flu Vacci	5 $10 Visa gift cards or 1 $50 Visa gift card	Members can earn up to $50 worth of Visa gift cards. They can earn 1 $50 Visa gift card by mailing in $50 worth of coupons all at once or up to 5 $10 Visa gift cards when mailing in coupons one at a time.	The enrollee participation is tracked by providing the approved fulfillment house vendor a complete membership file used to mail member fulfillment kits every month. Member mails their attested coupons directly to the fulfillment vendor. Upon receipt of t	19184	4947
H0545	INTER VALLEY HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H0562	HEALTH NET OF CALIFORNIA,INC.	2019	1	HEALTH NET OF CALIFORNIA REWARDS PROGRAM	BREAST CANCER SCREENING, COLORECTAL CANCER SCREENING, ANNUAL FLU VACCINATION, BONE DENSITY TEST, DIABETIC RETINOPATHY SCREENING, HBA1C SCREENING, ANNUAL WELLNESS EXAM, HRA COMPLETION	VISA PREPAID DEBIT CARD,E-GIFT CARD, GIFT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS. MEMBERS INTERACT THROUGH THE  PROGRAM VIA THE MAIL OR TELEPHONIC AND DIGITAL CHANNELS. MEMBER INTERACTIONS ACROSS THE CHANNELS ARE CAPTURED IN NOVUHEALTHS CMS-COMPLIANT DATA STORAGE AS ACTIVATIONS AND REDEMPTIONS	115904	27366
H0571	CHINESE COMMUNITY HEALTH PLAN	2019	1	Medicare Member Incentive Program	Mammogram Screening, Colon Cancer Screening, Diabetes Eye Exam, Diabetic Kidney Monitoring,  HbA1c Test, BMD Test/DEXA Scan, Fill prescription for drug that treats Rheumatoid Arthritis, Exercise Survey, Fall Prevention Checklist	Gift Cards	Each measure is assigned an associated gift card value ranging from $5 to $50.	Enrollees may report a completed measure by calling member services to report completion of measure(s) or mailing their vouchers to CCHP. Claims validation is required in order for any gift card to be issued.	5081	219
H0609	PACIFICARE OF COLORADO, INC.	2019	1	HouseCalls Program, Renew Rewards	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device).	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	77938	81689
H0624	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program	House Call	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued	6271	5800
H0630	KAISER FOUNDATION HP OF CO	2019	1	 	 	 	 	 	0	0
H0710	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	40	47
H0712	WELLCARE OF CONNECTICUT, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	9707	2486
H0724	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS	2019	1	BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, DIABETIC KIDNEY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, BONE DENSITY, INPATIENT MENTAL HEALTH FOLLOW UP, PCR OUTPATIENT VISIT 30 DAYS POST	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	1918	3228
H0755	OXFORD HEALTH PLANS (CT), INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	63551	70186
H0838	UNIVERSAL CARE, INC.	2019	1	Severely and Persistently Mentally Ill	Medication Compliance Education, sobriety Counseling, Weight Management, Smoking Cessaton Education, Exercise Coaching	Gift Cards	Participation in the health activity determines if member qualifies for a gift card.	Rewards and Incentives form is completed when a requirement is met.  The form is then forwarded for entry as an encounter in claims system.	2290	15
H0838	UNIVERSAL CARE, INC.	2019	2	Preventive Care Participation	Health Screenings	Gift Cards	Participation in the health activity determines if member qualifies for a gift card.	Rewards and Incentives form is completed when a requirement is met.  The form is then forwarded for entry as an encounter in claims system.	42861	64556
H0908	BUCKEYE COMMUNITY HEALTH PLAN, INC.	2019	1	BUCKEYE COMMUNITY HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, DIABETIC KIDNEY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, BONE DENSITY, INPATIENT MENTAL HEALTH FOLLOW UP, PCR OUTPATIENT VISIT 30 DAYS POST	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	1000	2982
H0913	WELLCARE HEALTH PLANS OF NEW JERSEY, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	5228	389
H0927	HEALTH CARE SERVICE CORPORATION	2019	1	 	 	 	 	 	0	0
H0982	SOLIS HEALTH PLANS, INC.	2019	1	 	 	 	 	 	0	0
H1016	AVMED, INC.	2019	1	Healthyperks-Circle	Annual Wellness Visit, Colon Cancer Screening, Breast Cancer Screening, Diabetes Blood Test (A1C), Osteoporosis Screening (Bone Mineral Density), Dilated Eye Exam,  Flu Shot, Pneumonia Vaccine, Treatment Plan Discussion ( with provider),  Personal Health Assessment, Online Wellness Courses, Taking Care of Your Mental Health (reveiw educational materials and talk to the doctor as needed), Taking Care of Your Physical Health (reveiw educational materials and talk to the doctor as needed)	Gift Cards	Members can complete activities to earn rewards for a maximum of $100 combined	Weekly Activity Reports	77	263
H1016	AVMED, INC.	2019	2	Healthyperks-Choice	Annual Wellness Visit, Colon Cancer Screening, Breast Cancer Screening, Diabetes Blood Test (A1C), Osteoporosis Screening (Bone Mineral Density), Dilated Eye Exam,  Flu Shot, Pneumonia Vaccine, Treatment Plan Discussion ( with provider),  Personal Health Assessment, Online Wellness Courses, Taking Care of Your Mental Health (reveiw educational materials and talk to the doctor as needed), Taking Care of Your Physical Health (reveiw educational materials and talk to the doctor as needed)	Gift Cards	Members can complete activities to earn rewards for a maximum of $90 combined	Weekly Activity Reports	5941	18869
H1019	CAREPLUS HEALTH PLANS, INC.	2019	1	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	2592	382
H1019	CAREPLUS HEALTH PLANS, INC.	2019	2	CarePlus Wellness Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	175192	71587
H1032	WELLCARE OF FLORIDA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	104282	25482
H1035	FLORIDA BLUE MEDICARE, INC.	2019	1	HealthyBlue Rewards	The health care activities and reward values were as follows: Annual Wellness $30 or In Home Assessment $30, Annual Flu Shot $20, Breast Cancer Screening $25, Colon Cancer Screening (Fecal Occult Blood Test/Fecal Immunochemical Test/Flexible Sigmoidoscopy Colonoscopy) $10 to $50, Diabetes Care Eye Exam $25, Diabetes Care Kidney Exam $15, Diabetes Care A1C $20, Osteoporosis (BMD Screening) $25, Men's Wellness or Women's Wellness or Diabetes Health programs $50.	Members were rewarded with gift cards to complete the specified health care activities. The members had the option of receiving an e-gift card immediately or having a physical gift card mailed to them. These were merchant gift cards that were not convertible to cash.	The reward value is based on Chapter 4 CMS guidelines pertaining to the value of the health related service and the status of members completing their health activity in the 2019 plan year based on a combination of claims data received by Florida Blue and member self-reported activity.	Members interact through the HealthyBlue program via telephonic and digital channels. Member interactions across the channels were captured in Welltoks CMS-compliant data storage as activations and redemptions (participation)	14457	13428
H1036	HUMANA MEDICAL PLAN, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	554954	2958901
H1036	HUMANA MEDICAL PLAN, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	10820	2232
H1045	PREFERRED CARE PARTNERS, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	59705	63964
H1099	HEALTH FIRST HEALTH PLANS	2019	1	Clinical Documentation Eye Incentive Program	Complete Diabetic Retinopathy Eye Exam	$20 gift card not redeemable for cash	Value of the gift card is based on market analysis and consistent with what the marketplace is offering	Incentives are tracked by Member ID number, name, address, date of birth, gender, date of exam, incentive gift card control number, and incentive mail date on the Diabetic Eye Exam Tracking spreadsheet. In the event of a lost, stolen or damaged card, each incident is tracked on the spreadsheet to determine trends. Trend is defined as a repeated occurrence within a demographic area more than 10x per calendar year.	2403	214
H1099	HEALTH FIRST HEALTH PLANS	2019	2	Comprehensive Health Assessment Incentive Program	Complete Physical Exam, Medication Review, Nutrition Screening, Healthy Behavior Screening, ADL Screening, Fall Risk Screening, Mental Status Exam, Depression Screening, Diabetic Screening and Complete Assessment	$50 gift card not redeemable for cash	Value of the gift card is based on market analysis and consistent with what the marketplace is offering	Participation is captured through reporting triggered by the correct EMR form being opened and signed for CHAs completed by Health First Medical Group.  For CHAs completed by Matrix, a report is sent from Matrix of all completed CHAs.  This reporting is obtained twice a month. Members completing the requirements to receive a gift card are tracked by name, ID number, address, gift card control number and date mailed. Gift cards are mailed within 6-8 weeks after their CHA visit.	40994	17963
H1100	INNOVATION HEALTH INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H1109	AETNA HEALTH INC.(GA)	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening. Diabetic Eye Exams, Diabetic Kidney Screenings,  blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can "activate" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more complaint in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	326	499
H1111	UNITEDHEALTHCARE OF GEORGIA, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	7064	6768
H1112	WELLCARE OF GEORGIA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	47876	15603
H1119	TSG GUARD, INC.	2019	1	 	 	 	 	 	0	0
H1142	BRIGHT HEALTH INSURANCE COMPANY OF OHIO, INC.	2019	1	MA Annual Wellness/Physical Rewards Program	Annual wellness visit or physical	Visa gift card	20 USD	Mail-in form completed by member and signed by provider	60	44
H1170	KAISER FOUNDATION HP OF GA, INC.	2019	1	 	 	 	 	 	0	0
H1181	NETWORK HEALTH INSURANCE CORPORATION	2019	1	 	 	 	 	 	0	0
H1189	CHRISTUS HEALTH PLAN	2019	1	 	 	 	 	 	0	0
H1225	HOPKINS HEALTH ADVANTAGE, INC.	2019	1	 	 	 	 	 	0	0
H1230	KAISER FOUNDATION HP, INC.	2019	1	Yes, Silver&Fit Rewards Program	Members are rewarded for meeting a threshold of fitness facility visits and/or physical activity.	Members may earn nominal rewards such as a Silver&Fit hat or collectable pin each quarter.	The value of the reward is the cost per unit. Silver&Fit Rewards are of nominal value.	Members are offered the opportunity to participate in the rewards program upon enrollment. Their participation is tracked through a field in the system that indicates whether they choose to participate or not.	670	591
H1248	LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY	2019	1	 	 	 	 	 	0	0
H1278	HARKEN HEALTH INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	2544	2406
H1286	UNITEDHEALTHCARE OF OREGON, INC.	2019	1	HouseCalls Program, Renew Rewards	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device).	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	7641	8019
H1290	DEVOTED HEALTH PLAN OF FLORIDA, INC.	2019	1	Devoted Dollars	PCP Visit, Flu Shot	Gift Cards	$25 per quarter for a PCP visit, $10 per flu season for a flu shot	A medical claim for a PCP visit triggers a PCP visit reward, a medical claim, a pharmacy claim, or a member attestation triggers reward for a flu shot.	7332	4428
H1302	BLUE CROSS OF IDAHO CARE PLUS, INC.	2019	1	Healthy Rewards Program	Annual Wellness Visit,Improve your Physical Health (Fall Prevention),Bone Density Test,Rheumatoid Arthritis Management,Breast Cancer Screening,Diabetes Kidney Exam,Improve Bladder Control,Diabetes Blood Test (A1C) #1,Colon Cancer Screening,Flu Shot,Diabetes Eye Exam,Diabetes Blood Test (A1C) #2,Improve Your Mental Health,Diabetes Blood Test (A1C) #2	Gift cards	The activities are set at the beginning of the rewards period and based on the complexity of the health care activity. For example, a flu shot is not as complicated as a colorectal cancer screening therefore the reward for a flu shot is $10.00, whereas the reward for a colorectal cancer screening ranges from $15.00 to $50.00 depending on exam type.	We track high level activity weekly related to how many members activate, how many members redeem health care activities and the overall participation rate. We track redemptions monthly. We also track the impact to the HEDIS rates.	82	147
H1304	REGENCE BLUESHIELD OF IDAHO	2019	1	Onlife Health Member Incentive Program	Annual Wellness Exam, Colorectal Cancer Screening, Breast Cancer Screening	Gift Cards	Members earn gift cards by having the services (AWV, Breast Cancewr Screening, Colorectal Cancer Screening)	Members Opt-in to the program and Onlife, tracks their rewards based on opt-in status and whether or not our claims' feed shows the services rendered to participants.	625	631
H1350	BLUE CROSS OF IDAHO CARE PLUS, INC.	2019	1	Healthy Rewards Program	Annual Wellness Visit,Improve your Physical Health (Fall Prevention),Bone Density Test,Rheumatoid Arthritis Management,Breast Cancer Screening,Diabetes Kidney Exam,Improve Bladder Control,Diabetes Blood Test (A1C) #1,Colon Cancer Screening,Flu Shot,Diabetes Eye Exam,Diabetes Blood Test (A1C) #2,Improve Your Mental Health,Diabetes Blood Test (A1C) #2	Gift cards	The activities are set at the beginning of the rewards period and based on the complexity of the health care activity. For example, a flu shot is not as complicated as a colorectal cancer screening therefore the reward for a flu shot is $10.00, whereas the reward for a colorectal cancer screening ranges from $15.00 to $50.00 depending on exam type.	We track high level activity weekly related to how many members activate, how many members redeem health care activities and the overall participation rate. We track redemptions monthly. We also track the impact to the HEDIS rates.	3421	6162
H1352	BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.	2019	1	Yes	Mammogram, Annual Wellness Exam	Limit of two, $25 gift cards to use at retail stores	Rewards are calculated based on the submission of claims for the related services tied to the member rewards benefit. A claim submitted for the health related services included in the program, triggers gift card availability.	Tracking is based on eligibility, enrollment, related services rendered, claim submitted, and reward pay out	1832	2651
H1365	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	2019	1	Grocery Gift Card for completion of Home Risk Assessment or attend Mobile Health Center event	Annual Wellness Visits and preventative screenings	$15 Hannaford Gift Card	$15 Gift Card per year per person triggered by the completion of a visit	Vendors send weekly reports indicating which members have participated in the program	161	161
H1372	MARQUIS ADVANTAGE, INC.	2019	1	 	 	 	 	 	0	0
H1415	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	10437	1542
H1416	HARMONY HEALTH PLAN,  INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	80451	30691
H1426	VITALITY HEALTH PLAN OF CALIFORNIA, INC.	2019	1	 	 	 	 	 	0	0
H1436	ABSOLUTE TOTAL CARE, INC.	2019	1	ABSOLUTE TOTAL CARE, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, DIABETIC KIDNEY SCREENING, COLORECTAL CANCER SCREENING	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	5680	6872
H1463	HEALTH ALLIANCE CONNECT, INC.	2019	1	Wellness Rewards	Eligible services and associated points are as listed: Annual PCP visit (required) (30 points), Breast Cancer Screening (10 points), Colorectal Cancer Screening (20 points), eye exam (10 points), Flu Shot (5 points), Social Activity (5 points), Tal k with your physician about: Urinary incontinence (5 points), Fall risk (5 points), Female Osteoporosis screening/treatment (5 points), Physical Activity (5 points), Mental Health (5 points)	Fulfilling 50 points out of 105 total possible points will allow the member to receive a $50 Amazon gift card reward	Activities have points assigned to them for the participants to check off and fulfill	Interactive database that can be exported to excel and report.	2514	2514
H1468	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	218	23
H1468	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	115940	657999
H1468	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	1690	360
H1475	ILLINICARE HEALTH PLAN	2019	1	ILLINICARE HEALTH PLAN	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, PCR OUTPATIENT VISIT 30 DAYS POST, INPATIENT MENTAL HEALTH FOLLOW UP, BONE DENSITY, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, BONUS REWARD FOR COMPLETING ALL REWARDS	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	189	429
H1537	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO	2019	1	HouseCalls Program, Renew Rewards	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device).	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	781	784
H1587	ARKANSAS SUPERIOR SELECT, INC.	2019	1	 	 	 	 	 	0	0
H1607	ANTHEM INSURANCE COMPANIES, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	4	4
H1607	ANTHEM INSURANCE COMPANIES, INC.	2019	2	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	721	680
H1608	COVENTRY HEALTH AND LIFE INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H1609	AETNA HEALTH INC. (FL)	2019	1	 	 	 	 	 	0	0
H1610	COVENTRY HEALTH CARE OF VIRGINIA	2019	1	Healthy Connections	The Healthy Connections program is a telephonic member journey to support Members in maintaining and improving their Health Outcomes.	Members receive an incentive to activate the journey and complete module 1. They receive another reward after they complete Module 8. The incentives for this program are gift cards to WalMart.	The total reward potential is $25 ($10 for completing Module 1 and $15 for completing Module 8). Analytical analysis suggests this value will help to progress our Health Outcome Survey results and improve members mental and physical activity levels.	We receive an activity file at the completion of Module 8 which provides the Members that completed Module 1 and Module 8.	375	509
H1659	UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY	2019	1	Nurse Practitioner Visit Incentive	An exam and wellness visit with a Nurse Practitioner, there is no charge for the visit and members receive a gift card for completing the visit	Gift Card	$25	Excel Spreadsheet	19	19
H1660	HARVARD PILGRIM HEALTH CARE INC.	2019	1	Harvard Pilgrim Rewards	Annual Wellness Visit, Breast Cancer Screening, Colorectal Cancer Screening, Diabetes Dilated Eye Exam	Beneficiaries may choose gift cards from Amazon, Walmart, Target and Applebees	Beneficiaries are rewarded $25 in gift certificates for completion of the Annual Wellness Visit, Breast Cancer Screening and Diabetes Dilated Eye Exam.  Beneficiaries are rewarded $50 in gift certificates for completion of the Colorectal Cancer Screening.	Beneficiaries are able to attest to the completion of any activity through a web application, an IVR application or by paper mail.  Responses are aggregated in a database to track and monitor activity.	1537	2402
H1664	HOME STATE HEALTH PLAN, INC.	2019	1	HOME STATE HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	616	1470
H1666	HCSC INSURANCE SERVICES COMPANY	2019	1	Rewards and Incentives Program	Annual Wellness Visit, Fall Risk Assessment, Flu Vaccine, Blood Glucose A1c Screening, ColorectalScreening, In Home Assessment, Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening	Registered members earn Gift Cards total annual maximum rewards is $100. For members in this contract we used $25 gift card awards for all Healthy Actions, inclusive of Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening. Members that complete the Annual Wellness Visit recieve two rewards of $25, amounting amounting to a total $50 reward	Evaluated the cost  value of each service,  ensured that the  value of the award is less than that of the  service provided  while significant enough to drive the member to complete it	We track participation in the Healthy Rewards Program, via Weekly Registration reports, Healthy Action Activity Reorts and Reward Redemption Reports	6671	19819
H1692	COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening. Diabetic Eye Exams, Diabetic Kidney Screenings,  blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can ""activate"" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more complaint in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	287	497
H1723	ABSOLUTE TOTAL CARE, INC.	2019	1	ABSOLUTE TOTAL CARE, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, DIABETIC KIDNEY SCREENING, COLORECTAL CANCER SCREENING	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	3825	4728
H1737	HEALTH ALLIANCE - MIDWEST, INC.	2019	1	Wellness Rewards	Eligible services and associated points are as listed: Annual PCP visit (required) (30 points), Breast Cancer Screening (10 points), Colorectal Cancer Screening (20 points), eye exam (10 points), Flu Shot (5 points), Social Activity (5 points), Tal k with your physician about: Urinary incontinence (5 points), Fall risk (5 points), Female Osteoporosis screening/treatment (5 points), Physical Activity (5 points), Mental Health (5 points)	Fulfilling 50 points out of 105 total possible points will allow the member to receive a $50 Amazon gift card reward	Activities have points assigned to them for the participants to check off and fulfill	Interactive database that can be exported to excel and report.	102	102
H1777	CATHOLIC SPECIAL NEEDS PLAN, LLC	2019	1	 	 	 	 	 	0	0
H1787	GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC	2019	1	 	 	 	 	 	0	0
H1846	MOUNT CARMEL HEALTH INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H1894	AMERIGROUP WASHINGTON, INC.	2019	1	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	99	92
H1924	PORT HOLDINGS, INC.	2019	1	 	 	 	 	 	0	0
H1944	UNITEDHEALTHCARE OF NEW ENGLAND, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	28622	27111
H1951	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	163126	694763
H1951	HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	3099	630
H1961	PEOPLES HEALTH, INC.	2019	1	Peoples Health Member Rewards Program  2019	Comprehensive Wellness Assessment, Breast Cancer Screening, Colorectal Cancer Screening	Gift Card	In order to calculate the value of a reward, Peoples Health took several things into consideration including: 1. industry standard - the dollar amount which members perceived had value and subsequently triggered member to complete activity, and 2. reward-cost ratio  the reward amount is lower than the actual cost of the service being provided.	Peoples Health contracted with NOVU, a member engagement company, to manage the 2019 Peoples Health Member Rewards program. NOVU provides daily reports covering: Total Members  Eligible population, Activated Members  A breakdown of how many members that have activated into the program and the channels through which they have activated, Activities Redeemed  Aggregate number of health care activities that have been closed , Activities  Stats on each health care activity (total number eligible, total number redeemed, total reward value)	28591	28118
H1969	REGENCE BLUESHIELD OF IDAHO	2019	1	Onlife Health Member Incentive Program	Annual Wellness Exam, Colorectal Cancer Screening, Breast Cancer Screening	Gift Cards	Members earn gift cards by having the services (AWV, Breast Cancewr Screening, Colorectal Cancer Screening)	Members Opt-in to the program and Onlife, tracks their rewards based on opt-in status and whether or not our claims' feed shows the services rendered to participants.	300	338
H1977	UPPER PENINSULA HEALTH PLAN, LLC	2019	1	 	 	 	 	 	0	0
H1994	SELECTHEALTH, INC.	2019	1	Healthy Living	The only activity required for participation in the Healthy Living Program is the Annual Wellness Visit/Routine Physical Exam. If this is complete, members may choose from additional activities to earn points that are redeemed for a gift card. The optional activities are: Flu Shot, Colonoscopy, Mammogram, Eye Exam, Enroll in myhealth online portal, physical activity attestation, and Members Choice (describe what they did to stay healthy and active).	Members can receive a $50 gift card	Face value of the gift card	Members must track activities and submit information the online portal, by calling member services, or by mailing us the completed physical form. This information is tracked & reward is processed upon completion of required activities.	42704	5329
H1997	REGENCE BLUESHIELD	2019	1	 	 	 	 	 	0	0
H2001	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	2019	1	HouseCalls Program, Renew Rewards, Renew Motion, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device), Renew Motion and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. Renew Motion Program: The Motion platform calculates rewards by converting points earned for achieving each FIT goal on a daily basis to dollars.  Points are converted to dollars on a quarterly basis and the member is automatically issued a gift card based on participation. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. Renew Motion Program: The Motion platform tracks participation on a minute level basis by the member wearing a Fitbit or other tracking mechanism which tracks and updates the members dashboard accordingly. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	576260	577406
H2011	BRIGHT HEALTH INSURANCE COMPANY OF TENNESSEE	2019	1	MA Annual Wellness/Physical Rewards Program	Annual wellness visit or physical	Visa gift card	20 USD	Mail-in form completed by member and signed by provider	2	2
H2020	DELAWARE LIFE INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H2029	HUMANA INSURANCE OF PUERTO RICO, INC.	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	1089	45
H2029	HUMANA INSURANCE OF PUERTO RICO, INC.	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	20	0
H2029	HUMANA INSURANCE OF PUERTO RICO, INC.	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	7	1
H2032	INSURANCE COMPANY OF SCOTT AND WHITE	2019	1	 	 	 	 	 	0	0
H2034	COMMUNITY CARE HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H2108	BRAVO HEALTH MID-ATLANTIC, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	18872	3259
H2161	UPPER PENINSULA HEALTH PLAN, LLC	2019	1	 	 	 	 	 	0	0
H2168	VILLAGE SENIOR SERVICES CORPORATION	2019	1	 	 	 	 	 	0	0
H2171	CARE N' CARE INSURANCE COMPANY, INC.	2019	1	Matrix Mobile Clinic	Comprehensive physical exam, perform necessary labs and screenings, review of preventative services, assess significant and chronic diseases, medication review, recommendation for care management	$25.00 Visa gift card	Reward recommended by vendor based on their other clients' experiences	The Matrix vendor provides a weekly Excel status update of who has been scheduled and seen for an event	862	77
H2172	KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES	2019	1	Yes, Silver&Fit Rewards Program	Members are rewarded for meeting a threshold of fitness facility visits and/or physical activity.	Members may earn nominal rewards such as a Silver&Fit hat or collectable pin each quarter.	The value of the reward is the cost per unit. Silver&Fit Rewards are of nominal value.	Members are offered the opportunity to participate in the rewards program upon enrollment. Their participation is tracked through a field in the system that indicates whether they choose to participate or not.	282	120
H2174	TRILLIUM COMMUNITY HEALTH PLAN	2019	1	TRILLIUM COMMUNITY HEALTH PLAN	ANNUAL FLU VACCINATION, ANNUAL WELLNESS VISIT, HEALTH RISK ASSESSMENT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	2288	4994
H2185	LIFEWORKS ADVANTAGE, LLC	2019	1	 	 	 	 	 	0	0
H2224	SENIOR WHOLE HEALTH, LLC	2019	1	 	 	 	 	 	0	0
H2225	COMMONWEALTH CARE ALLIANCE, INC.	2019	1	 	 	 	 	 	0	0
H2226	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program	House Call	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued	9611	8677
H2228	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	107416	107949
H2230	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	2019	1	Health Risk Assessment (HRA)	We offer a $10 reward in the form of a gift card for members who completes the Health Risk Assessment.  Members can earn the $10 reward once per year.	Gift Card	Our Product Management, Health & Medical Management, and Marketing teams collaborated to calculate the value of the reward.  We decided that $10 was an appropriate amount to incentivize our members to complete the HRA.  We agreed that this value was compliant with the CMS requirement that the value may be expected to affect the enrollee behavior but not exceed the value of the health related service or activity itself. 	The team that manages the HRA provides a monthly report that tracks HRA completions and incentives earned and we get reporting back from the vendor to confirm the gift cards have been distributed.	1341	1341
H2235	BAYCARE SELECT HEALTH PLANS, INC.	2019	1	 	 	 	 	 	0	0
H2237	INDEPENDENT CARE HEALTH PLAN, INC.	2019	1	Extreme Ownership	Colon Cancer Screen	$20 gift card	$20 for completing the screen	Monthly query of paid claims	1476	165
H2237	INDEPENDENT CARE HEALTH PLAN, INC.	2019	2	Extreme Ownership	Diabetic Kidney Test	$20 gift card	$20 for completing the screen	Monthly query of paid claims	158	13
H2237	INDEPENDENT CARE HEALTH PLAN, INC.	2019	3	Extreme Ownership	HbA1c Testing for  Diabetics	$20 gift card	$20 for  completing the lab	Monthly query of paid claims	459	12
H2237	INDEPENDENT CARE HEALTH PLAN, INC.	2019	4	Extreme Ownership	Retinal Eye Screen	$20 gift card	$20 for  completing the screen	Excel file tracking completion and paid claims	772	440
H2237	INDEPENDENT CARE HEALTH PLAN, INC.	2019	5	Extreme Ownership	Statin medication	$20 gift card	$20 for  completing the fill	Monthly query of paid claims	69	14
H2237	INDEPENDENT CARE HEALTH PLAN, INC.	2019	6	Extreme Ownership	Medicare Wellness In-home Exam Program	$20 gift card	$20 for  completing the exam	Excel file tracking completion from vendors	7913	1550
H2237	INDEPENDENT CARE HEALTH PLAN, INC.	2019	7	$15 Welcome Catalog	Health Risk Assessment	Catalog gift of up to $15 value	The cost of the catalog gift	Monthly invoices from the catalog vendor	0	156
H2241	GOLDEN STATE MEDICARE HEALTH PLAN	2019	1	 	 	 	 	 	0	0
H2247	UNITEDHEALTHCARE COMMUNITY PLAN, INC.	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	1214	992
H2256	TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION	2019	1	 	 	 	 	 	0	0
H2261	BCBS  OF MASSACHUSETTS HMO BLUE, INC.	2019	1	Health Risk Assessment (HRA)	We offer a $10 reward in the form of a gift card for members who completes the Health Risk Assessment.  Members can earn the $10 reward once per year.	Gift Card	Our Product Management, Health & Medical Management, and Marketing teams collaborated to calculate the value of the reward.  We decided that $10 was an appropriate amount to incentivize our members to complete the HRA.  We agreed that this value was compliant with the CMS requirement that the value may be expected to affect the enrollee behavior but not exceed the value of the health related service or activity itself. 	The team that manages the HRA provides a monthly report that tracks HRA completions and incentives earned and we get reporting back from the vendor to confirm the gift cards have been distributed.	469	469
H2288	BRIGHT HEALTH INSURANCE COMPANY OF NEW YORK	2019	1	MA Annual Wellness/Physical Rewards Program	Annual wellness visit or physical	Visa gift card	20 USD	Mail-in form completed by member and signed by provider	69	47
H2292	OXFORD HEALTH INSURANCE, INC.	2019	1	Step Therapy	The following medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies.	6	14
H2320	PRIORITY HEALTH	2019	1	SmartRewards	Diabetic retinal eye screening, Breast cancer screening, Colorectal cancer screening, Signify In-home health assessment, Flu shot completion, Physician discussion on fall prevention, Physician discussion on physical activity	Gift Cards to retailers	Member is rewarded for each task completed.  A diabetic retinal eye screening rewards 50 dollars (usd).  A breast cancer screening rewards 25 dollars (usd).  A colorectal cancer screening rewards 25 (usd).  A Signify In-home health assessment rewards 25 (usd).  A flu shot completion rewards 10 dollars (usd).  A physician discussion on fall prevention rewards 10 dollars (usd).   A physician discussion on physical activity rewards 10 dollars (usd).	We use a third party vendor (Welltok) to handle enrollee participation. The vendor handles recording participation and fulfilling rewards.  All rewards (except the Signify In-home health assessment) are self reported with an attestation.  The Signify In-home health assessment has a file sent to Welltok to verify who is eligible for that reward.  A member must claim the reward for it to payout.	1538	5622
H2322	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	2019	1	Yes	Screenings for breast and colon cancer - discussion with doctor about bladder control, physical activity, and fall risk -  preventive bone mineral density screening and retinal, kidney disease, and HbA1c screenings for members with diabetes	Gift Cards of various amounts	The value is based off of Medicare Star weight and prior year rates. The higher the weight, the higher the reward. The lower the rate from the previous year, the highter the reward.	Members may register online or via post mail. Each registration is saved in an Access database and used for tracking services completed and reward values.	634	1245
H2322	ALLIANCE HEALTH AND LIFE INSURANCE COMPANY	2019	2	Yes	Bone density screening or Rx medication to treat osteoporosis within 6 months for women 67-85 with a recent fracture	$100 award voucher that lets the member choose from numerous national retailers to get a gift  card	This measure has a small number of members with a short time frame to see their provider for a medication or to have a bone density screening so we felt $100 may help improve this measure	Member list is pulled based on measure criteria to identify population and claims data is ran monthly to determine members who have completed a screening and are due for an award.	12	2
H2334	EON HEALTH, INC. (SC)	2019	1	Better Health 4 You	Annual Flu Shot (Influenza Vaccination), Annual Wellness Visit, Colorectal Cancer Screening, (iFOBT/Colonoscopy/Flex Sigmoidoscopy), Mammogram (Breast Cancer Screening)	Gift Cards	$15 gift card for annual wellness visit, $10 gift card for Annual Flu Shot (Influenza Vaccination),  Colorectal Cancer Screening, (iFOBT, Colonoscopy or Flex Sigmoidoscopy), Mammogram (Breast Cancer Screening)	The member takes the Better Health 4 You booklet to the appointment for completion by their physician. The physician form must be completed, signed, dated and faxed to Eon Health. Once the completed form is received at Eon, the Enrollment Team processes the form by completing the Incentive Tracker. The Better Health 4 You Booklet includes a Provider Reference Code List. Participation in the program is confirmed upon processing of claim with corresponding claims codes at which time the Gift card is approved and mailed to member.	0	0
H2354	HEALTH ALLIANCE PLAN OF MICHIGAN	2019	1	Yes	Screenings for breast and colon cancer, discussion with doctor about bladder control, physical activity, and fall risk,  preventive bone mineral density screening and retinal, kidney disease, and HbA1c screenings for members with diabetes	Gift Cards of various amounts	The value is based off of Medicare Star weight and prior year rates. The higher the weight, the higher the reward. The lower the rate from the previous year, the highter the reward.	Members may register online or via post mail. Each registration is saved in an Access database and used for tracking services completed and reward values.	8336	12302
H2354	HEALTH ALLIANCE PLAN OF MICHIGAN	2019	2	Yes	Bone density screening or Rx medication to treat osteoporosis within 6 months for women 67-85 with a recent fracture	$100 award voucher that lets the member choose from numerous national retailers to get a gift  card	This measure has a small number of members with a short time frame to see their provider for a medication or to have a bone density screening so we felt $100 may help improve this measure	Member list is pulled based on measure criteria to identify population and claims data is ran monthly to determine members who have completed a screening and are due for an award.	347	168
H2392	KANSAS SUPERIOR SELECT, INC.	2019	1	 	 	 	 	 	0	0
H2400	SIGNATURE ADVANTAGE, LLC	2019	1	 	 	 	 	 	0	0
H2406	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	39373	41574
H2416	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	2019	1	 	 	 	 	 	0	0
H2417	ITASCA MEDICAL CARE	2019	1	 	 	 	 	 	0	0
H2419	SOUTH COUNTRY HEALTH ALLIANCE	2019	1	Wellness Programs  and Preventive Care Reward Program	Exercising at a fitness center or health club, participation in up to five Community Education classes per calendar year, and an Annual Dental visit	Up to $20 off monthly health club membership fee, up to $15 toward the registration fee for Community education classes for up to five classes per calendar year, a $25 gift card for enrollees who complete an annual Dental Visit	Scholarships for health club membership fees, scholarships for Community Education class fees, annual dental visit gift card, is based on an annual review of current best practices for designing and maintaining successful incentive programs, an annual analysis of reward and incentive participation across all South Country products, set standards (policies and procedures) of eligibility for each gift card reward and scholarship program based on budgetary allotment.	Participation is tracked via manual data entry in South Countrys enrollee database system (Client Contact Manager) by enrollee name, date of service or class, name of incentive or scholarship, incentive or scholarship amount, healthcare provider if applicable, program participation voucher source if applicable, and whether or not enrollee meets the eligibility requirements for the gift card reward or scholarship program.	103	103
H2422	HEALTHPARTNERS, INC.	2019	1	MSHO Preventive Care Rewards	Mammography, Colorectal Cancer Screening, Osteoporosis Screening, Annual wellness visit	$25 gift card	All rewards are set up $25	Claims submission at completion of the service	3563	2555
H2422	HEALTHPARTNERS, INC.	2019	2	Silver&Fit	Fitness facility visits and/or amount of physical activity	Hat or collectable pin	Cost per unit	Participation is tracked through a system field that  indicates whether a member has chosen to participate	26	9
H2425	BLUE PLUS	2019	1	Osteoporosis Management in Women Who Had a Fracture (OMW)	Bone scan	$25 (OMW) Visa Gift Card	The reward card value is calculated depending on the value of the service	Members who are eligible are contacted and provided with the offer. Member agrees to offer and completes service, vendor or member provides us with reporting showing who completed the scan or completed form, member is added to the gift card tracking sheet, member information is provided to finance with gift card amount who then sends the request to the bank to process the members gift card, which is then mailed	8	2
H2446	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	2019	1	 	 	 	 	 	0	0
H2456	UCARE MINNESOTA	2019	1	Wellness Incentive	annual wellness visit or preventive checkup	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	13420	882
H2456	UCARE MINNESOTA	2019	2	Colonoscopy Incentive	fecal occult blood test, flexible sigmoidoscopy, colonoscopy	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	2002	513
H2456	UCARE MINNESOTA	2019	3	Community Education	wellness session, health related activity, wellbeing activity	session discount	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	13420	233
H2456	UCARE MINNESOTA	2019	4	Dental Incentive	Dental visit	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	9120	574
H2456	UCARE MINNESOTA	2019	5	Diabetes Incentive	Hemoglobin A1c HbA1c testing	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	627	311
H2456	UCARE MINNESOTA	2019	6	Diabetes Incentive	eye exam retinal	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	849	276
H2456	UCARE MINNESOTA	2019	7	Diabetes Incentive	nephropathy	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	487	214
H2456	UCARE MINNESOTA	2019	8	Mammogram Incentive	mammogram	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	1155	481
H2456	UCARE MINNESOTA	2019	9	Osteoporosis Screening	osteoporosis screening	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	88	25
H2456	UCARE MINNESOTA	2019	10	Asthma Incentive	Respiratory Therapist home visit and care management phone support for asthma	gift card	Value of the activity or service and budget available for the estimated number of participants	member care management system	1	1
H2458	MEDICA HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H2459	UCARE MINNESOTA	2019	1	Community Education	wellness session, health related activity, wellbeing activity	session discount	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	103491	1211
H2459	UCARE MINNESOTA	2019	2	Colonoscopy Incentive	fecal occult blood test, flexible sigmoidoscopy, colonoscopy	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	10602	484
H2459	UCARE MINNESOTA	2019	3	Diabetes Incentive	Hemoglobin A1c HbA1c testing	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	2359	1148
H2459	UCARE MINNESOTA	2019	4	Diabetes Incentive	eye exam retinal	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	3492	1051
H2459	UCARE MINNESOTA	2019	5	Diabetes Incentive	nephropathy	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	1839	604
H2459	UCARE MINNESOTA	2019	6	Mammogram Incentive	mammogram	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	4372	782
H2459	UCARE MINNESOTA	2019	7	Osteoporosis Screening	osteoporosis screening	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	287	81
H2463	HUMANA HEALTH PLAN OF TEXAS, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	5642	30795
H2463	HUMANA HEALTH PLAN OF TEXAS, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	81	20
H2486	HUMANA MEDICAL PLAN OF UTAH, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	2938	5495
H2486	HUMANA MEDICAL PLAN OF UTAH, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	36	9
H2491	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	18729	4984
H2506	AETNA BETTER HEALTH, INC. (IL)	2019	1	HEDIS Measure Program	Adults Access to Preventive/Ambulatory Health Services (AAP) , Breast Cancer Screening (BCS),Colorectal Cancer Screen (COL),Comprehensive Diabetes Care (CDC) 3 Sub measure Hemoglobin A1C testing Medical Attention to Nephropathy Dilated Retinal exam, Care of Older Adults (COA) 4 Sub measures Advance Care Planning Medication Review Functional Status Assessment Pain Assessment	$25 gift card per each respective activity. CDC and COA require closure of gaps across the applicable sub-measures as noted in column B.	Based on I best practices and local and federal guidelines	We use our HEDIS consolidated table to track who has completed a service that closes their gap in care and send the list of members to our fulfillment vendor to send out the cards.	6741	7909
H2531	UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.	2019	1	HouseCalls Program	House Call	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued	4496	4018
H2533	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	2019	1	Breast Cancer Screening (BCS) Program	Breast Cancer Screening	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	Members participate by completing the service and returning a postcard. Service is tracked through claims data verification.	1274	125
H2533	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.	2019	2	Diabetes Reward Program	Nephropathy screening, HbA1c test, Diabetic eye exam	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	Members participate by completing the service and returning a postcard. Service is tracked through claims data verification.	732	132
H2563	OPTIMA HEALTH PLAN	2019	1	Annual Wellness Visit Program	Wellness Exam	Gift Card	Member receives a $25 gift card upon completion of an Annual Wellness Visit or Welcome to Medicare Exam	Plan reviews submitted claims from primary care physicians.   Rewards are sent to members that have claims submitted with the procedure codes of G0402, G0438, or G0439.	3292	2681
H2591	HEALTH ALLIANCE - MIDWEST, INC.	2019	1	Wellness Rewards	Eligible services and associated points are as listed: Annual PCP visit (required) (30 points), Breast Cancer Screening (10 points), Colorectal Cancer Screening (20 points), eye exam (10 points), Flu Shot (5 points), Social Activity (5 points), Tal k with your physician about: Urinary incontinence (5 points), Fall risk (5 points), Female Osteoporosis screening/treatment (5 points), Physical Activity (5 points), Mental Health (5 points)	Fulfilling 50 points out of 105 total possible points will allow the member to receive a $50 Amazon gift card reward	Activities have points assigned to them for the participants to check off and fulfill	Interactive database that can be exported to excel and report.	32	32
H2593	AMERIGROUP TEXAS, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	26	24
H2593	AMERIGROUP TEXAS, INC.	2019	2	Central Annual Routine Physical	Annual Routine Physical	$100.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	1685	1508
H2593	AMERIGROUP TEXAS, INC.	2019	3	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	4311	3968
H2593	AMERIGROUP TEXAS, INC.	2019	4	Rewards for Health Program	Depression Screening, Colorectal Cancer Screening, Breast Cancer Screening (Mammogram), Annual Physical Exam, New Member Physical Exam at CareMore Care Centers, Physical Activity Monitoring, Diabetes Care  Eye Exam, Fall Risk Management, Annual Flu Vacci	5 $10 Visa gift cards or 1 $50 Visa gift card	Members can earn up to $50 worth of Visa gift cards. They can earn 1 $50 Visa gift card by mailing in $50 worth of coupons all at once or up to 5 $10 Visa gift cards when mailing in coupons one at a time.	The enrollee participation is tracked by providing the approved fulfillment house vendor a complete membership file used to mail member fulfillment kits every month. Member mails their attested coupons directly to the fulfillment vendor. Upon receipt of t	15431	5467
H2610	ESSENCE HEALTHCARE, INC.	2019	1	 	 	 	 	 	0	0
H2663	COVENTRY HEALTH CARE OF MISSOURI, INC	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening. Diabetic Eye Exams, Diabetic Kidney Screenings,  blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can ""activate"" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more complaint in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	7471	12195
H2775	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	44253	8185
H2793	IMPERIAL INSURANCE COMPANIES INC.	2019	1	 	 	 	 	 	0	0
H2802	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	119860	126356
H2816	AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	13616	1866
H2829	INNOVATION HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H2879	MOLINA HEALTHCARE OF WISCONSIN, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	977	554
H2915	PENNSYLVANIA HEALTH & WELLNESS, INC.	2019	1	PENNSYLVANIA HEALTH & WELLNESS, INC.	ANNUAL FLU VACCINATION, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	2830	2381
H2926	PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE	2019	1	 	 	 	 	 	0	0
H2944	HUMANA INSURANCE COMPANY	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	6305	5195
H2944	HUMANA INSURANCE COMPANY	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	119	20
H2960	HOMETOWN HEALTH PLAN, INC.	2019	1	Healthy Tracks	Participation in Healthy Tracks Portal	Non Cash Value Incentive	The same for every member	Electronic Record	206	6
H2960	HOMETOWN HEALTH PLAN, INC.	2019	2	Retinal Eye Exam Initative	Completion of Annual Diabetic Eye Exam	Non Cash Value Incentive	The same for every member	Electronic Record	1764	30
H2960	HOMETOWN HEALTH PLAN, INC.	2019	3	Health Fair Participation	Participation in Diabetic Health Fair	Non Cash Value Incentive	The same for every member	Electronic Record	1764	80
H2960	HOMETOWN HEALTH PLAN, INC.	2019	4	Colorectal Cancer Initiative	Completion of Annual FIT Test or Colonoscopy	Non Cash Value Incentive	The same for every member	Electronic Record	4810	196
H2960	HOMETOWN HEALTH PLAN, INC.	2019	5	Osteoporosis Screening	Completion of Bone Density Screening	Non Cash Value Incentive	The same for every member	Electronic Record	105	47
H2960	HOMETOWN HEALTH PLAN, INC.	2019	6	Annual Health Assessment	Completion of Annual Wellness Visit	Non Cash Value Incentive	The same for every member	Electronic Record	16059	154
H2962	ULTIMATE HEALTH PLANS, INC.	2019	1	Recommended Preventive Services Rewards	Breast Cancer Screening, Colorectal Cancer Screening, Diabetic Retinal Screening, Nephropathy Screening	Gift card	All rewards are the same $25 value gift card per preventive service. The value of the gift card was arrived at by  estimating the appropriate  amount expected to elicit intended enrollee behavior while not exceeding the value of the  service or activity.	Claim received for each preventive service	3326	5034
H2986	STANFORD HEALTHCARE ADVANTAGE	2019	1	 	 	 	 	 	0	0
H3071	COMMUNITY CARE ALLIANCE OF ILLINOIS, NFP	2019	1	 	 	 	 	 	0	0
H3113	OXFORD HEALTH PLANS (NJ), INC.	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	29882	27225
H3132	AHF MCO OF FLORIDA, INC.	2019	1	YES	Colonoscopy  Member Incentive Program. By completing a colonoscopy by a Gastroenterologist (GI) specialist. Qualified members must be ages 50 years and older and have not completed a screening within the last 10 years, or as advised by their doctor. Each qualified member is outreached to my mail and phone, informing them of the program.	Members may earn a $50 grocery store Gift card upon verification of completion.	The value amount of the incentive is weighed on the value of the service and the commitment and time required of the member to carry out the desired action. The colonoscopy is procedure performed by a doctor experienced in the procedure and lasts approximately 30-60 minutes. There are medications will be given to the patients before and during the procedure. Since the service is semi-extensive and promotes good health, therefore a $50 grocery gift card that cannot be spent on alcohol or cigarettes seems rational as a reward.	Members will be tracked by the Quality team based on the returned letters that must be signed by their provider and are received via mail. The Quality team will also retrieve member claims records to verify the members screening completion.  .	641	39
H3132	AHF MCO OF FLORIDA, INC.	2019	2	YES	Diabetic Retinal Eye Exam Member Incentive Program. The diabetic retinal eye exam is to be completed by an optometrist or an ophthalmologist. To be qualified, members must be diabetic and have not completed a screening in the current year. Each qualified member is outreached to by mailed letters and phone calls, informing them of the program.	Members may earn a $20 grocery store Gift card upon verification of completion	The value amount of the incentive is weighed on the value of the service and the commitment and time required of the member to carry out the desired action. The eye exam is and outpatient service and is not extensive and also promotes good health, therefore a $20 grocery gift card that cannot be spent on alcohol or cigarettes seems rational as a reward.	Members will be tracked by the Quality team based on the returned letters that are signed by their provider and are received via mail. The Quality team will also retrieve member claims records to verify the members screening completion	248	43
H3152	AETNA HEALTH INC. (NJ)	2019	1	 	 	 	 	 	0	0
H3154	HORIZON INSURANCE COMPANY	2019	1	2019 Member Rewards and Incentive Program	Annual Wellness Visit, Osteoporosis/BMD Test, Breast Cancer Screening, Colorectal Cancer Screening - Colonoscopy or Sigmoidoscopy, Colorectal Cancer Screening - CT Colonography, Stool DNA, FOBT Kit, Diabetes - Eye Exam	CVS Gift Card for completing the screening	Gift Card amount is set for each measure, based on the complexity of how the care gap is closed	This is tracked by way of Gift Card redemption forms received from members paired with claims data	21357	4332
H3170	SAPPHIRE EDGE, INC.	2019	1	Welvie - My Surgery	Direct Decision Support for preference sensitive surgeries.	$25.00 Amazon Gift Card for completion of program.	Limited to $25.	Enrollees must register in the program and program progress is tracked electronically.	171	133
H3170	SAPPHIRE EDGE, INC.	2019	2	Annual Wellness Visit	Annual Wellness Visit	$50.00 Walmart Gift Card for completion of annual wellness visit	Limited to $50	Member must complete their annual wellness visit as defined by the program requirements.	752	685
H3204	PRESBYTERIAN HEALTH PLAN	2019	1	Yes	Preventative Screenings, Comprehensive Diabetes Care, Breast Cancer Screening, Colorectal Cancer Screening	Amazon Gift Card	$25 flat rate. One gift card per member for completion of all applicable screenings.	Program participation is monitored through claims validation and provider appointment confirmation. The outcomes are then tracked on a spreadsheet	39829	5
H3206	PRESBYTERIAN INSURANCE COMPANY, INC.	2019	1	Yes	Preventative Screenings, Comprehensive Diabetes Care, Breast Cancer Screening, Colorectal Cancer Screening	Amazon Gift Card	$25 flat rate. One gift card per member for completion of all applicable screenings.	Program participation is monitored through claims validation and provider appointment confirmation. The outcomes are then tracked on a spreadsheet.	2649	0
H3219	ALLINA HEALTH AND AETNA INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H3227	KALOS HEALTH, INC.	2019	1	 	 	 	 	 	0	0
H3237	HEALTH NET COMMUNITY SOLUTIONS, INC.	2019	1	HEALTH NET COMMUNITY SOLUTIONS, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C TESTING, BONE DENSITY, HEALTH RISK ASSESSMENT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	9608	13272
H3239	AETNA BETTER HEALTH, INC. (LA)	2019	1	 	 	 	 	 	0	0
H3240	AMERIGROUP NEW JERSEY, INC.	2019	1	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	48	38
H3251	HEALTH CARE SERVICE CORPORATION	2019	1	Rewards and Incentives Program	Annual Wellness Visit, Fall Risk Assessment, Flu Vaccine, Blood Glucose A1c Screening, ColorectalScreening, In Home Assessment, Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening	Registered members earn Gift Cards total annual maximum rewards is $100. For members in this contract we used $25 gift card awards for all Healthy Actions, inclusive of Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening. Members that complete the Annual Wellness Visit recieve two rewards of $25, amounting amounting to a total $50 reward	Evaluated the cost  value of each service,  ensured that the  value of the award is less than that of the  service provided  while significant enough to drive the member to complete it	We track participation in the Healthy Rewards Program, via Weekly Registration reports, Healthy Action Activity Reorts and Reward Redemption Reports	5688	17110
H3259	VOLUNTEER STATE HEALTH PLAN	2019	1	Rewards and Incentive Program	Annual Wellness Visit, Breast Cancer Screening, Colorectal Cancer Screening, Diabetes HbA1C testing, Diabetes Urine Nephropathy Screening, Diabetes Retinal Eye Screening, Bone Density Screening for Women with a Fracture	Gift Cards	Market research was conducted to determine an appropriate value that would have a positive outcome on member behavior. The defined incentive values vary by individual measure and the type of screening required for fulfilling the participation requirements.	On a monthly basis, BCSBT identifies the members eligible for the Rewards Program and patrols the data repositories for completed behaviors. The data is summarized for program oversight purposes and the details are delivered to the designated internal team for fulfillment. The internal team works with the Outgoing Mailroom to complete the rewards fulfillment. Meticulous records are kept by the fulfillment team that tracks the handling and processing of the gift cards that are used as the reward.	21202	30624
H3276	CONNECTICARE INSURANCE COMPANY, INC.	2019	1	 	 	 	 	 	0	0
H3291	PRUITTHEALTH PREMIER, INC.	2019	1	 	 	 	 	 	0	0
H3293	MMM OF FLORIDA, INC.	2019	1	 	 	 	 	 	0	0
H3305	MVP HEALTH PLAN, INC.	2019	1	Medicare Wellness Rewards	Welcome to Medicare visit or Annual Wellness visit, Blood pressure check, Height Weight and BMI Measurement, Colorectal cancer screening, Flu shot	$75.00	The reward is calcuated by the member meeting all of the five preventitive services.  There are no incremental rewards.	The member completes the Wellness Rewards form.  His/her physician attests that he/she met the requirements.  The member then submits the form to MVP for processing.	34035	5603
H3307	OXFORD HEALTH PLANS (NY), INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	31277	38062
H3312	AETNA HEALTH INC. (NY)	2019	1	 	 	 	 	 	0	0
H3328	THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC.	2019	1	Wellness Incentive Program	Mammograms in women (every 2 years), Colonoscopy in men and women (every 10 years), Bone Scans in women (for one bone scan in women aged 65 and above), Diabetes HbA1c Test (one test per calendar year).	$50.00 gift card for a mammogram, $50.00 gift card for a colonoscopy, $50.00 gift card for a bone scan, $50.00 gift card for an HbA1c test.	Enrollees can earn one gift card by test based on the frequency outlined. Evidence of obtaining the required screening or test is based on qualifying claims submitted by providers.	Enrollees participating in the program are tracked in a database.	50224	28249
H3330	HEALTH INSURANCE PLAN OF GREATER NEW YORK	2019	1	Health and Wellness/Prevention and Bone Mineral Density Incentive Program	Annual checkup with primary care physician, mammogram-breast cancer screening, colorectal (colon) cancer screening which includes colonoscopy or stool test, diabetes tests which includes HbA1c blood test, urine test and dilated eye exam, lastly a bone mineral density screening	Reward Cards in the amounts of: $15, $25, and $50	Reward values are pre-calculated and pre-determined in accordance to the type of screening or appointment completed by member	Member participation is tracked in an internal Incentive Database through Access.	9481	7412
H3335	EXCELLUS HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H3342	EMPIRE HEALTHCHOICE ASSURANCE, INC.	2019	1	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	47	43
H3344	INDEPENDENT HEALTH BENEFITS CORPORATION	2019	1	Independent Health's FitWorks Medicare	Enhanced Annual Visit, preventive screening services, preventive vision services, preventive dental services.	A $50 gift card.	Members earn points for completing a variety of activities. Activites include getting their Enhanced Annual Visit (30 points), getting preventive screenings (10 points for each service), getting preventive dental services (max 20 points), and getting routine vision services (10 points). Members that earn 100 points receive the $50 gift card.	All effective Independent Health Medicare Advantage plan members are automatically enrolled into FitWorks Medicare. Points are given to the member automatically as services are completed by the member.	4385	310
H3347	ELDERPLAN, INC.	2019	1	Elderplan Wellness Incentive Program	Colorectal Cancer Screening, Flu Shot, Mammogram, Retinal Eye Exam	$20 Visa gift card	A $20 incentive is rewarded through a VISA gift card to enrollees for each eligible completed health service.	Enrollees submit a  reward form for each completed service to participate in the program. Once received, the forms are scanned and logged for tracking. Submitted services are then validated via claims and/or medical records for reward processing.	333	962
H3351	EXCELLUS HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H3359	HEALTHFIRST HEALTH PLAN, INC.	2019	1	Reward Card Program	Bone Density Test, Breast Cancer Screening, Colorectal Cancer Screening, Diabetic Retinal Exam, Completion of Health Risk Assessment	Members are offered a reward card that can be used in-stores and online shops	We chose to use the baseline amount of $10 per measure and increase the reward with measures that are not performing at the desired level	We maintain a database that keeps track of member participation	36543	26436
H3362	INDEPENDENT HEALTH ASSOCIATION, INC.	2019	1	Independent Health's FitWorks Medicare	Enhanced Annual Visit, preventive screening services, preventive vision services, preventive dental services.	A $50 gift card.	Members earn points for completing a variety of activities. Activites include getting their Enhanced Annual Visit (30 points), getting preventive screenings (10 points for each service), getting preventive dental services (max 20 points), and getting routine vision services (10 points). Members that earn 100 points receive the $50 gift card.	All effective Independent Health Medicare Advantage plan members are automatically enrolled into FitWorks Medicare. Points are given to the member automatically as services are completed by the member.	60293	5709
H3379	UNITEDHEALTHCARE OF NEW YORK, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	13478	13866
H3384	HEALTHNOW NEW YORK INC.	2019	1	Annual Wellness Visit	Annual Wellness Visits, In-Home Assessments	$20 Gift Card	If the services required are billed the member receives the gift card.	Corporate reporting is in place to monitor the enrollees that complete the eligible services and those who receive gift cards.	41050	28015
H3384	HEALTHNOW NEW YORK INC.	2019	2	Member Rewards	Breast Cancer Screening, Colorectal Cancer Screening	$20 Gift Card	If the services required are billed the member receives the gift card.	Corporate reporting is in place to monitor the enrollees that complete the eligible services and those who receive gift cards.	41050	17139
H3387	UNITEDHEALTHCARE OF NEW YORK, INC.	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	53069	47140
H3388	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	2019	1	Home visit and bone scan, rheumatoid arthritis medication documentation	Engaging with Case Manager for home visit and bone scan, Sending CDPHP medication shipment documentation for rheumatoid arthritis medication	$15 gift card to Target or Price Chopper	The face value of the gift card	Engagement is tracked on an excel spreadsheet	236	77
H3404	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	2019	1	Medicare Part B Step Therapy Care Coordination Program	Interactive drug review and consultation to discuss drug strategies/regimen and provide educational material mailings	$50 gift card certificate	Value of reward/incentive is calculated as an equivalent to more than half the amount saved on average per participant	Enrollment file of comparison of members identified versus rewards issued	9	0
H3404	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	2019	2	Completion of Annual Wellness Visit, various Screenings, Tests, and Exams	Completion of Annual Wellness Visit, Breast Cancer Screening, Colorectal Cancer Screening, Diabetic A1C Test, Diabetic Eye Exam, Diabetic Kidney Exam, Bone Mineral Density Test, and Blue Connect Registration.	Blue Connect Registration.	Each member is eligible to receive $25 for completing services to close qualifying care gaps or by registering for the web-based member portal up to a limit of $125 per member.	Blue Cross NC used claims extractions to track the completion of qualifying medical services and specialized URL code to track the registration for the member portal.	15020	26977
H3404	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	2019	3	Prospective Risk Adjustment In-HomeAssessment Program	The plan targets members who are documented or are suspected of having multiple chronic conditions for an in home assessment.	Participating enrolees can earn a $50 retail gift card.	The value of the reward is less than the value of the medical service received.	The vendor completing the assessments reports to BCBSNC weekly which members have undergone assessments.  BCBSNC also received a medical record as a result of the assessment.	13256	2375
H3416	HEALTHPARTNERS UNITYPOINT HEALTH, INC.	2019	1	Silver&Fit	Fitness facility visits and/or amount of physical activity	Hat or collectable pin	Cost per unit	Participation is tracked through a system field that  indicates whether a member has chosen to participate	41	36
H3447	HEALTHKEEPERS, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	24	22
H3447	HEALTHKEEPERS, INC.	2019	2	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	4466	4178
H3447	HEALTHKEEPERS, INC.	2019	3	Rewards for Health Program	Depression Screening, Colorectal Cancer Screening, Breast Cancer Screening (Mammogram), Annual Physical Exam, New Member Physical Exam at CareMore Care Centers, Physical Activity Monitoring, Diabetes Care  Eye Exam, Fall Risk Management, Annual Flu Vacci	5 $10 Visa gift cards or 1 $50 Visa gift card	Members can earn up to $50 worth of Visa gift cards. They can earn 1 $50 Visa gift card by mailing in $50 worth of coupons all at once or up to 5 $10 Visa gift cards when mailing in coupons one at a time.	The enrollee participation is tracked by providing the approved fulfillment house vendor a complete membership file used to mail member fulfillment kits every month. Member mails their attested coupons directly to the fulfillment vendor. Upon receipt of t	7592	3014
H3449	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	2019	1	Medicare Part B Step Therapy Care Coordination Program	Interactive drug review and consultation to discuss drug strategies/regimen and provide educational material mailings	$50 gift card certificate	Value of reward/incentive is calculated as an equivalent to more than half the amount saved on average per participant	Enrollment file of comparison of members identified versus rewards issued	16	0
H3449	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	2019	2	Completion of Annual Wellness Visit, various Screenings, Tests, and Exams	Completion of Annual Wellness Visit, Breast Cancer Screening, Colorectal Cancer Screening, Diabetic A1C Test, Diabetic Eye Exam, Diabetic Kidney Exam, Bone Mineral Density Test, and Blue Connect Registration.	Blue Connect Registration.	Each member is eligible to receive $25 for completing services to close qualifying care gaps or by registering for the web-based member portal up to a limit of $125 per member.	Blue Cross NC used claims extractions to track the completion of qualifying medical services and specialized URL code to track the registration for the member portal.	22981	43563
H3449	BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA	2019	3	Prospective Risk Adjustment In-HomeAssessment Program	The plan targets members who are documented or are suspected of having multiple chronic conditions for an in home assessment.	Participating enrolees can earn a $50 retail gift card.	The value of the reward is less than the value of the medical service received.	The vendor completing the assessments reports to BCBSNC weekly which members have undergone assessments.  BCBSNC also received a medical record as a result of the assessment.	20925	4521
H3464	UNITEDHEALTHCARE OF ARKANSAS, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	5396	4938
H3471	HEALTH ALLIANCE NORTHWEST HEALTH PLAN	2019	1	Wellness Rewards	Eligible services and associated points are as listed: Annual PCP visit (required) (30 points), Breast Cancer Screening (10 points), Colorectal Cancer Screening (20 points), eye exam (10 points), Flu Shot (5 points), Social Activity (5 points), Tal k with your physician about: Urinary incontinence (5 points), Fall risk (5 points), Female Osteoporosis screening/treatment (5 points), Physical Activity (5 points), Mental Health (5 points)	Fulfilling 50 points out of 105 total possible points will allow the member to receive a $50 Amazon gift card reward	Activities have points assigned to them for the participants to check off and fulfill	Interactive database that can be exported to excel and report.	1004	1004
H3499	COORDINATED CARE CORPORATION	2019	1	MANAGED HEALTH SERVICES- INDIANA	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, INPATIENT MENTAL HEALTH FOLLOW UP	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	840	2237
H3528	CONNECTICARE, INC.	2019	1	 	 	 	 	 	0	0
H3533	HUMANA HEALTH COMPANY OF NEW YORK, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	31843	74455
H3533	HUMANA HEALTH COMPANY OF NEW YORK, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	656	139
H3536	MATTHEW THORNTON HEALTH PLAN, INC.	2019	1	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	206	190
H3561	HEALTH NET COMMUNITY SOLUTIONS, INC.	2019	1	HEALTH NET CALIFORNIA REWARDS PROGRAM	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C TESTING, BONE DENSITY, HEALTH RISK ASSESSMENT, DIABETIC RETINOPATHY SCREENING, COLORECTAL CANCER SCREENING	VISA PREPAID DEBIT CARD, E-GIFT CARD, GIFT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS. MEMBERS INTERACT THROUGH THE  PROGRAM VIA THE MAIL OR TELEPHONIC AND DIGITAL CHANNELS. MEMBER INTERACTIONS ACROSS THE CHANNELS ARE CAPTURED IN NOVUHEALTHS CMS-COMPLIANT DATA STORAGE AS ACTIVATIONS AND REDEMPTIONS	18266	32969
H3572	AHF MCO OF GEORGIA, INC.	2019	1	 	 	 	 	 	0	0
H3597	AETNA HEALTH INC. (ME)	2019	1	 	 	 	 	 	0	0
H3653	PARAMOUNT CARE, INC.	2019	1	Elite Member Incentive Program	Complete an annual wellness exam visit AND two preventive services from recommended by doctor from list which includes basica metabolic or lipid panel labs, colorectal screening, DEXA scan, flu or pneumonia vaccine, and mammorgram.  If member is a diabetic choices include nephropathy screening, retinopahty screening, and/or A1C blood test	$50 visa gift card	The perceived benefit to the member includes time taken to scheduled/attend visit, money spendin travel expenses, and potential to save their life by early detection or prevention of serious illness	Program is open to all members and monthly an analyst runs a report to determine which of our members have met the requirements using HEDIS code sets.  We use an Excel spreadsheet to track member compliance with the program	16279	9583
H3655	COMMUNITY INSURANCE COMPANY	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	230	205
H3655	COMMUNITY INSURANCE COMPANY	2019	2	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	15655	14390
H3660	SUMMACARE INC.	2019	1	Colorectal Cancer Screening, Test Verification, Breast Cancer Screening, Diabetic Eye Exam	The health related services and/or activities included in the Rewards and Incentive programs at SummaCare are Colonoscopy, Sigmoidoscopy, Fit Kit Completion, Mammograms, Diabetic Dilated Retinal Eye Exam, Completion of Test Verification Form. For the Colorectal Cancer Campaign members are encouraged to complete a Colorectal Cancer FIT Kit provided to them by SummaCare, Return Test Verification, form showing the Date of their Colonoscopy or Sigmoidoscopy if completed prior to SummaCare enrollment or Complete Colonoscopy or sigmoidoscopy in order to receive their reward. For the Breast Cancer Campaign members are encouraged to complete their mammograms. For the Diabetic Eye Exams members are encouraged to complete their Dilated Retinal Eye Exam or return their Test Verification form if SummaCare did not receive the claim from their Eye Care provider or the test was prior to SummaCare enrollment.	Members receive a gift card for completing all the tasks in a specific clinical campaign	SummaCare must receive a medical or vision claim proving the member completed the requested testing, member can return the FIT Kit provided, member can complete the Test verification form and return to SummaCare in the self-addressed stamped envelope so medical Record review can be completed to validate compliance. There is no calculation other than the members completing one of the tasks listed for each campaign. If at least one item has been completed for each campaign a reward is earned.	Member participation is tracked by monthly running Sequel queries on the claim payment system to determining receipt of a medical or vision claim. Additional sequel queries are run monthly to locate any test verification forms returned and entered into the Test Verification Database. Medical Record review is completed and tracked in the same location. All members who receive a mailing from the SummaCare Clinical Campaign team are housed in a database within the SummaCare Data Warehouse and is reported monthly to the Clinical Campaign Team, Quarterly to the Compliance Team and Annually to CMS.	7301	1070
H3664	AULTCARE HEALTH INSURING CORPORATION	2019	1	 	 	 	 	 	0	0
H3668	MOUNT CARMEL HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H3672	THE HEALTH PLAN OF WEST VIRGINIA, INC.	2019	1	 	 	 	 	 	0	0
H3706	GLOBALHEALTH, INC.	2019	1	 	 	 	 	 	0	0
H3708	OKLAHOMA SUPERIOR SELECT, INC.	2019	1	 	 	 	 	 	0	0
H3749	UNITEDHEALTHCARE OF OKLAHOMA, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	14620	14998
H3755	COMMUNITY CARE HMO, INC	2019	1	 	 	 	 	 	0	0
H3794	CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	6690	6205
H3805	UNITEDHEALTHCARE OF OREGON, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	47543	48178
H3810	ALLCARE HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H3811	SAMARITAN HEALTH PLANS, INC.	2019	1	 	 	 	 	 	0	0
H3813	MODA HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H3814	ATRIO HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H3815	ALIGNMENT HEALTH PLAN	2019	1	Alignment Healthy Rewards Program	Complete a Health Assessment (JSA/HRA), Complete a Colon Cancer Screening, Complete a Diabetes Blood Test, Complete an Eye Exam (Diabetic retinal eye exam), Complete an Osteoporosis Screening (BMD test), Complete a Breast Cancer Screening, Complete a Flu Vaccine, Review medications, Register for the Member Portal to Connect to Healthcare Resources	Reward dollars loaded on Alignment branded ACCESS Card (Debit Card).	Each reward activity has a different dollar value $5, $10, $15, $25. The value of the reward is calculated based on identifying a value less than the actual reward provided to the member.	All enrollees are automatically eligible in Alignment's rewards program upon enrollment. Once a member completes a reward activity, Alignment tracks this based on data received and automatically loads the reward dollars on the member's ACCESS Card. For example, if a member completes a Breast Cancer Screening, once Alignment receives a confirmed claim the reward dollars are loaded on the member's ACCESS Card.	29431	48698
H3817	REGENCE BLUECROSS BLUESHIELD OF OREGON	2019	1	 	 	 	 	 	0	0
H3822	HEALTH CARE SERVICE CORPORATION	2019	1	Rewards and Incentives Program	Annual Wellness Visit, Fall Risk Assessment, Flu Vaccine, Blood Glucose A1c Screening, ColorectalScreening, In Home Assessment, Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening	Registered members earn Gift Cards total annual maximum rewards is $100. For members in this contract we used $25 gift card awards for all Healthy Actions, inclusive of Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening. Members that complete the Annual Wellness Visit recieve two rewards of $25, amounting amounting to a total $50 reward	Evaluated the cost  value of each service,  ensured that the  value of the award is less than that of the  service provided  while significant enough to drive the member to complete it	We track participation in the Healthy Rewards Program, via Weekly Registration reports, Healthy Action Activity Reorts and Reward Redemption Reports	14983	45120
H3832	HAWAII MEDICAL SERVICE ASSOCIATION	2019	1	 	 	 	 	 	0	0
H3864	PACIFICSOURCE COMMUNITY HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H3890	HOPKINS HEALTH ADVANTAGE, INC.	2019	1	 	 	 	 	 	0	0
H3907	UPMC HEALTH PLAN, INC.	2019	1	Y- Medicare/SNP Preventive Incentive	Annual Wellness Visit (AWV), Mammogram, Colorectal Cancer Screening, DiabeticRetinal Eye Exam,	VISA Prepaid Card: Annual  Wellness Visit- $20   Mammogram- $50  Colorectal Cancer Screening- $60 Diabetic Retinal Eye Exam- $25	Defined   amounts for each screening type per VISA Prepaid card	When a  member completes an AWV and/or one or more of the screenings (gap is closed) and we receive the claim(s) for the screening(s) the VISA Prepaid cards are issued.  Once card for each reward type	161229	126928
H3909	QCC INSURANCE COMPANY	2019	1	Independence health rewards	The rewards program focused on a plan-specified contract, H3909, to close gaps in care for specific measures. Members were rewarded with gift cards to attend the specified health care activities. Members were able to activate into the rewards program, attest to their health care activity and redeem gift cards via mail (redemptions), call center and a digital channel.	The members had the option of printing an e-Gift card immediately or having a physical gift card mailed to them. These were merchant gift cards that were not convertible to cash. The health care activities and reward values were as follows: Breast Cancer Screening $25, Colon Cancer Screening (Fecal Occult Blood Test, Fecal Immunochemical Test, Flexible Sigmoidoscopy, Colonoscopy) $25, Diabetes Eye Exam $25, Diabetic HbA1C testing 2x$10, Osteoporosis Screening (DEXA scan) $25, Diabetic Nutrition Counseling $25, Annual Wellness Visit $10	The reward value is calculated based on the health care activity, the members propensity to complete the health care activity, and the CMS guideline pertaining to the value of the health related service or activity.	Members interact through the NovuHealth program via the mail, telephonic and digital channels. Member interactions across the channels are captured in NovuHealths CMS-compliant data storage as activations and redemptions (participation).	8173	445
H3909	QCC INSURANCE COMPANY	2019	2	Personal Health Visit (PHV) program	The Personal Health Visit program is offered to Medicare members who are not in the Diabetic, Low Income Subsidy or Osteoperosis Management in Women denominators, and administered through a vendor called Inovalon. Members are targeted based on suspected gaps in their medical history by analyzing their claims, pharmacy, and lab data. The Nurse Practictioner (NP) performing the visit captures detailed diagnosis codes and quality screening information while performing a complete physical examination, discussing medications, and any other health concerns the member might have.	Participants can earn one of five options for a $50 gift card. The retailers offered are Target, Walmart, Walgreens, Barnes and Noble, and Home Depot.	Based on CMS regulations, the value of the incentive must be less than the value of the health-related service or activity. The Personal Health Visit program is currently being run through Inovalon.  Based on Independences agreed upon pricing with Inovalon, the contract states that Independence pays Inovalon $322 per Personal Health Visit.  Therefore, Independence needed to stay below the $322 value. CMS also states that the value of the incentive must have a value that may be expected to affect enrollee behavior. As a result, Independence agreed upon a value of $50 per member. Each member is only eligible for one Personal Health Visit per year and therefore is only eligible for $50 per year through this program.	Enrollee participation is tracked through several avenues. First and foremost, our vendor outreaches to certain members each month and advertises the program.  Most of the participation in the program takes place through proactive outreaches.  However, in addition, members also hear about the program through word-of-mouth, our Customer Service area, our Case Management team, or on our website.  Either way, members interested in the program end up speaking with an Inovalon call center employee.  Through this conversation, members choose their preferred gift card and are scheduled for a visit.  Upon completion of the visit, the data is sent back to Inovalon for processing.  Only members who the data has been received correctly completed the service and therefore are entitled to the gift card.  The gift card is then mailed to the member within 60 days of the completed Personal Health Visit. Independence receives a weekly file listing the operational metrics, including member-level.  Finally, Independence receives a monthly gift card report outlining the members who have received their gift card, what gift card they chose, and how long it took the member to receive their gift card.	962	962
H3916	HIGHMARK SENIOR HEALTH COMPANY	2019	1	Passport Rewards Program	Annual Wellness Visit or Annual Physical Exam, Diabetic retinal eye exam, Breast cancer screening, Colorectal cancer screening, Nephropathy test, Bone Mineral Density Test, House Call Visit	Once the necessary activity(ies) are completed by a member, they can earn between $25 and $50 gift card of their choice. The member will receive a gift card selection mailer where they can choose the gift card of their choice from the restaurant/retailers being offered: Amazon, Lowes, Target, Applebees, Eatn Park, Weis, Macys, Dicks Sporting Goods, GNC, Sheetz, Darden, Walmart, Kohl's, AMC Theaters, Bed Bath And Beyond	Value of the reward is calculated by comparing to the plan value of the rewardable activity or the perceived value of the activity as an indirect impact to multiple other quality related activities.	We track enrollee participation via the Welltok reporting that is sent on a monthly basis. We receive member level data for members that are eligible for a reward and have redeemed a gift card.	135549	42547
H3923	CAPITAL ADVANTAGE INSURANCE COMPANY	2019	1	Yes	Preventative Screening such as annual well visit, breast cancer screening, colorectal cancer screening, bone density test, flu shot, Diabetic HbA1c tests, Diabetic retinal exam, arthritis management, monitoring physical health, and fall prevention	each reward is received as merchant gift card(s)	values range from $5 to $50	Enrollees provide date of service and provider to receive specific health activity reward	13390	4418
H3924	GEISINGER INDEMNITY INSURANCE COMPANY	2019	1	Annual Health and Wellness Visit	Annual Wellness Exam	WalMart Gift Card	25.00 for completion of the annual wellness visit	Enrollee submitted a voucher to pariticipate and was entered into our wellness platform after completion of the AWV the rendering provider signed the voucher and the enrollee returned for reimbursement	3855	3855
H3928	AETNA HEALTH, INC. (LA)	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening. Diabetic Eye Exams, Diabetic Kidney Screenings,  blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can "activate" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more complaint in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	76	135
H3930	SPARTAN PLAN NY, INC.	2019	1	 	 	 	 	 	0	0
H3931	AETNA HEALTH INC. (PA)	2019	1	 	 	 	 	 	0	0
H3949	BRAVO HEALTH PENNSYLVANIA, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	47171	7563
H3952	KEYSTONE HEALTH PLAN EAST, INC.	2019	1	Independence health rewards	The rewards program focused on a plan-specified contract, H3952, to close gaps in care for specific measures. Members were rewarded with gift cards to attend the specified health care activities. Members were able to activate into the rewards program, attest to their health care activity and redeem gift cards via mail (redemptions), call center and a digital channel.	The members had the option of printing an e-Gift card immediately or having a physical gift card mailed to them. These were merchant gift cards that were not convertible to cash. The health care activities and reward values were as follows: Breast Cancer Screening $25, Colon Cancer Screening (Fecal Occult Blood Test, Fecal Immunochemical Test, Flexible Sigmoidoscopy, Colonoscopy) $25, Diabetes Eye Exam $25, Diabetic HbA1C testing 2x$10, Osteoporosis Screening (DEXA scan) $25, Diabetic Nutrition Counseling $25, Annual Wellness Visit $10	The reward value is calculated based on the health care activity, the members propensity to complete the health care activity, and the CMS guideline pertaining to the value of the health related service or activity.	Members interact through the NovuHealth program via the mail, telephonic and digital channels. Member interactions across the channels are captured in NovuHealths CMS-compliant data storage as activations and redemptions (participation).	89786	12219
H3952	KEYSTONE HEALTH PLAN EAST, INC.	2019	2	Personal Health Visit (PHV) program	The Personal Health Visit program is offered to Medicare members who are not in the Diabetic, Low Income Subsidy or Osteoperosis Management in Women denominators, and administered through a vendor called Inovalon. Members are targeted based on suspected gaps in their medical history by analyzing their claims, pharmacy, and lab data. The Nurse Practictioner (NP) performing the visit captures detailed diagnosis codes and quality screening information while performing a complete physical examination, discussing medications, and any other health concerns the member might have.	Participants can earn one of five options for a $50 gift card. The retailers offered are Target, Walmart, Walgreens, Barnes and Noble, and Home Depot.	Based on CMS regulations, the value of the incentive must be less than the value of the health-related service or activity. The Personal Health Visit program is currently being run through Inovalon.  Based on Independences agreed upon pricing with Inovalon, the contract states that Independence pays Inovalon $322 per Personal Health Visit.  Therefore, Independence needed to stay below the $322 value. CMS also states that the value of the incentive must have a value that may be expected to affect enrollee behavior. As a result, Independence agreed upon a value of $50 per member. Each member is only eligible for one Personal Health Visit per year and therefore is only eligible for $50 per year through this program.	Enrollee participation is tracked through several avenues. First and foremost, our vendor outreaches to certain members each month and advertises the program.  Most of the participation in the program takes place through proactive outreaches.  However, in addition, members also hear about the program through word-of-mouth, our Customer Service area, our Case Management team, or on our website.  Either way, members interested in the program end up speaking with an Inovalon call center employee.  Through this conversation, members choose their preferred gift card and are scheduled for a visit.  Upon completion of the visit, the data is sent back to Inovalon for processing.  Only members who the data has been received correctly completed the service and therefore are entitled to the gift card.  The gift card is then mailed to the member within 60 days of the completed Personal Health Visit. Independence receives a weekly file listing the operational metrics, including member-level.  Finally, Independence receives a monthly gift card report outlining the members who have received their gift card, what gift card they chose, and how long it took the member to receive their gift card.	20004	20004
H3954	GEISINGER HEALTH PLAN	2019	1	Annual Health and Wellness Visit	Annual Wellness Exam	WalMart Gift Card	25.00 for completion of the annual wellness visit	Enrollee submitted a voucher to pariticipate and was entered into our wellness platform after completion of the AWV the rendering provider signed the voucher and the enrollee returned for reimbursement	11353	11353
H3957	HIGHMARK CHOICE COMPANY	2019	1	Passport Rewards Program	Annual Wellness Visit or Annual Physical Exam, Diabetic retinal eye exam, Breast cancer screening, Colorectal cancer screening, Nephropathy test, Bone Mineral Density Test, House call visit.	Once the necessary activity(ies) are completed by a member, they can earn between $25 and $50 gift card of their choice. The member will receive a gift card selection mailer where they can choose the gift card of their choice from the restaurant/retailers being offered: Amazon, Lowes, Target, Applebees, Eatn Park, Weis, Macys, Dicks Sporting Goods, GNC, Sheetz, Darden, Walmart, Kohl's, AMC Theaters, Bed Bath And Beyond	Value of the reward is calculated by comparing to the plan value of the rewardable activity or the perceived value of the activity as an indirect impact to multiple other quality related activities.	We track enrollee participation via the Welltok reporting that is sent on a monthly basis. We receive member level data for members that are eligible for a reward and have redeemed a gift card.	85348	37263
H3959	AETNA HEALTH INC. (PA)	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening. Diabetic Eye Exams, Diabetic Kidney Screenings,  blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can "activate" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more complaint in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	9154	16671
H3959	AETNA HEALTH INC. (PA)	2019	2	Healthy Connections	The Healthy Connections program is a telephonic member journey to support Members in maintaining and improving their Health Outcomes.	Members receive an incentive to activate the journey and complete module 1. They receive another reward after they complete Module 8. The incentives for this program are gift cards to WalMart.	The total reward potential is $25 ($10 for completing Module 1 and $15 for completing Module 8). Analytical analysis suggests this value will help to progress our Health Outcome Survey results and improve members mental and physical activity levels.	We receive an activity file at the completion of Module 8 which provides the Members that completed Module 1 and Module 8.	8752	9370
H3962	KEYSTONE HEALTH PLAN CENTRAL, INC.	2019	1	Yes	Preventative Screening such as annual well visit, breast cancer screening, colorectal cancer screening, bone density test, flu shot, Diabetic HbA1c tests, Diabetic retinal exam, arthritis management, monitoring physical health, and fall prevention	each reward is received as merchant gift card(s)	values range from $5 to $50	Enrollees provide date of service and provider to receive specific health activity reward	17783	6109
H3979	GHS HEALTH MAINTENANCE ORGANIZATION, INC.	2019	1	Rewards and Incentives Program	Annual Wellness Visit, Fall Risk Assessment, Flu Vaccine, Blood Glucose A1c Screening, ColorectalScreening, In Home Assessment, Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening	Registered members earn Gift Cards total annual maximum rewards is $100. For members in this contract we used $25 gift card awards for all Healthy Actions, inclusive of Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening. Members that complete the Annual Wellness Visit recieve two rewards of $25, amounting amounting to a total $50 reward	Evaluated the cost  value of each service,  ensured that the  value of the award is less than that of the  service provided  while significant enough to drive the member to complete it	We track participation in the Healthy Rewards Program, via Weekly Registration reports, Healthy Action Activity Reorts and Reward Redemption Reports	1393	4333
H4003	MMM HEALTHCARE, LLC	2019	1	Recompensando tu Salud	Special Care Clinics, Eye Exam Clinics, Multi Health Clinics, Vaccination Clinics, Health Education and Quality workshops as well as interventions, and the compliance with the preventive care tests or assessments: Screening Mammography, Colorectal Cancer Screening, Retinopathy test, Annual Health Assessment, Densitometry test, A1c Test, Kidney Disease monitoring	hand fan, hand sanitizer, lunch box, tote bags, insect repellant, umbrella, eyeglass microfiber cloth, sun visor, ID card holder, magnifying glass, flashlight, water bottle, gel pads, first aid small tote, exercise band, manicure kit, sunglasses, FM radio, pens, note pads, Iphone charging cable, Android charging cable, headphones, hand towels, coffe mug, manual massager, gift cards	We use the value of a similar/equal product on the retail market to determine the value of the specific reward item and then make sure that the value we give out for the completion of the activity to be rewarded does not exceed the value of the activity itself	Using our Customer Service Application, C3PO, as well as Excel Workbooks and/or attendance sheets provided by departments who are in charge of the clinic.	39124	48485
H4004	MMM HEALTHCARE, LLC	2019	1	Recompensando tu Salud	Special Care Clinics, Eye Exam Clinics, Multi Health Clinics, Vaccination Clinics, Health Education and Quality workshops as well as interventions, and the compliance with the preventive care tests or assessments: Screening Mammography, Colorectal Cancer Screening, Retinopathy test, Annual Health Assessment, Densitometry test, A1c Test, Kidney Disease monitoring	hand fan, hand sanitizer, lunch box, tote bags, insect repellant, umbrella, eyeglass microfiber cloth, sun visor, ID card holder, magnifying glass, flashlight, water bottle, gel pads, first aid small tote, exercise band, manicure kit, sunglasses, FM radio, pens, note pads, Iphone charging cable, Android charging cable, headphones, hand towels, coffe mug, manual massager, gift cards	We use the value of a similar/equal product on the retail market to determine the value of the specific reward item and then make sure that the value we give out for the completion of the activity to be rewarded does not exceed the value of the activity itself	Using our Customer Service Application, C3PO, as well as Excel Workbooks and/or attendance sheets provided by departments who are in charge of the clinic.	6944	8590
H4005	TRIPLE S ADVANTAGE, INC.	2019	1	Reward and Incentive Program	Preventive Care Tests:  Breast Cancer Screening in Women, Colorectal Cancer Screening, Diabetic Patients Retinal Eye Exam, Diabetic Patients Kidney Disease Monitoring.	Gift Card	It's a $10.00 fixed amount for each preventive care test completed during the year.	An initial communication was sent during the first quarter of 2019 to the complete membership under this contract.  The Self-Mailer explains the enrollee the initiative and why was important for them to comply with preventive care measures and the incentives they were going to receive when tests were completed. During the year, communications and orientations were provided to the enrollees regarding different health topics including those related to the required preventive tests.  Also, a follow up mailing was done for those non-compliant members.  Weekly reports were generated and included in Mi Triple S Collaborative Platform identifying the non-compliant members and were shared with all PCPs for their support to follow up and to ensure their patients complied with the preventive tests needed. Once all targeted tests were performed and properly verified by the Stars Unit Department a $10 gift card was sent via mail. Verification of test completion was performed in a quarterly basis.  All elegible preventive tests were to be completed on or before September, 30 2019. An excel spreadsheet maintains all information regarding the members compliance status and incentive payment.	5737	9903
H4007	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	44809	4105
H4007	HUMANA HEALTH PLANS OF PUERTO RICO, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	518	39
H4036	ANTHEM INSURANCE COMPANIES, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	35	33
H4036	ANTHEM INSURANCE COMPANIES, INC.	2019	2	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	1508	1373
H4091	SIMPRA ADVANTAGE, INC.	2019	1	 	 	 	 	 	0	0
H4093	PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC	2019	1	 	 	 	 	 	0	0
H4094	OPTIMUM CHOICE, INC.	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	375	310
H4140	DOCTORS HEALTHCARE PLANS, INC.	2019	1	 	 	 	 	 	0	0
H4141	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	72188	310750
H4141	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	1426	355
H4152	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	2019	1	 	 	 	 	 	0	0
H4172	NHC ADVANTAGE, LLC	2019	1	 	 	 	 	 	0	0
H4198	COMMUNITYCARE GOVERNMENT PROGRAMS, INC.	2019	1	 	 	 	 	 	0	0
H4213	USABLE MUTUAL INSURANCE COMPANY	2019	1	Welvie - My Surgery	Direct Decision Support for preference sensitive surgeries.	$25.00 Amazon Gift Card	Gift Card given for completion of program.	Enrollees must register in the program and program progress is tracked electronically.	283	222
H4227	VISTA HEALTH PLAN, INC.	2019	1	Member Appreciation - Christian St Y	Preventive health screening including BP and BMI for all participants and additional screenings such as HbA1c testing and urine collection for nephropathy testing for diabetic members	Gift Card	Gift Card Face Value - $15.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	298	30
H4227	VISTA HEALTH PLAN, INC.	2019	2	Diabetic Screening - Dornsife Center	Preventive Health Screening includeing BP, BMI, HbA1c testing and urine collection for nephropathy testing	Gift Card	Gift Card Face Value - $25.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	110	4
H4227	VISTA HEALTH PLAN, INC.	2019	3	Member Appreciation - Delco	Preventive health screening including BP and BMI for all participants and additional screenings such as HbA1c testing and urine collection for nephropathy testing for diabetic members	Gift Card	Gift Card Face Value - $25.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	345	26
H4227	VISTA HEALTH PLAN, INC.	2019	4	Member Appreciation - Dixon House	Preventive health screening including BP and BMI for all participants and additional screenings such as HbA1c testing and urine collection for nephropathy testing for diabetic members	Gift Card	Gift Card Face Value - $25.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	838	69
H4227	VISTA HEALTH PLAN, INC.	2019	5	Around the Clock / HEDIS Event	Preventive Health Screening includeing BP, BMI, Diabetetes retinal imaging, HbA1c testing and urine collection for nephropathy testing	Gift Card	Gift Card Face Value - $25.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	201	33
H4227	VISTA HEALTH PLAN, INC.	2019	6	Member Appreciation - John F Street	Preventive health screening including BP and BMI for all participants and additional screenings such as HbA1c testing, Diabetetes retinal imaging and urine collection for nephropathy testing for diabetic members	Gift Card	Gift Card Face Value - $25.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	395	36
H4227	VISTA HEALTH PLAN, INC.	2019	7	Diabetes HEDIS Screening - YMCA West	Preventive Health Screening includeing BP, BMI, Diabetetes retinal imaging, HbA1c testing and urine collection for nephropathy testing	Gift Card	Gift Card Face Value - $25.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	145	13
H4227	VISTA HEALTH PLAN, INC.	2019	8	Member Appreciation  - Chester City Hall 2019	Preventive health screening including BP and BMI for all participants and additional screenings such as HbA1c testing, Diabetetes retinal imaging and urine collection for nephropathy testing for diabetic members	Gift Card	Gift Card Face Value - $25.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	478	69
H4227	VISTA HEALTH PLAN, INC.	2019	9	Member Appreciation - Passi	Preventive health screening including BP and BMI for all participants and additional screenings such as HbA1c testing, Diabetetes retinal imaging and urine collection for nephropathy testing for diabetic members	Gift Card	Gift Card Face Value - $25.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	713	48
H4227	VISTA HEALTH PLAN, INC.	2019	10	Pink on Pupose 2019	Preventive Health Screening includeing BP, BMI, Diabetetes retinal imaging, HbA1c testing and urine collection for nephropathy testing	Gift Card	Gift Card Face Value - $35.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	68	12
H4227	VISTA HEALTH PLAN, INC.	2019	11	HEDIS N Phila Diabetes Event	Preventive Health Screening includeing BP, BMI, Diabetetes retinal imaging, HbA1c testing and urine collection for nephropathy testing	Gift Card	Gift Card Face Value - $35.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	193	11
H4227	VISTA HEALTH PLAN, INC.	2019	12	HEDIS S Phila Diabetes Event	Preventive Health Screening includeing BP, BMI, Diabetetes retinal imaging, HbA1c testing and urine collection for nephropathy testing	Gift Card	Gift Card Face Value - $35.00 per member that completed onsite screening at the event	Collect the reciepts of gift carsd that were distributed at the event and enter to the Gift card information to the  database to track and monitor the distribution	198	34
H4227	VISTA HEALTH PLAN, INC.	2019	13	HEDIS Colorectal Cancer Screening In Home FIT Kit	Preventive Health Screening	Gift Cards	Gift Card Face Value - $20.00 per member that completed & returned the In home Fit Kit Test.	Verify members in need of the preventive health screening and track members.  Verify testing completion by monthly claims reporting and LabCorp weekly reporting.	1745	111
H4227	VISTA HEALTH PLAN, INC.	2019	14	HEDIS Colorectal Cancer Screening Colonoscopy	Preventive Health Screening	Gift Cards	Gift Card Face Value - $30.00 per member that completed a colonoscopy	Verify members in need of the preventive health screening and track members.  Verify testing completion by monthly claims reporting and medical record reviews.	1417	101
H4227	VISTA HEALTH PLAN, INC.	2019	15	HEDIS Breast Cancer Screening	Mammography	Gift Cards	Gift Card Face Value - $25.00 per member that completed mammography services.	Verify members in need of breast cancer screenings and track members.  Verify testing completion by monthly claims reporting. (Offered January 1 - July 31, 2019)	658	190
H4227	VISTA HEALTH PLAN, INC.	2019	16	HEDIS Breast Cancer Screening	Mammography	Gift Cards	Gift Card Face Value - $35.00 per member that completed mammography services.	Verify members in need of breast cancer screenings and track members.  Veify testing completion by monthly claims reporting. (Offered August 1 - October 31, 2019)	381	71
H4227	VISTA HEALTH PLAN, INC.	2019	17	HEDIS Breast Cancer Screening	Mammography	Gift Cards	Gift Card Face Value - $50.00 per member that completed mammography services.	Verify members in need of breast cancer screenings and track members.  Veify testing completion by monthly claims reporting. (Offered November 1 - December 31, 2019)	305	27
H4227	VISTA HEALTH PLAN, INC.	2019	18	LabCorp/Professional Technicians Diabetes Screening In Home Visits	Diabetes home visit testing for members in need of services, including HbA1c testing and urine collection for nephropathy testing	Gift Cards	Gift Card Face Value - $20.00 per member that completed in home diabetes testing.	Verify members in need of diabetic testing and track members receiving in home testing visits.  Verify testing is complete by claims data and LabCorp weekly reporting.	654	28
H4227	VISTA HEALTH PLAN, INC.	2019	19	Diabetic Retinal Exams	Diabetic Preventive Health screening	Gift Cards	Gift Card Face Value - $25.00 per member that completed a diabetic retinal exam.	Verify members in need of diabetic retinal eye exams and track members.  Veify testing completion by monthly claims reporting. (Offered Jan 1, 2019 - September 30, 2019)	877	105
H4227	VISTA HEALTH PLAN, INC.	2019	20	Diabetic Retinal Exams	Diabetic Preventive Health screening	Gift Cards	Gift Card Face Value - $35.00 per member that completed a diabetic retinal exam.	Verify members in need of diabetic retinal eye exams and track members.  Veify testing completion by monthly claims reporting. (Offered October 1, 2019 - December 31, 2019)	697	99
H4227	VISTA HEALTH PLAN, INC.	2019	21	Diabetic HbA1c Lab Testing	Diabetic Preventive Health screening	Gift Cards	Gift Card Face Value - $20.00 per diabetic member that completed HbA1c lab testing.	Verify diabetic members in need of HbA1c testing and track members.  Verify testing completion by monthly claims reporting.	248	86
H4227	VISTA HEALTH PLAN, INC.	2019	22	Diabetic Nephropathy Lab Testing	Diabetic Preventive Health screening	Gift Cards	Gift Card Face Value - $20.00 per diabetic member that completed Nephropathy lab testing.	Verify diabetic members in need of nephropathy lab testing and track members.  Verify testing completion by monthly claims reporting.	159	34
H4227	VISTA HEALTH PLAN, INC.	2019	23	Health Risk Assessment (HRA) Completion Pilot	Identify health needs and risk factors	Gift Cards	Gift Card Face Value - $20.00 per member that completed/returned an HRA Assessment.	Pilot Program- 50 Care Management Opt-out members randomly selected to receive a paper HRA form.   Forms completed/returned by members tracked weekly.	50	14
H4236	SPARTAN PLAN PA, INC.	2019	1	 	 	 	 	 	0	0
H4279	UPMC FOR YOU, INC	2019	1	Y- Medicare/SNP Preventive Incentive	Annual Wellness Visit (AWV), Mammogram, Colorectal Cancer Screening, DiabeticRetinal Eye Exam,	VISA Prepaid Card: Annual  Wellness Visit- $20   Mammogram- $50  Colorectal Cancer Screening- $60 Diabetic Retinal Eye Exam- $25	Defined amounts for each screening type per VISA Prepaid card	When a  member completes an AWV and/or one or more of the screenings (gap is closed) and we receive the claim(s) for the screening(s) the VISA Prepaid cards are issued.  Once card for each reward type	32622	24705
H4346	HMO COLORADO, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	6	5
H4346	HMO COLORADO, INC.	2019	2	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	143	139
H4346	HMO COLORADO, INC.	2019	3	Rewards for Health Program	Depression Screening, Colorectal Cancer Screening, Breast Cancer Screening (Mammogram), Annual Physical Exam, New Member Physical Exam at CareMore Care Centers, Physical Activity Monitoring, Diabetes Care  Eye Exam, Fall Risk Management, Annual Flu Vacci	5 $10 Visa gift cards or 1 $50 Visa gift card	Members can earn up to $50 worth of Visa gift cards. They can earn 1 $50 Visa gift card by mailing in $50 worth of coupons all at once or up to 5 $10 Visa gift cards when mailing in coupons one at a time.	The enrollee participation is tracked by providing the approved fulfillment house vendor a complete membership file used to mail member fulfillment kits every month. Member mails their attested coupons directly to the fulfillment vendor. Upon receipt of t	9762	2274
H4388	SECURITY HEALTH PLAN OF WISCONSIN, INC.	2019	1	 	 	 	 	 	0	0
H4407	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	11696	3080
H4461	CARITEN HEALTH PLAN INC.	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	25	5
H4461	CARITEN HEALTH PLAN INC.	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	130690	668076
H4461	CARITEN HEALTH PLAN INC.	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	2736	649
H4490	MISSOURI MEDICARE SELECT, LLC	2019	1	 	 	 	 	 	0	0
H4497	MEDICAL MUTUAL OF OHIO	2019	1	Medical Mutual Wellness Rewards Program	Annual Wellness Visit, Breast Cancer Screening, Retinal Eye Exam, Colonoscopy	$10-50 AM-EX (American Express gift card)	The completion of any of the listed services during the 2019 calendar year earns members rewards as follows (a member may earn up to $50 in a year but may not receive an additional reward for completing the same service twice): Annual Wellness Visit earns $10, Breast Cancer Screening earns $10, Retinal Eye Exam earns $10, Colonoscopy earns $20	A claims sweep is conducted each quarter to look for relevant claims indicating a member had an eligible service	9089	3878
H4506	SELECTCARE OF TEXAS, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	61997	14999
H4513	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	236975	59552
H4514	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	19720	18477
H4523	AETNA HEALTH INC. (TX)	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening. Diabetic Eye Exams, Diabetic Kidney Screenings,  blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can "activate" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more complaint in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	2708	4359
H4527	PHYSICIANS HEALTH CHOICE OF TEXAS, LLC	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	26506	28092
H4590	UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	51029	57836
H4604	UNITEDHEALTHCARE OF UTAH, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	26477	27416
H4605	REGENCE BLUECROSS BLUESHIELD OF UTAH	2019	1	Onlife Health Member Incentive Program	Annual Wellness Exam, Colorectal Cancer Screening, Breast Cancer Screening	Gift Cards	Members earn gift cards by having the services (AWV, Breast Cancewr Screening, Colorectal Cancer Screening)	Members Opt-in to the program and Onlife, tracks their rewards based on opt-in status and whether or not our claims' feed shows the services rendered to participants.	724	707
H4623	HUMANA REGIONAL HEALTH PLAN, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	15503	55975
H4623	HUMANA REGIONAL HEALTH PLAN, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	340	96
H4754	PACIFICSOURCE COMMUNITY HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H4778	SPARTAN PLAN IL, INC.	2019	1	 	 	 	 	 	0	0
H4847	WELLCARE OF SOUTH CAROLINA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	1266	251
H4853	BRIGHT HEALTH COMPANY OF ARIZONA	2019	1	MA Annual Wellness/Physical Rewards Program	Annual wellness visit or physical	Visa gift card	20 USD	Mail-in form completed by member and signed by provider	267	190
H4868	WELLCARE OF NEW YORK, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	38186	4523
H4875	PRIORITY HEALTH	2019	1	SmartRewards	Diabetic retinal eye screening, Breast cancer screening, Colorectal cancer screening, Signify In-home health assessment, Flu shot completion, Physician discussion on fall prevention, Physician discussion on physical activity	Gift Cards to retailers	Member is rewarded for each task completed.  A diabetic retinal eye screening rewards 50 dollars (usd).  A breast cancer screening rewards 25 dollars (usd).  A colorectal cancer screening rewards 25 (usd).  A Signify In-home health assessment rewards 25 (usd).  A flu shot completion rewards 10 dollars (usd).  A physician discussion on fall prevention rewards 10 dollars (usd).   A physician discussion on physical activity rewards 10 dollars (usd).	We use a third party vendor (Welltok) to handle enrollee participation. The vendor handles recording participation and fulfilling rewards.  All rewards (except the Signify In-home health assessment) are self reported with an attestation.  The Signify In-home health assessment has a file sent to Welltok to verify who is eligible for that reward.  A member must claim the reward for it to payout.	420	1486
H4882	HEALTHPARTNERS, INC.	2019	1	Silver&Fit	Fitness facility visits and/or amount of physical activity	Hat or collectable pin	Cost per unit	Participation is tracked through a system field that  indicates whether a member has chosen to participate	584	546
H4909	ANTHEM INSURANCE COMPANIES, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	16	14
H4909	ANTHEM INSURANCE COMPANIES, INC.	2019	2	GRS Annual Routine Physical	Annual Routine Physical	$25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	15665	14829
H4909	ANTHEM INSURANCE COMPANIES, INC.	2019	3	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	3466	3198
H4922	AGEWELL NEW YORK, LLC	2019	1	RewardWell	Annual Wellness Visit  performed by the Primary Care Physician. Colonoscopy, FOBT, IFOBT, FIT KIT. Hemoglobin A1c testing, Dilated Eye Exam, Kidney Disease Monitoring. Completed Advanced Directives Form, Medication Review with Pharmacist or network Physician,  Functional status assessment, Pain Assessment.	Annual Wellness Visit -A Gift Card with a total value $15. Colonoscopy - A Gift Card with a total value $50. FOBT, or IFOBT, or FIT KIT - A Gift Card with a total value $25. Completed Advanced Directives Form, Medication Review with Pharmacist or network Physician,  Functional status assessment, and Pain Assessment - A Gift Card with a total value $15. Hemoglobin A1c testing, Dilated Eye Exam, and Kidney Disease Monitoring - A Gift Card with a total value $50	Members must be eligible and complete the individual healthcare action or combined healthcare actions where applicable to receive rewards	Health actions are tracked using claims data, plan's care management system, and other data reports supplied by our PBM, EnvisionRx, and providers data. Once all criteria are met, the member can request Reward.	1552	28
H4931	BANNER - UNIVERSITY CARE ADVANTAGE	2019	1	Health Risk Assessment Incentive Program for B-UCA members enrolled in the Plan during 2019	Health Risk Assessment	Gift Card to Subway or JC Penney	Members receive a $10 gift card if they complete a Health Risk Assessment form and turn it into the Health Plan	Completed Health Risk Assessment forms are tracked in an Excel spreadsheet	12191	3249
H4931	BANNER - UNIVERSITY CARE ADVANTAGE	2019	2	Annual Well Visit Incentive Program for B-UCA members enrolled in the Plan in 2019	Annual Wellness Visit	Gift Card to Subway or JC Penney	Members receive a $10 gift card if they obtain a provider signature on an approved incentive form attesting to completion of an Annual Wellness Vist	Completed incentive forms are tracked in an Excel spreadsheet	12191	537
H4931	BANNER - UNIVERSITY CARE ADVANTAGE	2019	3	Breast Cancer Screening Incentive Program for B-UCA female members 50 - 74 yoa	Breast Cancer Screening	Gift Card to Subway or JC Penney	Members receive a $10 gift card if they obtain provider signature on an approved incentive form attesting to completion of screening for breast cancer	Completed incentive forms are tracked in an Excel spreadsheet	4070	165
H4931	BANNER - UNIVERSITY CARE ADVANTAGE	2019	4	Colorectal Cancer Screening Incentive Program for B-UCA members 50 - 75 years of age	Colorectal Cancer Screening	Gift Card to Subway or JC Penney	Members receive a $10 gift card if they obtain provider signature on an approved incentive form attesting to completion of screening for colon cancer	Completed incentive forms are tracked in an Excel spreadsheet	7562	143
H4931	BANNER - UNIVERSITY CARE ADVANTAGE	2019	5	Diabetic Eye Exam Incentive Program for B-UCA members 18 - 75 years of age with diabetes	Diabetic Eye Exam	Gift Card to Subway or JC Penney	Members receive a $10 gift card if they obtain provider signature on an approved incentive form attesting to completion of a diabetic eye exam	Completed incentive forms are tracked in an Excel spreadsheet	2437	81
H5008	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	25163	22003
H5009	REGENCE BLUESHIELD	2019	1	 	 	 	 	 	0	0
H5010	ASURIS NORTHWEST HEALTH	2019	1	 	 	 	 	 	0	0
H5042	CDPHP UNIVERSAL BENEFITS, INC.	2019	1	Home visit and bone scan	Engaging with Case Manager for home visit and bone scan	$15 gift card to Target or Price Chopper	The face value of the gift card	Engagement is tracked on an excel spreadsheet	16	2
H5050	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	2019	1	Yes, Silver&Fit Rewards Program	Members are rewarded for meeting a threshold of fitness facility visits and/or physical activity.	Members may earn nominal rewards such as a Silver&Fit hat or collectable pin each quarter.	The value of the reward is the cost per unit. Silver&Fit Rewards are of nominal value.	Members are offered the opportunity to participate in the rewards program upon enrollment. Their participation is tracked through a field in the system that indicates whether they choose to participate or not.	733	563
H5087	WELLCARE OF CALIFORNIA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	32743	10404
H5106	HIGHMARK SENIOR SOLUTIONS COMPANY	2019	1	Passport Rewards Program	Annual Wellness Visit or Annual Physical Exam, Diabetic retinal eye exam, Breast cancer screening, Colorectal cancer screening, Nephropathy test, Bone Mineral Density Test, and House call visit.	Once the necessary activity(ies) are completed by a member, they can earn between $25 and $50 gift card of their choice. The member will receive a gift card selection mailer where they can choose the gift card of their choice from the restaurant/retailers being offered: Amazon, Lowes, Target, Applebees, Eatn Park, Weis, Macys, Dicks Sporting Goods, GNC, Sheetz, Darden, Walmart, Kohl's, AMC Theaters, Bed Bath And Beyond	Value of the reward is calculated by comparing to the plan value of the rewardable activity or the perceived value of the activity as an indirect impact to multiple other quality related activities.	We track enrollee participation via the Welltok reporting that is sent on a monthly basis. We receive member level data for members that are eligible for a reward and have redeemed a gift card.	3417	930
H5117	LOUISIANA HEALTHCARE CONNECTIONS, INC.	2019	1	LOUISIANA HEALTHCARE CONNECTIONS, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	258	295
H5141	CLOVER INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H5172	COMMUNITY HEALTH GROUP	2019	1	Annual Physician Assessment	Initial/Annual Health Assessment. This visit includes a review of enrollee medical and social history, education and counseling about preventive services, including certain screenings, shots, and referrals for other care, if needed.	gift card	The value of the reward is the same for each completed Initial/Annual Health Assessment.	Enrollees who participate in the program are tracked in an Excel database.	6476	5765
H5190	SUNSHINE STATE HEALTH PLAN, INC.	2019	1	SUNSHINE STATE HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C TESTING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, BONE DENSITY SCREENING, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, ANNUAL DENTAL EXAM, PELVIC EXAM	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	2281	6204
H5199	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	839	87
H5209	CARE WISCONSIN HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H5211	SECURITY HEALTH PLAN OF WISCONSIN, INC.	2019	1	Drug Management Care Coordination Program (DMCCP)	The DMCCP consists of an interactive initial medication review and follow up after 3 months of initial visit, provision of education materials about the medications within the program, and implementation of medication adherence strategies. Currently targeted medications for Part B Step Therapy include: Preferred Medication: Bevacizumab (Avastin) for non-preferred Medications: Aflibercept (Eylea), Ranibizumab (Lucentis), and Pegaptanib (Macugen) Preferred Medication: Epoetin alfa (Retacrit) for non-preferred Medications: Epoetin alfa (Epogen) and Epoetin alfa (Procrit).	$375 Walmart gift card for completion of the DMCCP	The average cost of the preferred drug was compared to the average cost of the non preferred drug. MTM savings estimate was combined with the annual estimated drug savings for the number of members expected to use the program. A per member savings was calculated over all members eligible for the step therapy program.  At least half of the savings from the program was required to be given to the member and resulted in the reward value.	Vendor Magellan indentify members who meet criteria for participation in the DMCCP. These members are then sent to Security Health Plan on a weekly basis where we outreach the members first via invitation letter, then by follow up phone calls if needed. Progress for each member in the program is tracked internally.	16	8
H5215	NETWORK HEALTH INSURANCE CORPORATION	2019	1	 	 	 	 	 	0	0
H5216	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	29396	3113
H5216	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	1459498	4731867
H5216	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	20421	4160
H5253	UNITEDHEALTHCARE OF WISCONSIN, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	219846	239924
H5262	QUARTZ HEALTH PLAN CORPORATION	2019	1	 	 	 	 	 	0	0
H5273	CAREPARTNERS OF CONNECTICUT, INC.	2019	1	 	 	 	 	 	0	0
H5280	MOLINA HEALTHCARE OF OHIO, INC.	2019	1	MMP Breast Cancer Screening Member Incentive (MMP BCS)	Breast Cancer Screening	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	Member participation will be tracked by program eligibility status and claims data.	1261	437
H5294	SUPERIOR HEALTH PLAN, INC.	2019	1	SUPERIOR HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	3301	6069
H5302	AETNA HEALTH INC. (GA)	2019	1	 	 	 	 	 	0	0
H5322	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	22250	20162
H5325	COVENTRY HEALTH CARE OF KANSAS, INC.	2019	1	 	 	 	 	 	0	0
H5337	AETNA BETTER HEALTH, INC. (OH)	2019	1	 	 	 	 	 	0	0
H5355	IEHP HEALTH ACCESS	2019	1	Family Asthma Program	The Family Asthma Program is perfect for all newly diagnosed patients of all ages who are interested in controlling their asthma using medication, environmental changes, and communication with their healthcare provider.  They will learn to identify asthma symptoms, environmental triggers, and times to seek out medical attention.   Technical assistance is provided for the use of a peak flow meter and aero chamber use along with an Asthma Action Plan.   The importance of having both controller and rescue medication is emphasized. Format: Large Group. Duration: One (1) 2.5-hour session	Upon completion of the class, Members will receive an Asthma kit (spacer and peak flow meter), a hypoallergenic mattress cover, and pillow case.	A $40 value is based on the wholesale cost of the kit and linens: Kit= $25 Linens=$15	Participation is entered and tracked utilizing Excel and POWER BI.	3	3
H5355	IEHP HEALTH ACCESS	2019	2	Eat Healthy Be Active	The Eat Healthy Be Active Workshop series is open to any IEHP Member who is motivated to make lifestyle changes through healthy eating and exercise. Sample menus and recipes are featured along with food substitutions and calorie comparisons. Other popular topics include choosing healthier options at the grocery store, eating out, food safety, food labeling, and describes the physical activity recommendations and offers examples of aerobic and muscle and strengthening exercises for all ages, including older adults.  Six 2 hour sessions.  Sessions may be completed consecutively or out of sequence.  All Ages	Upon completion of the class, members are eligible to receive a free Slow Cooker or Crock pot	Cost of Item=$20	Participation is entered and tracked utilizing MS Access and POWER BI.	9	8
H5355	IEHP HEALTH ACCESS	2019	3	Diabetes Self Management Program	The Diabetes Self-Management Program is ideal for patients who have a diagnosis of diabetes.  It is a disease-management program to help IEHP Members manage their blood sugar and improve eating and exercise habits.  Social support is a key element of this community-based program.  Focuses on maintaining lifestyle changes and self-monitoring.  Format: Small/Large Group.  Duration: Twenty- Six (26) 1-hour sessions over one (1) year period.  Ages: 13 and over	Upon completion of the class, members are eligible to receive a tool kit which includes a foot mirror, portion plate, exercise band, lotion, and microfilament.	Cost of each Item=$50	Participation is entered and tracked utilizing MS Access and POWER BI.	13	45
H5377	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	205	1135
H5377	HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	9	3
H5386	SHARP HEALTH PLAN	2019	1	 	 	 	 	 	0	0
H5410	HEALTHSPRING OF FLORIDA	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	6819	1686
H5420	MEDICA HEALTHCARE PLANS, INC.	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	9123	8839
H5422	BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA	2019	1	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	387	371
H5425	SCAN HEALTH PLAN	2019	1	Chronic Disease Self-Management Program workshop. A 6-week self-management workshop	Presentation and practice of self-management tools to help with chronic disease management	Self-Management book and choice of a) meditation and exercise CD or b) SCAN water bottle, belt and exercise towel. Rewards a or b offered only for those who complete the workshop (attend 4 of 6 sessions).	Actual cost	We maintain a list of participants, dates and sessions attended in a database	17	13
H5427	FREEDOM HEALTH, INC.	2019	1	HEDIS Disease-Modifying Anti-Rheumatics Drug Therapy for Rheumatoid Arthritis Mbr Incentive Program	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) for Rheumatoid Arthritis Medication Management	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) Program Gift Card 1- DMARD discussion with physician	RA Gift card 1- DMARD discussion with physician calculated at $25 to be enough to elicit member initiation of physician DMARD discussion action while not exceeding DMARD costs or specialist physician appointments	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	1101	876
H5427	FREEDOM HEALTH, INC.	2019	2	HEDIS Disease-Modifying Anti-Rheumatics Drug Therapy for Rheumatoid Arthritis Mbr Incentive Program	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) for Rheumatoid Arthritis Medication Management	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) Program Gift Card 2 -DMARD prescription fill	RA Gift Card 2- DMARD prescription fill calculated at $25 to be enough to elicit member action while not exceeding average DMARD RX costs	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	1101	864
H5427	FREEDOM HEALTH, INC.	2019	3	HEDIS Osteoporosis Management for Women (OMW) Incentive Program	Bone Density Testing and/or Osteoporosis Medication management for Women post fracture	Osteoporosis Management for Women (OMW) Program Gift Card	OMW $50 reward calculated based on not exceeding average osteoporosis medications costs, cost of subsequent fracture or cost of bone density test and associated follow-up while ensuring the reward was deemed to be an amount that would elicit timely action by eligible members.	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	1135	300
H5430	ONECARE BY CARE1ST HEALTH PLAN ARIZONA INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	2975	525
H5431	HEALTHSUN HEALTH PLANS, INC.	2019	1	 	 	 	 	 	0	0
H5433	ORANGE COUNTY HEALTH AUTHORITY	2019	1	 	 	 	 	 	0	0
H5434	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	2019	1	HealthyBlue Rewards	The health care activities and reward values were as follows: Annual Wellness $50 or In Home Assessment $50, Annual Flu Shot $20, Breast Cancer Screening $25, Colon Cancer Screening (Fecal Occult Blood Test/Fecal Immunochemical Test/Flexible Sigmoidoscopy Colonoscopy) $10 to $50, Diabetes Care Eye Exam $25, Diabetes Care Kidney Exam $15, Diabetes Care A1C $20, Osteoporosis (BMD Screening) $25, Men's Wellness or Women's Wellness or Diabetes Health programs $50.	Members were rewarded with gift cards to complete the specified health care activities. The members had the option of receiving an e-gift card immediately or having a physical gift card mailed to them. These were merchant gift cards that were not convertible to cash.	The reward value is based on Chapter 4 CMS guidelines pertaining to the value of the health related service and the status of members completing their health activity in the 2019 plan year based on a combination of claims data received by Florida Blue and member self-reported activity.	Members interact through the HealthyBlue program via telephonic and digital channels. Member interactions across the channels were captured in Welltoks CMS-compliant data storage as activations and redemptions (participation)	2795	1926
H5435	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device).	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	5784	5659
H5439	HEALTH NET LIFE INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H5454	CLEAR SPRING HEALTH OF ILLINOIS, INC.	2019	1	 	 	 	 	 	0	0
H5471	SIMPLY HEALTHCARE PLANS, INC.	2019	1	 	 	 	 	 	0	0
H5475	MERIDIAN HEALTH PLAN OF MICHIGAN, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	18949	2024
H5496	IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.	2019	1	 	 	 	 	 	0	0
H5521	AETNA LIFE INSURANCE COMPANY	2019	1	Aetna Healthy Rewards	Annual wellness visit, Breast cancer screening, Colon cancer screening, Diabetes related screenings/exams, Healthy home visit, Flu shot, Identify PCP, Participate in SilverSneakers	Members are incented for obtaining preventative services. Rewards are provided in the form of gift cards from national and regional merchants.	The value is set based on the amount we believe is required to motivate the membership to be more compliant in obtaining that particular service, but is less than the value of the service provided. The values generally range from $10 - $50 per activity completed.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	51484	61907
H5522	HEALTHASSURANCE PENNSYLVANIA, INC.	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening, Diabetic Eye Exams, Diabetic Kidney Screenings, blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can "activate" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more complaint in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	9514	17103
H5522	HEALTHASSURANCE PENNSYLVANIA, INC.	2019	2	Healthy Connections	The Healthy Connections program is a telephonic member journey to support Members in maintaining and improving their Health Outcomes.	Members receive an incentive to activate the journey and complete module 1. They receive another reward after they complete Module 8. The incentives for this program are gift cards to WalMart.	The total reward potential is $25 ($10 for completing Module 1 and $15 for completing Module 8). Analytical analysis suggests this value will help to progress our Health Outcome Survey results and improve members mental and physical activity levels.	We receive an activity file at the completion of Module 8 which provides the Members that completed Module 1 and Module 8.	7933	8477
H5525	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	1828	205
H5525	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	120451	250673
H5525	HUMANA BENEFIT PLAN OF ILLINOIS, INC.	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	1999	418
H5526	HEALTHNOW NEW YORK INC.	2019	1	Annual Wellness Visit	Annual Wellness Visits, In-Home Assessments	$20 Gift Card	If the services required are billed the member receives the gift card.	Corporate reporting is in place to monitor the enrollees that complete the eligible services and those who receive gift cards.	16676	11064
H5526	HEALTHNOW NEW YORK INC.	2019	2	Member Rewards	Breast Cancer Screening, Colorectal Cancer Screening	$20 Gift Card	If the services required are billed the member receives the gift card.	Corporate reporting is in place to monitor the enrollees that complete the eligible services and those who receive gift cards.	16676	8131
H5528	GROUP HEALTH INCORPORATED	2019	1	 	 	 	 	 	0	0
H5533	UPMC HEALTH NETWORK, INC.	2019	1	Y- Medicare/SNP Preventive Incentive	Annual Wellness Visit (AWV), Mammogram, Colorectal Cancer Screening, DiabeticRetinal Eye Exam,	VISA Prepaid Card: Annual  Wellness Visit- $20   Mammogram- $50  Colorectal Cancer Screening- $60 Diabetic Retinal Eye Exam- $25	Defined amounts for each screening type per VISA Prepaid card	When a  member completes an AWV and/or one or more of the screenings (gap is closed) and we receive the claim(s) for the screening(s) the VISA Prepaid cards are issued.  Once card for each reward type	10509	7861
H5549	VNS CHOICE	2019	1	 	 	 	 	 	0	0
H5576	VANTAGE HEALTH PLAN, INC.	2019	1	Vantage Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening, Eye Exam, Kidney Disease Monitoring, Blood Sugar Monitoring, Impoving Bladder Control, Statin Therapy for patients with CVD, FLU vacc, Physical Activity, Wellness Visit	Gift Card	Average among vendors for each measure	We receive weekly files of who and how many people activated and redeemed rewards.	1155	683
H5577	MCS ADVANTAGE, INC.	2019	1	MCS Te Cuida	Breast Cancer Screening, Colorectal Cancer Screening, Annual Flu Vaccine,  & Diabetes Care Eye Exam	Gift card	The cost of the gift card is lower than preventive care cost as established in CMS Guidelines. The reward for each health related services and/or activities are.For Flu Vaccine    $10,Diabetes Care Eye Exam $20, Breast Cancer Screening $25,Colorectal Cancer Screening $25	Every member receives a brochure to notify them about the program. It contains information related to the preventive services they are eligible. Members could qualify from 1 to 4 measures according to CMS definition in Stars Ratings. Once the member returns the brochure completed, the information is uploaded into the CRM system and the member is enrolled in the program	164796	34967
H5577	MCS ADVANTAGE, INC.	2019	2	Step Therapy for Part B Drugs in MA	Drug management care coordination with step therapy Part B  agents for  rheumatoid arthritis (RA), crohn's disease (CD), and multiple sclerosis (MS)	Gift card	Steps for calculating the value of the reward: 1.Using the preferred prescribed drug versus the drug with the step therapy requirement, a cost difference calculation is made in order to determine the annualized drug cost difference. 2.Drug cost is determined multiplying the average wholesale price  by the guaranteed PBM discount (83%) and the result will be the cost per vial that is used to compute therapy cost (unless the patient in question has a coverage in which a % of the vial cost is paid by the patient: the remainder would then be the net cost used to calculate the costs). 3. Actual therapy cost (total cost of vials per therapy) is subtracted from what the non-preferred drug cost wouldve been had that one been selected.  4. At the end of the year, once the drug therapy cost has been computed, expenses are subtracted in order to determine the net savings to be distributed according to CMS indications. Expenses are: 1) Platform developed to document and track the interventions 2) Clinical intervention protocols development 3) Clinical education material development and mailing 4) Professional resources to implement and manage the care management program  Pharmacist, Nurse, Education specialist, Analyst, Executive 5. Once the annual net savings are determined, 51% of them are awarded to the enrollees	Each enrollee was tracked based on patient-centered care coordination needs and treatment frequency.  Enrollees with RA and CD were intervened a total of 6 times and enrollees with MS were intervened 4 times. The interventions were documented  and tracked on pharmacy department ACCESS platform.	41	12
H5580	MERCY CARE	2019	1	Mercy Care Advantage Rewards	breast cancer screening, colon cancer screening, bone density testing, flu shot, annual wellness visit, diabetes blood test Jan-Jun, diabetes blood test Jul-Dec, diabetes eye exam, diabetes kidney exam, rheumatoid arthritis	Gift cards	All members are eligible to receive the flu shot or annual wellness visit rewards.  Other rewards target members based on specific clinical indicators or standards of care.  The value of the award was derived by selecting a level that maximized member participation at a reasonable cost.  Reward values are breast cancer screening $25, colon cancer screening $50, bone density testing $25, flu shot $15, annual wellness visit $25, diabetes blood test Jan-Jun $15, diabetes blood test Jul-Dec $15, diabetes eye exam $25, diabetes kidney exam $15, rheumatoid arthritis $25	Participation is tracked using a weekly dashboard and data files from the vendor	810	2242
H5587	HEALTH CHOICE ARIZONA, INC.	2019	1	Health Choice Healthy Rewards	Annual Wellness Exams, Breast Cancer Screening, Colorectal Exams	Grocery store gift card	$25.00	Documentation in Care Radius member software with Excel spreadsheet tracking	8181	40
H5590	BRIDGEWAY HEALTH SOLUTIONS	2019	1	BRIDGEWAY HEALTH SOLUTIONS	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C TESTING, ANNUAL WELLNESS VISIT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	9011	7391
H5591	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	2019	1	Grocery Gift Card for completion of Home Risk Assessment or attend Mobile Health Center event	Annual Wellness Visits and preventative screenings	$15 Hannaford Gift Card	$15 Gift Card per year per person triggered by the completion of a visit	Vendors send weekly reports indicating which members have participated in the program	4171	4171
H5591	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	2019	2	Martins Point HRA Incentive Program	HRA Completion	$15 Hannaford Gift Card	A set amount for completing an HRA	Systems report completion of HRAs	298	296
H5594	OPTIMUM HEALTHCARE, INC.	2019	1	HEDIS Disease-Modifying Anti-Rheumatics Drug Therapy for Rheumatoid Arthritis Mbr Incentive Program	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) for Rheumatoid Arthritis Medication Management	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) Program Gift Card 1- DMARD discussion with physician	RA Gift card 1- DMARD discussion with physician calculated at $25 to be enough to elicit member initiation of physician DMARD discussion action while not exceeding DMARD costs or specialist physician appointments	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	785	664
H5594	OPTIMUM HEALTHCARE, INC.	2019	2	HEDIS Disease-Modifying Anti-Rheumatics Drug Therapy for Rheumatoid Arthritis Mbr Incentive Program	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) for Rheumatoid Arthritis Medication Management	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) Program Gift Card 2 -DMARD prescription fill	RA Gift Card 2- DMARD prescription fill calculated at $25 to be enough to elicit member action while not exceeding average DMARD RX costs	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	785	649
H5594	OPTIMUM HEALTHCARE, INC.	2019	3	HEDIS Osteoporosis Management for Women (OMW) Incentive Program	Bone Density Testing and/or Osteoporosis Medication management for Women post fracture	Osteoporosis Management for Women (OMW) Program Gift Card	OMW $50 reward calculated based on not exceeding average osteoporosis medications costs, cost of subsequent fracture or cost of bone density test and associated follow-up while ensuring the reward was deemed to be an amount that would elicit timely action by eligible members.	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	899	230
H5608	DENVER HEALTH MEDICAL PLAN, INC.	2019	1	 	 	 	 	 	0	0
H5613	MVP HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H5619	ARCADIAN HEALTH PLAN, INC.	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	54	10
H5619	ARCADIAN HEALTH PLAN, INC.	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	413103	1807674
H5619	ARCADIAN HEALTH PLAN, INC.	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	6098	1449
H5628	MOLINA HEALTHCARE OF UTAH, INC.	2019	1	Molina Healthcare Wellness Rewards	Breast Cancer Screening, Colon Cancer Screening,  Bone Density Test, Diabetes Eye Exam, Diabetes Kidney Exam, Diabetes A1c Blood Test, Arthritis Management,  Flu Shot, Health Risk Assessment	Breast Cancer Screening $75 gift card, Colon Cancer Screening $25-$150  gift card, Bone Density Test $50 gift card, Diabetes Eye Exam $100 gift card, Diabetes Kidney Exam $25 gift card, Diabetes A1c Blood Test $50 gift card,  Arthritis Management $50 gift card, Flu Shot $25 gift card, Health Risk Assessment $25 gift card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	Members must submit notification of service completion via mail, phone or online. Members can receive a maximum of one incentive per activity but can earn multiple incentives if they are eligible for the service and complete multiple activities.	4559	2290
H5628	MOLINA HEALTHCARE OF UTAH, INC.	2019	2	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	12051	7495
H5644	NETWORK HEALTH INSURANCE CORPORATION	2019	1	 	 	 	 	 	0	0
H5649	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	2019	1	Diabetes and Hyperlipidemia Management Classes	Diabetes and Hyperlipidemia  educational and dietary Management Classes. $15 Grocery Store Gift Cards are offered for attendance	$15 Grocery Store Gift Cards	Each supermarket gift card has a value of $15. This is the minimum value that can be purchased in bulk from the supermarket retailer and remain in compliance with the OIG guidance on gift cards.	The class coordinator provides a sign-in sheet for members attending the class.	14888	127
H5649	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	2019	2	Passport to a Healthy You	The 2019 Passport to a Healthy You is an incentive program that rewards members for completing their yearly preventive screenings. Members must complete the screenings with their providers and the providers signature is required on the passport in order to receive the gift card. Members may also visit the Central Health Wellness Center to complete their screenings and receive the gift card on the same day of their visit.	$25 Target Gift Card	Gift Card has a value of $25	Each returned and completed passport is reviewed by the Star Department. The passports, members information, and gift card numbers are logged into our internal tracking system (Plan Apps). Members can only redeem this reward once per year.	40596	8317
H5649	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	2019	3	Wellness Center	Members who receive a full preventive visit at Central Health Medicare Plans (CHMP) Wellness Center receive gift card rewards. When the member has a full visit at CHPCs Wellness Center, our clinician would obtain histories from the member, review labs and medications with the member, conduct physical exams and screenings, provide assessments, health education and recommendations to the member. CHPCs clinician would complete as many applicable HEDIS/Star measurements as possible. The report is faxed to the members PCP and the member is advised to follow up with PCP for the remaining of the care. Members who come to the Health Fair events at Wellness Centers are not qualified for this reward. Member can only get the reward once in every calendar year regardless how many visits they have at Wellness Centers in the same year.	$15 Target or Grocery Store Gift Card	Gift Card has a value of $15	When the gift card is issued to the member, Wellness Center staff records the information on paper. After returning to CHPCs main office, staff transfer the information onto an Excel tracking list and CHPCs computer database (Plan Application). CHPCs Medical Affairs Departments manager conducts validation on Excel and Plan Application tracking monthly and any errors would be corrected right away. The Excel list is submitted to Finance Department monthly as well. Because the Wellness Center team also helps to distribute gift cards for members who completed the Passport to a Healthy You incentive program, they also update the tracking of Passport gift card in the Excel and Plan Application. Before giving member the Passport gift cards, staff check the Plan Application to make sure that member did not receive the Passport gift card already. After issuing the gift card, we update the Plan Application tracking as soon as possible (usually within one business day) to help avoid giving the gift card again to the member in case the member mails in their passport after receiving the gift card at the Wellness Center.	40596	811
H5649	CENTRAL HEALTH PLAN OF CALIFORNIA, INC.	2019	4	Diabetes Prevention Program	$15 Grocery/Target Gift Cards are offered for completing 8 regular or make-up sessions. Pedometers are awarded for completing 10 regular or make-up sessions of the program. Measuring spoons are awarded for completing 5 sessions. $15 Grocery/Target Gift Cards are offered for completing 6 months of the program, or 20 regular or make-up sessions. (Members were entered into a draw for an additional $15 gift card with equal chances of winning.) Members are awarded (1) ticket for their completion of sessions, whether its a regular or make-up session. If member is unable to attend, then the session may be completed telephonically and will receive the (1) ticket for completing the session. Members are also awarded (1) ticket for completion of their food and fitness logs. Member may use different methods of recording food and fitness, such as photographs, mobile applications, or booklets they are given in class. All members of the program are entered into a drawing at the 6 month mark and at the 12 month mark (completion of the program) for a health-related incentive or gift card. All members have equal opportunity to earn equal amounts of tickets to be entered into both drawings.	$15 Grocery Store/Target Gift Cards, pedometers, fitness trackers, or other health-related items	The value of the other rewards is calculated based off of the market value of the item	The program coordinator provides a sign-in sheet for members attending the class. All data for completion of sessions (regular or make-up) is kept in a database.  CDC requires data submission every six months	11	66
H5652	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	2019	1	 	 	 	 	 	0	0
H5656	SELECTCARE HEALTH PLANS, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	2002	204
H5703	SOUTH COUNTRY HEALTH ALLIANCE	2019	1	Wellness Programs and Preventive Care Reward Program	Pregnancy Care exam, Young Adult Well Care exam including Chlamydia screening, Dental visit, exercising at a fitness center or health club, participation in up to five Community Education classes per calendar year, ECFE (Early Childhood Family Education) classes.	$50 gift card reward for completing five Prenatal Care visits and one Postpartum Care visit within 21 and 56 days after delivery with a healthcare provider, $10 gift card reward for enrollees ages 18 to 21 who complete an annual Young Adult Well Care Exam and a $10 gift card bonus for completing the Chlamydia screening during the exam, $25 Dental gift card for completing an annual dental visit, up to $20 off  a monthly health club membership fee, provide up to $15 of the registration fee for Community Education classes for up to five classes per calendar year, unlimited ECFE classes.	The value of gift card rewards, scholarships for health club membership fees and scholarships for Community Education classes and ECFE (Early Childhood Family Education) classes fees is based on an annual review of current best practices for designing and maintaining successful incentive programs, an annual analysis of reward and incentive participation across all South Country products, set standards (policies and procedures) of eligibility for each gift card reward and scholarship program based on budgetary allotment.	Participation is tracked via manual data entry in South Countrys enrollee database system (Client Contact Manager) by enrollee name, date of service or class, name of incentive or scholarship, incentive or scholarship amount, healthcare provider if applicable, program participation voucher source if applicable, and whether or not enrollee meets the eligibility requirements for the gift card reward or scholarship program.	133	133
H5746	AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.	2019	1	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	63	58
H5774	TRIPLE S ADVANTAGE, INC.	2019	1	Reward and Incentive Program	Preventive Care Tests:  Breast Cancer Screening in Women, Colorectal Cancer Screening, Diabetic Patients Retinal Eye Exam, Diabetic Patients Kidney Disease Monitoring.	Gift Card	It's a $10.00 fixed amount for each preventive care test completed during the year.	An initial communication was sent during the first quarter of 2019 to the complete membership under this contract.  The Self-Mailer explains the enrollee the initiative and why was important for them to comply with preventive care measures and the incentives they were going to receive when tests were completed. During the year, communications and orientations were provided to the enrollees regarding different health topics including those related to the required preventive tests.  Also, a follow up mailing was done for those non-compliant members.  Weekly reports were generated and included in Mi Triple S Collaborative Platform identifying the non-compliant members and were shared with all PCPs for their support to follow up and to ensure their patients complied with the preventive tests needed. Once all targeted tests were performed and properly verified by the Stars Unit Department a $10 gift card was sent via mail. Verification of test completion was performed in a quarterly basis.  All elegible preventive tests were to be completed on or before September, 30 2019. An excel spreadsheet maintains all information regarding the members compliance status and incentive payment.	44769	99968
H5779	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	2824	240
H5793	AETNA HEALTH INC. (CT)	2019	1	 	 	 	 	 	0	0
H5810	MOLINA HEALTHCARE OF CALIFORNIA	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	2028	1101
H5823	MOLINA HEALTHCARE OF WASHINGTON, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	9525	4105
H5826	COMMUNITY HEALTH PLAN OF WASHINGTON	2019	1	FITCHEK in-home colon cancer screening program	At home colorectal cancer screening	Members who participate are sent a gift card for participating.	$15 is the standard reward amount used.	Enrollees eligible for an in-home test based on colorectal cancer screening guidelines are automatically enrolled in the program and are tracked for earning rewards through a returned screening kit.	10483	500
H5852	AIDS HEALTHCARE FOUNDATION	2019	1	YES	Colonoscopy  Member Incentive Program. By completing a colonoscopy by a Gastroenterologist (GI) specialist. Qualified members must be ages 50 years and older and have not completed a screening within the last 10 years, or as advised by their doctor. Each qualified member is outreached to my mail and phone, informing them of the program.	Members may earn a $50 grocery store Gift card upon verification of completion.   .	The value amount of the incentive is weighed on the value of the service and the commitment and time required of the member to carry out the desired action. The colonoscopy is procedure performed by a doctor experienced in the procedure and lasts approximately 30-60 minutes. There are medications will be given to the patients before and during the procedure. Since the service is semi-extensive and promotes good health, therefore a $50 grocery gift card that cannot be spent on alcohol or cigarettes seems rational as a reward.	Members will be tracked by the Quality team based on the returned letters that must be signed by their provider and are received via mail. The Quality team will also retrieve member claims records to verify the members screening completion.	277	17
H5852	AIDS HEALTHCARE FOUNDATION	2019	2	YES	Diabetic Retinal Eye Exam Member Incentive Program. The diabetic retinal eye exam is to be completed by an optometrist or an ophthalmologist. To be qualified, members must be diabetic and have not completed a screening in the current year. Each qualified member is outreached to by mailed letters and phone calls, informing them of the program.	Members may earn a $20 grocery store Gift card upon verification of completion	The value amount of the incentive is weighed on the value of the service and the commitment and time required of the member to carry out the desired action. The eye exam is and outpatient service and is not extensive and also promotes good health, therefore a $20 grocery gift card that cannot be spent on alcohol or cigarettes seems rational as a reward.	Members will be tracked by the Quality team based on the returned letters that are signed by their provider and are received via mail. The Quality team will also retrieve member claims records to verify the members screening completion.	97	38
H5854	ANTHEM HEALTH PLANS, INC.	2019	1	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	2800	2577
H5859	HEALTH PLAN OF CAREOREGON, INC.	2019	1	A gift card for Preventive care	Preventive Screenings, Flu Shot, Annual Wellness Visits, Health Risk Assessment	Gift Cards	One Twenty-Five dollar gift cards per member based on completion of a preventive service and up to two fifteen dollar gift cards for a flu shot and health risk assessment	Self-reported by member via phone or mail acknowledged by a medical professional or validated by a claim when not acknowledged or reported by phone.	5158	7951
H5883	BLUE CARE NETWORK OF MICHIGAN	2019	1	NovuHealth - Member Appreciation - Quality	Annual Physical, Breast Cancer Screening, Annual Flu Vaccine, Monitoring Physical Activity, Osteoporosis Management, Diabetes Care-Eye Exam, Diabetes Care-Kidney Screening, Diabetes Care-Blood Sugar Controlled, Rheumatoid Arthritis Management.	Annual Physical $15, Breast Cancer Screening $25, Annual Flu Vaccine $15, Monitoring Physical Activity $10, Osteoporosis Management $25, Diabetes Care-Eye Exam $25, Diabetes Care-Kidney Screening $15, Diabetes Care-Blood Sugar Controlled $25 x2, Rheumatoid Arthritis Management $25.	Reward value is based on market research and ask of the member. Value of reward is less than the market value of the service per CMS guidelines.	Member self-attestation.  Tracked in partnership with NovuHealth.	1526	10803
H5883	BLUE CARE NETWORK OF MICHIGAN	2019	2	NovuHealth - Member Appreciation - Satisfaction	Annual Wellness Visit, Flu Shot, Monitor Your Health.	Annual Wellness Visit $15, Flu Shot $15, Monitor Your Health $10.	Reward value is based on market research and ask of the member. Value of reward is less than the market value of the service per CMS guidelines.	Member self-attestation.  Tracked in partnership with NovuHealth.	1792	10528
H5883	BLUE CARE NETWORK OF MICHIGAN	2019	3	Welvie - My Surgery	Direct Decision Support for preference sensitive surgeries.	$25.00 Amazon Gift Card for completion of program.	Limited to $25.	Enrollees must register in the program and program progress is tracked electronically.	5716	4459
H5926	MOLINA HEALTHCARE OF MICHIGAN, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	12191	6499
H5928	BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN	2019	1	Blue Shield of CA Promise Appreciation Program	Annual Wellness Visit, Medication Review, Daily Activities Assessment, Pain Screening, Flu Shot, Diabetes Blood Test (A1c), Eye Exam, Breast Cancer Screening, Bone Density Test, Colon Cancer Screening, Monitor Your Physical Health, Fall Prevention, Statin Treatment	Gift Card(s)	Vendor recommendation per industry standard	Vendor provides weekly program KPI reports	1862	4662
H5932	GATEWAY HEALTH PLAN, INC.	2019	1	Goodness Rewards - Annual Wellness Visit	An annual wellnest visit with the member's provider.	$50 on  gift card	The value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via bi-weekly tracking of completed/paid activities.	21010	13896
H5932	GATEWAY HEALTH PLAN, INC.	2019	2	Goodness Rewards - Diabetic A1c Test	A1c blood test between May and December 2019	$50 on  gift card	The value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via bi-weekly tracking of completed/paid activities.	772	724
H5932	GATEWAY HEALTH PLAN, INC.	2019	3	Goodness Rewards - Breast Cancer Screening	A mammogram between July  and December of 2019	$50 on  gift card	The value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via bi-weekly tracking of completed/paid activities.	8707	4439
H5932	GATEWAY HEALTH PLAN, INC.	2019	4	Goodness Rewards - Diabetic Retinal Eye Exam	Rentinal eye exam between May and December of 2019	$50 on  gift card	The value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via bi-weekly tracking of completed/paid activities.	3591	1255
H5932	GATEWAY HEALTH PLAN, INC.	2019	5	Goodness Rewards - Blood Pressure Screening	Blood Pressure screening between May and December of 2019	$50 on  gift card	The value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via bi-weekly tracking of completed/paid activities.	483	483
H5932	GATEWAY HEALTH PLAN, INC.	2019	6	Goodness Rewards - Colorectal Cancer Screening	Colonoscopy or Flexible sigmoidoscopy beween September and December of 2019	$50 on  gift card	A colonoscopy is seen as best practice and only needs to be completed once every 10 years while a flexible sigmoidoscopy needs to be completed every 5 years. The determination was made to incent a colonoscopy at a higher rate to better influence the decision to complete a colonoscopy. The overall value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via bi-weekly tracking of completed/paid activities.	4932	724
H5932	GATEWAY HEALTH PLAN, INC.	2019	7	Goodness Rewards - Flu Vaccine	Flu vaccine between July  and December of 2019	$10 on  gift card	The value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via bi-weekly tracking of completed/paid activities.	20806	2304
H5932	GATEWAY HEALTH PLAN, INC.	2019	8	Goodness Rewards - Diabetic Microalbumin Screening	Microalbumin urine screening between May  and December of 2019	$50 on  gift card	The value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via bi-weekly tracking of completed/paid activities.	831	645
H5932	GATEWAY HEALTH PLAN, INC.	2019	9	Goodness Rewards - HRA	Complete an HRA in 2019	$25 on  gift card	The value of this reward was determined based on industry best practice research on the best way to influence positive behavior. Gateway  follows the business rule of not setting a reward at a value higher than the cost of the service to the Health Plan.	Participation is tracked on a monthly basis my monitoring member attestations to activities and the verification of claims receipt. Participation is also monitored via Monthly tracking of completed/paid activities.	20953	16501
H5937	UCARE MINNESOTA	2019	1	Community Education	wellness session, health related activity, wellbeing activity	session discount	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	2725	523
H5937	UCARE MINNESOTA	2019	2	Wellness Incentive	annual wellness visit or preventive checkup	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	175	234
H5937	UCARE MINNESOTA	2019	3	Asthma Incentive	Respiratory Therapist home visit and care management phone support for asthma	gift card	Value of the activity or service and budget available for the estimated number of participants	member care management system	17	75
H5937	UCARE MINNESOTA	2019	4	Migraine management incentive	health coaching	gift card	Value of the activity or service and budget available for the estimated number of participants	member care management system	44	23
H5937	UCARE MINNESOTA	2019	5	Health Risk Assessment incentive	a face to face health risk assessment	gift card	Value of the activity or service and budget available for the estimated number of participants	member care management system	2725	624
H5937	UCARE MINNESOTA	2019	6	Colonoscopy Incentive	fecal occult blood test, flexible sigmoidoscopy, colonoscopy	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	488	40
H5937	UCARE MINNESOTA	2019	7	Dental Incentive	Dental visit	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	1475	179
H5937	UCARE MINNESOTA	2019	8	Diabetes Incentive	Hemoglobin A1c HbA1c testing	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	219	101
H5937	UCARE MINNESOTA	2019	9	Diabetes Incentive	eye exam retinal	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	322	84
H5937	UCARE MINNESOTA	2019	10	Diabetes Incentive	nephropathy	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	198	62
H5937	UCARE MINNESOTA	2019	11	Mammogram Incentive	mammogram	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	261	140
H5937	UCARE MINNESOTA	2019	12	Child Health Incentive	Adolescent Well-Care Visit	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	0	0
H5937	UCARE MINNESOTA	2019	13	MOMS Incentive	Prenatal and Postpartum Care visits	gift card	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	10	3
H5938	CAPITAL HEALTH PLAN	2019	1	 	 	 	 	 	0	0
H5943	SCAN HEALTH PLAN	2019	1	 	 	 	 	 	0	0
H5945	PROMINENCE HEALTHFIRST	2019	1	Annual Health Assessment Program	Annual Health Assessment	Gift Cards	The value of the gift card was established to elicit enrollee behavior but not to exceed the value of the health related service or activity	Provider completes a patient care form and documents visit in electronic health record system	6873	3561
H5945	PROMINENCE HEALTHFIRST	2019	2	Prominence Perks Healthy Rewards Program	Colorectal Cancer Screening, Diabetes A1C Screening, Diabetes Nephropathy Screening, Diabetes Retinal Eye Exam, Breast Cancer Screening, Flu Shot	Gift Cards	The value of the gift card was established to elicit enrollee behavior but does not to exceed the value of the health related service or activity	Member sends in voucher as proof of service	6873	2788
H5959	BLUE CROSS AND BLUE SHIELD OF MINNESOTA	2019	1	Osteoporosis Management in Women Who Had a Fracture (OMW), Breast Cancer Screening (BCS)	Bone scan, mammogram	$25 (OMW) Visa Gift Card, $50 (BCS) Visa Gift Card	The reward card value is calculated depending on the value of the service	Members who are eligible are contacted and provided with the offer. Member agrees to offer and completes service, vendor or member provides us with reporting showing who completed the scan or completed form, member is added to the gift card tracking sheet, member information is provided to finance with gift card amount who then sends the request to the bank to process the members gift card, which is then mailed	5590	416
H5969	ALOHACARE	2019	1	 	 	 	 	 	0	0
H5970	HUMANA INSURANCE COMPANY OF NEW YORK	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	153	15
H5970	HUMANA INSURANCE COMPANY OF NEW YORK	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	25077	47355
H5970	HUMANA INSURANCE COMPANY OF NEW YORK	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	346	66
H5989	CENTERLIGHT HEALTHCARE, INC.	2019	1	 	 	 	 	 	0	0
H5991	HEALTH INSURANCE PLAN OF GREATER NEW YORK	2019	1	 	 	 	 	 	0	0
H5992	SENIOR WHOLE HEALTH OF NEW YORK, INC.	2019	1	 	 	 	 	 	0	0
H5995	ATRIO HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H6080	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	2019	1	IL Passport Incentive Program	The measures Controlling High Blood Pressure,  Colorectal Cancer Screening and Care for Older Adults were selected to be part of Meridians Passport Incentive Program. The incentive program was offered to MMAI members who were due for two or more of the selected HEDIS measures. If the member completes all required screenings by December 31st, 2019, they will receive a $50 gift card	A $50 gift card for completing all required health services	These measures were selected to reward members for engaging in their healthcare. Meridian calculated the values of these rewards based on year-over-year HEDIS performance and historical performance of incentive programs. If a priority HEDIS rate is not meeting end year goals, the inventive amount may be increased the following year in order to improve results. Additionally, incentive values are calculated annually based on the need for impact and size of the population for that particular year. Success of the incentive program is evaluated two months after the applicable incentive timeframe (in order to account for claims lag). Successful impact is determined by the number of members who received notification of the incentive and then completed their needed health services within timeframe	When a member is invited to participate in an incentive program, an identifying code is logged in the members profile in Meridians Managed Care System (MCS). When members are awarded an incentive, another identifying code is stamped in the members profile in Meridians Managed Care System and entered into a tracking grid.	3317	0
H6080	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	2019	2	Flu Vaccine	Flu Vaccine was selected to be included in Meridian's 2019 Healthy Incentive Program. Members who received the Flu Vaccine between September and December of 2019, will be entered into a drawing for the chance to win a $50 gift card	A $50 gift card for acquiring the flu vaccine	The influenza virus can cause serious health complications to members with multiple chronic conditions, which is the majority of the MMP population. Therefore, Meridian has targeted this population to improve flu vaccination rates through offering an incentive to members. The value of this reward was calculated based on comparable incentive programs offered by Meridian that utilize the same reward value and resulted in positive impact on performance. Success of the incentive program is evaluated two months after the applicable incentive timeframe (in order to account for claims lag). Successful impact is determined by the number of members who received notification of the flu vaccine incentive and then received their flu vaccine within timeframe	When a member is invited to participate in an incentive program, an identifying code is logged in the members profile in Meridians Managed Care System (MCS). When members are awarded an incentive, another identifying code is stamped in the members profile in Meridians Managed Care System and entered into a tracking grid.	7928	0
H6080	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.	2019	3	Sista Strut Breast Cancer Screening Event	Members were sent a mailing to complete their Breast Cancer Screening by August 31st, 2019.  The first 30 women who completed the screening and expressed interest were awarded free registration ($15 value) to participate in the Sista Strut 5K Breast Cancer Awareness Walk.	Awarded free event registration equivalent to a $15 value	Breast Cancer Screening was selected as a priority measure due to declining rates of completion in prior years. This year instead of a gift card Meridian decided to paritcipate, and encourage member particiation, in the Sista Strut 5K Breast Cancer Awareness walk.	When a member is invited to participate in an incentive program, an identifying code is logged in the members profile in Meridians Managed Care System (MCS). When members are awarded an incentive, another identifying code is stamped in the members profile in Meridians Managed Care System and entered into a tracking grid.	84	8
H6154	MEDICA HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H6229	BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.	2019	1	Rewards for Health Program	Depression Screening, Colorectal Cancer Screening, Breast Cancer Screening (Mammogram), Annual Physical Exam, New Member Physical Exam at CareMore Care Centers, Physical Activity Monitoring, Diabetes Care  Eye Exam, Fall Risk Management, Annual Flu Vaccine, Bladder Control and Urine Leakage Problem Discussion	5 $10 Visa gift cards or 1 $50 Visa gift card	Members can earn up to $50 worth of Visa gift cards. They can earn 1 $50 Visa gift card by mailing in $50 worth of coupons all at once or up to 5 $10 Visa gift cards when mailing in coupons one at a time.	The enrollee participation is tracked by providing the approved fulfillment house vendor a complete membership file used to mail member fulfillment kits every month. Member mails their attested coupons directly to the fulfillment vendor. Upon receipt of the coupon sheet, the vendor will record the following data in their system: member's full name, member ID, member address, member health service, date coupon was received, date of service, and provider name. The fulfillment vendor references the original membership file and records participation according to the member coupon submitted. A fulfillment log is generated by the vendor every week once rewards are issued. Data reports are generated by the mailhouse vendor every quarter with statistics on how many coupons were received during that quarter, number and types of rewards fulfilled, etc.	6235	759
H6237	REGENCE BLUECROSS BLUESHIELD OF OREGON	2019	1	 	 	 	 	 	0	0
H6306	FIRSTCAROLINACARE INSURANCE COMPANY	2019	1	Health Risk Assessment, Jump Start Assessment Program, HEDIS and Clinical Gap Closures	Completion of Health Risk Assessment or Jump Start Assessment by a physician or provider Head-to-toe screenings that go beyond your regular check-ups including vision fall risk memory and preventive services, Review of all your medications including over-the-counter vitamins and supplements, Dedicated time with a clinician who understands and can help you maximize your specific health plan benefits, Opportunity to enroll in specialized programs that promote ongoing health improvement.	$25 Walmart Gift Card for completing a health assessment,$25 Walmart Gift Card to members who have completed patient portion of health risk assessment form and also had a visit by a physician or provider by August 1 2019 or by December 31 2019 for any member who enrolled after July 1 2019,  $25 Walmart Gift Card to qualified members who completed a Jump Start Assessment in 2019.	The reward is valued by the vendor, Based on the prior year's data on engagement and outcomes of the program	Reward distribution is tracked via log containing member and gift card information, Based on types of visits completed within the program year	5681	4543
H6328	CARE N' CARE INSURANCE COMPANY, INC.	2019	1	Matrix Mobile Clinic	Comprehensive physical exam, perform necessary labs and screenings, review of preventative services, assess significant and chronic diseases, medication review, recommendation for care management	$25.00 Visa gift card	Reward recommended by vendor based on their other clients' experiences	The Matrix vendor provides a weekly Excel status update of who has been scheduled and seen for an event	3577	275
H6345	PRUITTHEALTH PREMIER NORTH CAROLINA, LLC	2019	1	 	 	 	 	 	0	0
H6348	COORDINATED CARE CORPORATION	2019	1	MANAGED HEALTH SERVICES- INDIANA	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, INPATIENT MENTAL HEALTH FOLLOW UP	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	468	1243
H6351	LIBERTY ADVANTAGE, LLC	2019	1	 	 	 	 	 	0	0
H6396	CARESOURCE	2019	1	MyHealth Rewards	Comprehensive Diabetes Screenings: HbA1C, Retinal Eye Exam, Microalbumin,Annual flu shot, Annual Physical Exam, Colorectal Screening, Mammogram	Gift Cards	Members earn $10 for each activity completed	All members are automatically enrolled in the MyHealth Rewards program when hey enroll with CareSource. CareSource tracks screening completions through provider claims	3496	6610
H6439	WELLCARE HEALTH PLANS OF ARIZONA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	1215	155
H6453	HMO LOUISIANA, INC.	2019	1	 	 	 	 	 	0	0
H6502	MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY	2019	1	Yes	Mammogram, Annual Wellness Exam	Limit of two, $25 gift cards to use at retail stores	Rewards are calculated based on the submission of claims for the related services tied to the member rewards benefit. A claim submitted for the health related services included in the program, triggers gift card availability.	Tracking is based on eligibility, enrollment, related services rendered, claim submitted, and reward pay out	416	610
H6526	UNITEDHEALTHCARE OF NEW MEXICO, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	2237	1983
H6528	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	564	526
H6550	SUNFLOWER STATE HEALTH PLAN, INC.	2019	1	SUNFLOWER STATE HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	1094	1608
H6595	UNITEDHEALTHCARE OF KENTUCKY, LTD.	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	383	293
H6622	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	41	7
H6622	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	298651	1514991
H6622	HUMANA WI HEALTH ORGANIZATION INSURANCE CORP	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	4757	1098
H6672	EON HEALTH, INC. (GA)	2019	1	Better Health 4 You	Annual Flu Shot (Influenza Vaccination), Annual Wellness Visit, Colorectal Cancer Screening, (iFOBT/Colonoscopy/Flex Sigmoidoscopy), Mammogram (Breast Cancer Screening)	Gift Cards	$15 gift card for annual wellness visit, $10 gift card for Annual Flu Shot (Influenza Vaccination),  Colorectal Cancer Screening, (iFOBT, Colonoscopy or Flex Sigmoidoscopy), Mammogram (Breast Cancer Screening)	The member takes the Better Health 4 You booklet to the appointment for completion by their physician. The physician form must be completed, signed, dated and faxed to Eon Health. Once the completed form is received at Eon, the Enrollment Team processes the form by completing the Incentive Tracker. The Better Health 4 You Booklet includes a Provider Reference Code List. Participation in the program is confirmed upon processing of claim with corresponding claims codes at which time the Gift card is approved and mailed to member.	11	22
H6723	MEDICAL MUTUAL OF OHIO	2019	1	Medical Mutual Wellness Rewards Program	Annual Wellness Visit, Breast Cancer Screening, Retinal Eye Exam, Colonoscopy	$10-50 AM-EX (American Express gift card)	The completion of any of the listed services during the 2019 calendar year earns members rewards as follows (a member may earn up to $50 in a year but may not receive an additional reward for completing the same service twice): Annual Wellness Visit earns $10, Breast Cancer Screening earns $10, Retinal Eye Exam earns $10, Colonoscopy earns $20	A claims sweep is conducted each quarter to look for relevant claims indicating a member had an eligible service	25346	9910
H6743	ATRIO HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H6750	HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.	2019	1	Harvard Pilgrim Rewards	Annual Wellness Visit, Breast Cancer Screening, Colorectal Cancer Screening, Diabetes Dilated Eye Exam	Beneficiaries may choose gift cards from Amazon, Walmart, Target and Applebees	Beneficiaries are rewarded $25 in gift certificates for completion of the Annual Wellness Visit, Breast Cancer Screening and Diabetes Dilated Eye Exam. Beneficiaries are rewarded $50 in gift certificates for completion of the Colorectal Cancer Screening.	Beneficiaries are able to attest to the completion of any activity through a web application, an IVR application or by paper mail. Responses are aggregated in a database to track and monitor activity.	1994	3167
H6776	ELDERSERVE HEALTH, INC.	2019	1	 	 	 	 	 	0	0
H6786	ANTHEM HEALTH PLANS OF MAINE, INC.	2019	1	 	 	 	 	 	0	0
H6815	HEALTH NET HEALTH PLAN OF OREGON	2019	1	 	 	 	 	 	0	0
H6821	MUTUAL OF OMAHA MEDICARE ADVANTAGE COMPANY	2019	1	 	 	 	 	 	0	0
H6870	SUPERIOR HEALTH PLAN, INC.	2019	1	SUPERIOR HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING,  INPATIENT MENTAL HEALTH FOLLOW UP	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	8468	15508
H6975	WELLCARE OF ALABAMA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	37	0
H6988	CENTERS PLAN FOR HEALTHY LIVING, LLC	2019	1	 	 	 	 	 	0	0
H7006	ATRIO HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H7020	CIGNA HEALTHCARE OF SOUTH CAROLINA, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	4852	966
H7115	MEMORIAL HERMANN HEALTH PLAN	2019	1	Memorial Hermann Healthy Advantage Wellness Program	Annual wellness exam with primary care provider, comprehensive eye exam, breast screening, and colorectal screening.	A gift card is awarded to the member for completing one or more of the five wellness/preventive related services during the plan year.	The value of a reward is equal to the dollar amount assigned to the gift card applicable to the service completed.	We track member participation in the program by running monthly claims reports to determine completed services. The members are then notified when he or she has completed one or more of the five wellness/preventive related service. The written notification informs the member to select a gift card of their choice that the health plan offers. Tracking of the gift card redemptions and fulfillment of such are maintained in a secure database. We track the member's gift card selection, the date the gift card was issued, the gift card tracking number and the specific wellness/preventive service that qualified for a reward.	5345	3697
H7149	AETNA HEALTH INC. (PA)	2019	1	 	 	 	 	 	0	0
H7165	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	2019	1	 	 	 	 	 	0	0
H7172	AETNA BETTER HEALTH, INC. (OH)	2019	1	Hypertension, Breast Cancer, Diabetic Engagement Program	Members were encouraged to have PCP visits to address their hypertension, screenings for breast cancer, eye exams and Hb1A	$25 gift card per measure for which the member is eligible	$25 gift card per measure  no calculation	Weekly reports are provided to the plan by the fulfillment vendor and imported into an internal database that is accessible to both Member Services and the Care Management Team. Database allows both departments to look up member reward status/reward codes.	7668	4890
H7173	PEACH STATE HEALTH PLAN, INC.	2019	1	PEACH STATE HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C TESTING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, INPATIENT MENTAL HEALTH FOLLOW UP, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	1939	5180
H7220	INDIANA UNIVERSITY HEALTH PLANS NFP, INC.	2019	1	 	 	 	 	 	0	0
H7245	PREMERA BLUE CROSS	2019	1	Healthy Rewards	Annual Physical, Breast Cancer Screening, Annual Flu Vaccine, Diabetes Care-Eye Exam	Annual Physical $25, Breast Cancer Screening $25, Annual Flu Vaccine $10, Diabetes Care-Eye Exam $50	Reward value is based on market research and ask of the member. Value of reward is less than the market value of the service, per CMS guidelines.	Member self-attestation.  Tracked in partnership with NovuHealth, vendor with experience running the program.	730	1248
H7284	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	930	2415
H7284	HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	29	6
H7301	COVENTRY HEALTH CARE OF ILLINOIS, INC.	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening, Diabetic Eye Exams, Diabetic Kidney Screenings, blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can "activate" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more compliant in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	3174	4944
H7317	HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)	2019	1	 	 	 	 	 	0	0
H7326	WELLCARE OF SOUTH CAROLINA, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	3103	954
H7404	PACIFICARE LIFE ASSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	1345	1216
H7419	TUFTS HEALTH PUBLIC PLANS, INC.	2019	1	 	 	 	 	 	0	0
H7464	UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	2487	2249
H7511	GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.	2019	1	 	 	 	 	 	0	0
H7522	MMM HEALTHCARE, LLC	2019	1	Recompensando tu Salud	Special Care Clinics, Eye Exam Clinics, Multi Health Clinics, Vaccination Clinics, Health Education and Quality workshops as well as interventions, and the compliance with the preventive care tests or assessments: Screening Mammography, Colorectal Cancer Screening, Retinopathy test, Annual Health Assessment, Densitometry test, A1c Test, Kidney Disease monitoring	hand fan, hand sanitizer, lunch box, tote bags, insect repellant, umbrella, eyeglass microfiber cloth, sun visor, ID card holder, magnifying glass, flashlight, water bottle, gel pads, first aid small tote, exercise band, manicure kit, sunglasses, FM radio, pens, note pads, Iphone charging cable, Android charging cable, headphones, hand towels, coffe mug, manual massager, gift cards	We use the value of a similar/equal product on the retail market to determine the value of the specific reward item and then make sure that the value we give out for the completion of the activity to be rewarded does not exceed the value of the activity itself	Using our Customer Service Application, C3PO, as well as Excel Workbooks and/or attendance sheets provided by departments who are in charge of the clinic	971	1216
H7621	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	6592	23655
H7621	HUMANA HEALTH PLAN OF CALIFORNIA, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	19	7
H7678	MOLINA HEALTHCARE OF TEXAS, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	1303	922
H7680	PROMINENCE HEALTHFIRST OF TEXAS	2019	1	Annual Health Assessment Program	Annual Health Assessment	Gift Cards	The value of the gift card was established to elicit enrollee behavior but not to exceed the value of the health related service or activity	Provider completes a patient care form and documents visit in electronic health record system	1177	962
H7680	PROMINENCE HEALTHFIRST OF TEXAS	2019	2	Prominence Perks Healthy Rewards Program	Colorectal Cancer Screening, Diabetes A1C Screening, Diabetes Nephropathy Screening, Diabetes Retinal Eye Exam, Breast Cancer Screening, Flu Shot	Gift Cards	The value of the gift card was established to elicit enrollee behavior but not to exceed the value of the health related service or activity	Member sends in voucher as proof of service	1177	409
H7728	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	18	17
H7728	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	2019	2	GRS Annual Routine Physical	Annual Routine Physical	$25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	2346	2274
H7728	ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.	2019	3	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	1684	1618
H7779	AMERICAN HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H7787	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	3217	443
H7802	SPARTAN PLAN VA, INC.	2019	1	 	 	 	 	 	0	0
H7833	UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.	2019	1	 	 	 	 	 	0	0
H7844	MOLINA HEALTHCARE OF MICHIGAN, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	11594	6157
H7853	BRIGHT HEALTH INSURANCE COMPANY	2019	1	MA Annual Wellness/Physical Rewards Program	Annual wellness visit or physical	Visa gift card	20 USD	Mail-in form completed by member and signed by provider	212	166
H7885	SAN MATEO HEALTH COMMISSION	2019	1	 	 	 	 	 	0	0
H7890	SANTA CLARA COUNTY HEALTH AUTHORITY	2019	1	 	 	 	 	 	0	0
H7917	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	2019	1	2019 myHealthpath	Annual Wellness Visit, Breast Cancer Screening, Colorectal Cancer Screening, Diabetes HbA1C testing, Diabetes Urine Nephropathy Screening, Diabetes Retinal Eye Screening, Bone Density Screening for Women with a fracture, health risk assessment, R&I digital opt-in	Gift cards	Market research was conducted to determine an appropriate value that would have a positive outcome on member behavior. The defined incentive values vary by individual measure and the type of screening required for fulfilling the participation requirements.The defined incentive values vary by individual measure and the type of screening required for fulfilling the participation requirements.	BCSBT provides My Healthpath Rewards Program eligibility data to a fulfillment vendor. Activity is tracked by the vendor to determine members who opt into the programand complete gatekeeper activities. Completed incentive activity data is configured through claims verification. Once verification is completed, an award file is securely transferred to the vendor for fulfillment to be completed. Summary activity reports are produced by the vendor on a bi-weekly basis and monthly incentive payout reports are maintained by the plan.	36036	55134
H7971	HORIZON INSURANCE COMPANY	2019	1	2019 Member Rewards and Incentive Program	Annual Wellness Visit, Osteoporosis/BMD Test, Breast Cancer Screening, Colorectal Cancer Screening - Colonoscopy or Sigmoidoscopy, Colorectal Cancer Screening - CT Colonography, Stool DNA, FOBT Kit, Diabetes - Eye Exam	CVS Gift Card for completing the screening	Gift Card amount is set for each measure, based on the complexity of how the care gap is closed	This is tracked by way of Gift Card redemption forms received from members paired with claims data	357	153
H8003	BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA	2019	1	 	 	 	 	 	0	0
H8010	CLOVER HMO OF NEW JERSEY, INC.	2019	1	 	 	 	 	 	0	0
H8016	ORANGE COUNTY HEALTH AUTHORITY	2019	1	 	 	 	 	 	0	0
H8026	AETNA BETTER HEALTH OF MICHIGAN INC.	2019	1	 	 	 	 	 	0	0
H8046	MOLINA HEALTHCARE OF ILLINOIS, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	8178	1665
H8064	FIRSTCAROLINACARE INSURANCE COMPANY	2019	1	Health Risk Assessment,  Jump Start Assessment Program	Complete Health Risk Assessment or Jump Start Assessment by a physician or provider.	$25 Walmart Gift Card to members who have completed patient portion of health risk assessment form and also had a visit by a physician or provider by August 1  2019 or by December 31 2019 for any member who enrolled after July 1 2019, $25 Walmart Gift Card to qualified members who completed a Jump Start Assessment in 2019	The reward is valued by the vendor.	Reward distribution is tracked via log containing member and gift card information	772	566
H8067	PROVIDER PARTNERS HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H8087	HUMANADENTAL INSURANCE COMPANY	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	18922	23215
H8087	HUMANADENTAL INSURANCE COMPANY	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	291	76
H8130	MOLINA HEALTHCARE OF FLORIDA, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	1831	1143
H8133	GHS INSURANCE COMPANY	2019	1	Rewards and Incentives Program	Annual Wellness Visit, Fall Risk Assessment, Flu Vaccine, Blood Glucose A1c Screening, ColorectalScreening, In Home Assessment, Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening	Registered members earn Gift Cards total annual maximum rewards is $100. For members in this contract we used $25 gift card awards for all Healthy Actions, inclusive of Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening. Members that complete the Annual Wellness Visit recieve two rewards of $25, amounting amounting to a total $50 reward	Evaluated the cost  value of each service,  ensured that the  value of the award is less than that of the  service provided  while significant enough to drive the member to complete it	We track participation in the Healthy Rewards Program, via Weekly Registration reports, Healthy Action Activity Reorts and Reward Redemption Reports	2120	5739
H8142	SCOTT AND WHITE HEALTH PLAN	2019	1	 	 	 	 	 	0	0
H8145	HUMANA INSURANCE COMPANY	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	68596	96615
H8145	HUMANA INSURANCE COMPANY	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	1721	300
H8170	AMERICA'S 1ST CHOICE OF SOUTH CAROLINA, INC.	2019	1	HEDIS Disease-Modifying Anti-Rheumatics Drug Therapy for Rheumatoid Arthritis Mbr Incentive Program	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) for Rheumatoid Arthritis Medication Management	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) Program Gift Card 1- DMARD discussion with physician	RA Gift card 1- DMARD discussion with physician calculated at $25 to be enough to elicit member initiation of physician DMARD discussion action while not exceeding DMARD costs or specialist physician appointments	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	8	8
H8170	AMERICA'S 1ST CHOICE OF SOUTH CAROLINA, INC.	2019	2	HEDIS Disease-Modifying Anti-Rheumatics Drug Therapy for Rheumatoid Arthritis Mbr Incentive Program	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) for Rheumatoid Arthritis Medication Management	Disease-Modifying Anti-Rheumatics Drug Therapy (DMARD) Program Gift Card 2 -DMARD prescription fill	RA Gift Card 2- DMARD prescription fill calculated at $25 to be enough to elicit member action while not exceeding average DMARD RX costs	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	8	8
H8170	AMERICA'S 1ST CHOICE OF SOUTH CAROLINA, INC.	2019	3	HEDIS Osteoporosis Management for Women (OMW) Incentive Program	Bone Density Testing and/or Osteoporosis Medication management for Women post fracture	Osteoporosis Management for Women (OMW) Program Gift Card	OMW $50 reward calculated based on not exceeding average osteoporosis medications costs, cost of subsequent fracture or cost of bone density test and associated follow-up while ensuring the reward was deemed to be an amount that would elicit timely action by eligible members.	Members qualifying into the HEDIS measures with rewards/incentive programs are identified through our HEDIS certified software. Member level cases are then created in our Case Management software by health plan HEDIS Improvement Coordinators. Health Plan Analysts complete ongoing reward/incentive program reporting to track members completing health services/activities that earn them program rewards.	10	2
H8189	MANAGED HEALTH SERVICES, WISCONSIN	2019	1	MANAGED HEALTH SERVICES, WISCONSIN	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	1380	3882
H8197	MOLINA HEALTHCARE OF TEXAS, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	11341	6107
H8211	MAMSI LIFE AND HEALTH INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	999	833
H8213	SELECT HEALTH OF SOUTH CAROLINA, INC.	2019	1	 	 	 	 	 	0	0
H8258	LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY	2019	1	Follow-Up After Hospitalization for Mental Illness (FUH) Member Incentive Program	Follow up after hospitalization for mental illness FUH measures the percentage of members 6 years of age or older who were hospitalized for treatment of selected mental illness diagnoses and who had a follow up visit with a mental health practitioner within 30 days	A $25 debit card, Members can receive two awards per year and four awards per lifetime	by the price of the item	Beacon our contracted Behavioral Health vendor does outreach to the qualifying members who have been discharged from the hospital. Beacon tracks the members who have gone in for their follow-up visit with their mental health provider and send us a monthly file with eligible members. Once we get this information we add it in a tracking database, confirm the member was an active member of LA Care Health Plan at the time of discharge and award the member	161	91
H8280	BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC.	2019	1	MA Annual Wellness/Physical Rewards Program	Annual wellness visit or physical	Visa gift card	20 USD	Mail-in form completed by member and signed by provider	8	6
H8298	HORIZON HEALTHCARE OF NEW JERSEY, INC.	2019	1	2019 Member Rewards and Incentive Program	Annual Wellness Visit, Osteoporosis/BMD Test, Breast Cancer Screening, Colorectal Cancer Screening - Colonoscopy or Sigmoidoscopy, Colorectal Cancer Screening - CT Colonography, Stool DNA, FOBT Kit, Diabetes - Eye Exam	CVS Gift Card for completing the screening	Gift Card amount is set for each measure, based on the complexity of how the care gap is closed	This is tracked by way of Gift Card redemption forms received from members paired with claims data	8245	1254
H8298	HORIZON HEALTHCARE OF NEW JERSEY, INC.	2019	2	2019 HRAT Incentive Program	Completion of Initial and Annual Health Risk Assessment HRAT	CVS Gift Card for completing the HRAT	Gift Card amount is a fixed amount for all Initial and Annual HRAT completions	This is tracked by way of a report identifying all initial HRAT and Annual HRAT completed on a monthly basis	10217	5769
H8423	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	2019	1	 	 	 	 	 	0	0
H8432	EMPIRE HEALTHCHOICE HMO, INC.	2019	1	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	3847	3479
H8452	CARESOURCE	2019	1	MyHealth Rewards	Comprehensive Diabetes Screenings: HbA1C, Retinal Eye Exam, Microalbumin	Gift Cards	Members earn $10 for each activity completed	All members are automatically enrolled in the MyHealth Rewards program when they enroll with CareSource. CareSource tracks screening completions through provider claims	4974	5529
H8457	LONGEVITY HEALTH PLAN OF NEW YORK, INC.	2019	1	 	 	 	 	 	0	0
H8552	ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY	2019	1	 	 	 	 	 	0	0
H8554	GHS INSURANCE COMPANY	2019	1	Rewards and Incentives Program	Annual Wellness Visit, Fall Risk Assessment, Flu Vaccine, Blood Glucose A1c Screening, ColorectalScreening, In Home Assessment, Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening	Registered members earn Gift Cards total annual maximum rewards is $100. For members in this contract we used $25 gift card awards for all Healthy Actions, inclusive of Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening. Members that complete the Annual Wellness Visit recieve two rewards of $25, amounting amounting to a total $50 reward	Evaluated the cost  value of each service,  ensured that the  value of the award is less than that of the  service provided  while significant enough to drive the member to complete it	We track participation in the Healthy Rewards Program, via Weekly Registration reports, Healthy Action Activity Reorts and Reward Redemption Reports	352	1085
H8578	HEALTH NEW ENGLAND, INC.	2019	1	Preventive Care Incentive Program	Adult Wellness Exam, physicals	Gift Card	$20	Upon receiving their Annual Wellness Visit or annual physical the member can fill out a short form online on our secure member portal, over the phone with HNE member services, or by mail and select their $20 reward.  Once notification of a completed form is received all responses are stored in an internal access database on our secure server. The members responses, name, member ID, address on file, gift card selection and date the gift card is sent is housed in the access table and backed up on our secure drive.	9138	818
H8597	AETNA BETTER HEALTH OF TEXAS INC.	2019	1	 	 	 	 	 	0	0
H8604	THP INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H8634	HEALTH CARE SERVICE CORPORATION	2019	1	Rewards and Incentives Program	Annual Wellness Visit, Fall Risk Assessment, Flu Vaccine, Blood Glucose A1c Screening, ColorectalScreening, In Home Assessment, Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening	Registered members earn Gift Cards total annual maximum rewards is $100. For members in this contract we used $25 gift card awards for all Healthy Actions, inclusive of Mammogram, Nephropathy Screening, Retinal Eye Exam, Bone Density Screening. Members that complete the Annual Wellness Visit recieve two rewards of $25, amounting amounting to a total $50 reward	Evaluated the cost  value of each service,  ensured that the  value of the award is less than that of the  service provided  while significant enough to drive the member to complete it	We track participation in the Healthy Rewards Program, via Weekly Registration reports, Healthy Action Activity Reorts and Reward Redemption Reports	8294	24674
H8649	AETNA HEALTH OF UTAH, INC	2019	1	Healthy Rewards	Breast Cancer Screening, Colorectal Cancer Screening, Diabetic Eye Exams, Diabetic Kidney Screenings,  blood pressure monitoring, A1C two times per year if they're a diabetic, flu shot, and/or having an annual wellness exam	The Members receive an activation kit that invites them to participate in Healthy Rewards, the kit explains they can "activate" the program by going online, calling in or mailing in coupons that are included in their activation kit. When the members complete any of the activities they attest by submitting the date of service, providers name and address. The member can then select from a variety of retailer a gift card to either be mailed to their home address, or redeemed online via a code. The reward values, per activity, range from $15 to $50 depending on the activity.	Based on analysis we bucket the reward opportunities  into three groups  maintain, progress and improve. Each grouping dictates a value for the reward and the likelihood we believe we have in moving the membership to be more compliant in obtaining that particular service.	Enrollees attest either online, telephonically, or via mail that they've completed the service. They provide the date of service, provider name and address. We receive monthly activity files that shares which members have redeemed which services and the date the attestation was made.	144	229
H8677	MOLINA HEALTHCARE OF CALIFORNIA	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	9494	4527
H8748	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	8640	8371
H8764	ASPIRE HEALTH PLAN	2019	1	Aspire Rewards	Annual Wellness Visit Or Health At Home Visit, Breast Cancer Screening, Colon Cancer Screening, Diabetes A1C Control Screening, Diabetes Eye Exam, Diabetes Kidney Screening	Gift Cards	The member earns a gift card for the completion of each activity by calling Aspire Rewards or attesting online on the Aspire Rewards site.	We receive a file from reward vendor showing activity completed	475	609
H8768	UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	7406	7014
H8783	UCARE HEALTH, INC.	2019	1	Community Education	wellness session, health related activity, wellbeing activity	session discount	Value of the activity or service and budget available for the estimated number of participants	member database of rewards and incentive activity	1716	10
H8786	AMERIGROUP TEXAS, INC.	2019	1	Amerigroup Member Rewards	Annual flu vaccine	20 reward dollars redeemable for OTCs and health care products	Member rewarded for receiving an annual flu vaccine	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	1480
H8786	AMERIGROUP TEXAS, INC.	2019	2	Amerigroup Member Rewards	Annual PCP visit	20 reward dollars redeemable for OTCs and health care products	Member rewarded for completing annual PCP visit	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	10039
H8786	AMERIGROUP TEXAS, INC.	2019	3	Amerigroup Member Rewards	Breast cancer screening	20 reward dollars redeemable for OTCs and health care products	Members 40 or older rewarded for receiving a cancer screening	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	451
H8786	AMERIGROUP TEXAS, INC.	2019	4	Amerigroup Member Rewards	Colorectal cancer screening	20 reward dollars redeemable for OTCs and health care products	Members 50 or older rewarded for receiving a colorectal cancer screening	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	1105
H8786	AMERIGROUP TEXAS, INC.	2019	5	Amerigroup Member Rewards	Controlled blood pressure	20 reward dollars redeemable for OTCs and health care products	Members who provide documentation for a controlled blood pressure under 140/90 two times a year	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	0
H8786	AMERIGROUP TEXAS, INC.	2019	6	Amerigroup Member Rewards	Diabetes set	60 reward dollars redeemable for OTCs and health care products	Diabetic members are rewarded for completing a retinopathy exam kidney exam and HbA1c blood test all three activities must be completed to receive reward	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	33
H8786	AMERIGROUP TEXAS, INC.	2019	7	Amerigroup Member Rewards	Participation in Interdisciplinary Care Team (IDT) meeting	20 reward dollars redeemable for OTCs and health care products	Members rewarded for participation in the Interdisciplinary Team (IDT) meeting with service coordinator physician optional	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	8504
H8786	AMERIGROUP TEXAS, INC.	2019	8	Amerigroup Member Rewards	Post discharge assessment	25 reward dollars redeemable for OTCs and health care products	Member rewarded for calling service coordinator within three days of a hospital SNF or NF discharge and completing an assessment	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	157
H8786	AMERIGROUP TEXAS, INC.	2019	9	Amerigroup Member Rewards	Post discharge PCP visit	20 reward dollars redeemable for OTCs and health care products	Member rewarded for follow-up visit with their PCP within 14 days of a hospital SNF or NF discharge	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	1930
H8786	AMERIGROUP TEXAS, INC.	2019	10	Amerigroup Member Rewards	Care Incentive Program	125 reward dollars redeemable for OTCs and health care products	Member rewarded for high level of engagement with their assigned physician and Interdisciplinary Team	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on manual  review. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption. Redemption reports are provided by vendor.	14407	0
H8786	AMERIGROUP TEXAS, INC.	2019	11	Personalized Labels	Personalized Labels	Personalized labels	Personalized labels for members in NF or identified by service coordinators with Alzheimer's or Dementia and would benefit from labels to identify personal belongings including clothing shoes and personal items	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	0
H8786	AMERIGROUP TEXAS, INC.	2019	12	Personal Disaster Plan	Personal Disaster Plan	Personal Disaster Plan	Members who complete a Personal Disaster Plan online or through their Service Coordinator will receive a First Aid Kit.	All members are auto enrolled into Amerigroup Member Rewards upon enrollment into the health plan. Internal reporting validates activities based on claims reports. Validated rewards are credited to members reward account housed with reward fulfillment vendor and are available for redemption.	14407	0
H8854	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	2019	1	Yes	Well visit	$15 Visa gift card	DSNP members that completed the preventative service in Column B and completed the rewards and incentive form received a Visa Gift Card. All rewards are based on evidence of service completion not the result or outcome.	A Quality Improvement Specialist tracked participation in the Rewards program via UMHAs internal system. All eligible active UMHA DSNP members were invited to participate in the rewards and incentive program.	266	266
H8854	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	2019	2	Yes	Mammogram	$15 Visa gift card	DSNP members that completed the preventative service in Column B and completed the rewards and incentive form received a Visa Gift Card. All rewards are based on evidence of service completion not the result or outcome.	A Quality Improvement Specialist tracked participation in the Rewards program via UMHAs internal system. All eligible active UMHA DSNP members were invited to participate in the rewards and incentive program.	213	213
H8854	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	2019	3	Yes	Colorectal	$15 Visa gift card	DSNP members that completed the preventative service in Column B and completed the rewards and incentive form received a Visa Gift Card. All rewards are based on evidence of service completion not the result or outcome.	A Quality Improvement Specialist tracked participation in the Rewards program via UMHAs internal system. All eligible active UMHA DSNP members were invited to participate in the rewards and incentive program.	138	138
H8854	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	2019	4	Yes	Post-Hospitalization	$15 Visa gift card	DSNP members that completed the preventative service in Column B and completed the rewards and incentive form received a Visa Gift Card. All rewards are based on evidence of service completion not the result or outcome.	A Quality Improvement Specialist tracked participation in the Rewards program via UMHAs internal system. All eligible active UMHA DSNP members were invited to participate in the rewards and incentive program.	6	6
H8854	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	2019	5	Yes	Health Risk Assessment	$15 Visa gift card	DSNP members that completed the preventative service in Column B received a Visa Gift Card. All rewards are based on evidence of service completion not the result or outcome.	A Quality Improvement Specialist tracked participation in the Rewards program via UMHAs internal system. All eligible active UMHA DSNP members were invited to participate in the rewards and incentive program.	946	946
H8854	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	2019	6	Yes	Flu Shot	$15 Visa gift card	DSNP members that completed the preventative service in Column B and completed the rewards snd incentive form received a Visa Gift Card. All rewards are based on evidence of service completion not the result or outcome.	A Quality Improvement Specialist tracked participation in the Rewards program via UMHAs internal system. All eligible active UMHA DSNP members were invited to participate in the rewards and incentive program.	226	226
H8854	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	2019	7	Yes	Diabetic Retinal Eye Exam	$15 Visa gift card	DSNP members that completed the preventative service in Column B received a Visa Gift Card. All rewards are based on evidence of service completion not the result or outcome.	A Quality Improvement Specialist tracked participation in the Rewards program via UMHAs internal system. All eligible active UMHA DSNP members were invited to participate in the rewards and incentive program.	106	106
H8854	UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.	2019	8	Yes	Diabetic Screenings (A1c and Nephrology)	$15 Visa gift card	DSNP members that completed the preventative service in Column B received a Visa Gift Card. All rewards are based on evidence of service completion not the result or outcome.	A Quality Improvement Specialist tracked participation in the Rewards program via UMHAs internal system. All eligible active UMHA DSNP members were invited to participate in the rewards and incentive program.	113	113
H8889	MEDICA HEALTH PLANS	2019	1	 	 	 	 	 	0	0
H8908	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	16670	20735
H8908	HUMANA MEDICAL PLAN OF MICHIGAN, INC.	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	205	33
H8967	GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC	2019	1	 	 	 	 	 	0	0
H9001	FALLON COMMUNITY HEALTH PLAN	2019	1	Pharmacy Safe Transitions Program	Pharmacist home visit after hospital discharge for high risk members	$10 CVS gift card	$10 CVS gift card	We use an Excel spreadsheet	49	40
H9003	KAISER FOUNDATION HP OF THE N W	2019	1	Yes, Silver&Fit Rewards Program	Members are rewarded for meeting a threshold of fitness facility visits and/or physical activity.	Members may earn nominal rewards such as a Silver&Fit hat or collectable pin each quarter.	The value of the reward is the cost per unit. Silver&Fit Rewards are of nominal value.	Members are offered the opportunity to participate in the rewards program upon enrollment. Their participation is tracked through a field in the system that indicates whether they choose to participate or not.	1324	1010
H9047	PROVIDENCE HEALTH ASSURANCE	2019	1	 	 	 	 	 	0	0
H9066	VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK	2019	1	 	 	 	 	 	0	0
H9070	COMPBENEFITS INSURANCE COMPANY	2019	1	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	16547	29540
H9070	COMPBENEFITS INSURANCE COMPANY	2019	2	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	313	83
H9082	MOLINA HEALTHCARE OF NEW MEXICO, INC.	2019	1	2019 Annual Wellness Visit Member Incentive Program	Annual Wellness Visit, In home assessment	$25 Walmart Gift Card	Amount was chosen based on existing health and wellness incentives within the contract and/or market, and CMS guidance/State regulations.	CPT codes submitted through medical claims data and documentation received from providers.	3204	1440
H9096	DEAN HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H9104	SCAN HEALTH PLAN	2019	1	 	 	 	 	 	0	0
H9153	WEST VIRGINIA SENIOR ADVANTAGE, INC.	2019	1	 	 	 	 	 	0	0
H9207	HEALTH PARTNERS PLANS, INC.	2019	1	Health Partners Plans Wellness Rewards	1. PCP/Specialist Visit, Colorectal Cancer Screening, Diabetes Retinal Eye Exam, Breast Cancer Screening, Bone Mineral Density Test	Members earned money on a reloadable card for each eligible activity completed in 2019. The rewards card could be used to purchase eligible health and wellness items at participating retailers.	Reward values are calculated based on an analysis of the value set by Medicare health plans in the industry for the individual activity in order to influence member behavior but also not exceeding the cost of the service or the value of the activity	Member engagement in the program is tracked through the internal call center automated messages (IVRs) and data through the internal portal used by HPP representatives	17351	16138
H9276	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	2019	1	SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C TESTING, DIABETIC KIDNEY SCREENING, DIABETIC RETINOPATHY SCREENING, ANNUAL WELLNESS VISIT, BONE DENSITY SCREENING, COLORECTAL CANCER SCREENING, HEALTH RISK ASSESSMENT, ANNUAL DENTAL EXAM, PELVIC EXAM	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	1357	3994
H9287	HEALTH NET COMMUNITY SOLUTIONS OF ARIZONA, INC.	2019	1	HEALTH NET COMMUNITY SOLUTIONS OF ARIZONA, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, HBA1C TESTING, ANNUAL WELLNESS VISIT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	2700	3739
H9302	PREMERA BLUE CROSS	2019	1	Healthy Rewards	Annual Physical, Breast Cancer Screening, Annual Flu Vaccine, Diabetes Care-Eye Exam	Annual Physical $25, Breast Cancer Screening $25, Annual Flu Vaccine $10, Diabetes Care-Eye Exam $50	Reward value is based on market research and ask of the member. Value of reward is less than the market value of the service, per CMS guidelines.	Member self-attestation.  Tracked in partnership with NovuHealth, vendor with experience running the program.	667	1109
H9364	WELLCARE OF MAINE, INC.	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	2924	255
H9403	EON HEALTH, INC. (SC)	2019	1	Better Health 4 You	Annual Flu Shot (Influenza Vaccination), Annual Wellness Visit, Colorectal Cancer Screening, (iFOBT/Colonoscopy/Flex Sigmoidoscopy), Mammogram (Breast Cancer Screening)	Gift Cards	$15 gift card for annual wellness visit, $10 gift card for Annual Flu Shot (Influenza Vaccination),  Colorectal Cancer Screening, (iFOBT, Colonoscopy or Flex Sigmoidoscopy), Mammogram (Breast Cancer Screening)	The member takes the Better Health 4 You booklet to the appointment for completion by their physician. The physician form must be completed, signed, dated and faxed to Eon Health. Once the completed form is received at Eon, the Enrollment Team processes the form by completing the Incentive Tracker. The Better Health 4 You Booklet includes a Provider Reference Code List. Participation in the program is confirmed upon processing of claim with corresponding claims codes at which time the Gift card is approved and mailed to member.	4	8
H9408	VIBRA HEALTH PLAN, INC.	2019	1	Member Incentive Program	Wellness Exam	Walmart Gift Card	Market driven incentive	Monthly claims report with service code G0438, G0438, G0402, 99397	3423	393
H9431	FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
H9455	HEALTH CHOICE UTAH, INC.	2019	1	Health Choice Healthy Rewards	Annual Wellness Exams, Breast Cancer Screening, Colorectal Exams	Wal-Mart store gift card	$25.00	Documentation in Care Radius member software with Excel spreadsheet tracking	212	40
H9460	CIGNA HEALTHCARE OF ST LOUIS, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	1499	324
H9487	MICHIGAN COMPLETE HEALTH, INC.	2019	1	MICHIGAN COMPLETE HEALTH, INC.	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, ANNUAL WELLNESS VISIT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	2616	1963
H9516	BRIGHT HEALTH INSURANCE COMPANY OF NEW YORK	2019	1	MA Annual Wellness/Physical Rewards Program	Annual wellness visit or physical	Visa gift card	20 USD	Mail-in form completed by member and signed by provider	8	5
H9525	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	16	11
H9525	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	2019	2	Central Annual Routine Physical	Annual Routine Physical	$100.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	1895	1707
H9525	COMPCARE HEALTH SERVICES INSURANCE CORPORATION	2019	3	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	1174	1086
H9572	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	2019	1	NovuHealth - Member Appreciation - Quality	Annual Physical, Breast Cancer Screening, Annual Flu Vaccine, Monitoring Physical Activity, Osteoporosis Management, Diabetes Care-Eye Exam, Diabetes Care-Kidney Screening, Diabetes Care-Blood Sugar Controlled, Rheumatoid Arthritis Management.	Annual Physical $15, Breast Cancer Screening $25, Annual Flu Vaccine $15, Monitoring Physical Activity $10, Osteoporosis Management $25, Diabetes Care-Eye Exam $25, Diabetes Care-Kidney Screening $15, Diabetes Care-Blood Sugar Controlled $25 x2, Rheumatoid Arthritis Management $25.	Reward value is based on market research and ask of the member. Value of reward is less than the market value of the service per CMS guidelines.	Member self-attestation. Tracked in partnership with NovuHealth.	3539	25016
H9572	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	2019	2	NovuHealth - Member Appreciation - Satisfaction	Annual Wellness Visit, Flu Shot, Monitor Your Health.	Annual Wellness Visit $15, Flu Shot $15, Monitor Your Health $10.	Reward value is based on market research and ask of the member. Value of reward is less than the market value of the service per CMS guidelines.	Member self-attestation. Tracked in partnership with NovuHealth.	3036	20582
H9572	BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY	2019	3	Welvie - My Surgery	Direct Decision Support for preference sensitive surgeries.	$25.00 Amazon Gift Card for completion of program.	Limited to $25.	Enrollees must register in the program and program progress is tracked electronically.	22221	17120
H9576	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND	2019	1	 	 	 	 	 	0	0
H9585	BOSTON MEDICAL CENTER HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H9589	EON HEALTH, INC. (GA)	2019	1	Better Health 4 You	Annual Flu Shot (Influenza Vaccination), Annual Wellness Visit, Colorectal Cancer Screening, (iFOBT/Colonoscopy/Flex Sigmoidoscopy), Mammogram (Breast Cancer Screening)	Gift Cards	$15 gift card for annual wellness visit, $10 gift card for Annual Flu Shot (Influenza Vaccination),  Colorectal Cancer Screening, (iFOBT, Colonoscopy or Flex Sigmoidoscopy), Mammogram (Breast Cancer Screening)	The member takes the Better Health 4 You booklet to the appointment for completion by their physician. The physician form must be completed, signed, dated and faxed to Eon Health. Once the completed form is received at Eon, the Enrollment Team processes the form by completing the Incentive Tracker. The Better Health 4 You Booklet includes a Provider Reference Code List. Participation in the program is confirmed upon processing of claim with corresponding claims codes at which time the Gift card is approved and mailed to member.	0	0
H9590	LONGEVITY HEALTH PLAN OF ILLINOIS, INC.	2019	1	 	 	 	 	 	0	0
H9615	MVP HEALTH PLAN, INC.	2019	1	Medicare Wellness Rewards	Welcome to Medicare visit or Annual Wellness visit, Blood pressure check, Height Weight and BMI Measurement, Colorectal cancer screening, Flu shot	$75.00	The reward is calcuated by the member meeting all of the five preventitive services.  There are no incremental rewards.	The member completes the Wellness Rewards form.  His/her physician attests that he/she met the requirements.  The member then submits the form to MVP for processing.	30067	5291
H9630	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	2019	1	ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC	ANNUAL FLU VACCINATION, BREAST CANCER SCREENING, COLORECTAL CANCER SCREENING, DIABETIC HBA1C TESTING, DIABETIC RETINOPATHY SCREENING, DIABETIC KIDNEY SCREENING, ANNUAL WELLNESS VISIT, HEALTH RISK ASSESSMENT, BONE DENSITY, INPATIENT MENTAL HEALTH FOLLOW UP	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	15408	44827
H9699	HMO PARTNERS, INC.	2019	1	Welvie - My Surgery, Care Gap Closure and Wellness Incentive	Direct Decision Support for preference sensitive surgeries, Breast Cancer Screening (BCS), Colorectal Cancer Screening (COL), Diabetes Care-Eye Exams (CDC-Eye), Diabetes Care-Kidney Diease Monitoring (CDC-Kidney), Diabetes Care-Blood Sugar Control (CDC-A1C), Annual Wellness Visit (AWV), Annual Flu Vaccine (AFV)	$25.00 Amazon Gift Card for completion of Welvie program, $25.00 gift card for Breast Cancer Screening, $25 gift card for Diabetes Care Eye Exam, $25 gift card for Diabetes Care Kidney Disease Monitoring, $25 gift card for Diabetes Care Blood Sugar Control (CDC-A1C), $25 gift card for Annual Wellness Visit, $50 gift card for colorectal screening, $10 gift card for Annual Flu Vaccine	Gift Card given for completion of Welvie program, Member attests to completing wellness visit	Enrollees must register in the program and program progress is tracked electronically, Weekly reporting	5667	1348
H9712	HAP MIDWEST HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H9725	CIGNA HEALTHCARE OF NORTH CAROLINA, INC.	2019	1	$50 Prevention Bonus Program	360 Exam (wellness exam)	$50 gift card to one of 3 retailers	No calculation is required.  The value of the gift card is $50, which is less than the value of a 360 Exam (wellness exam). The reward value was set to $50 to encourage participation.	Customer completes their 360 Exam at their doctor's office and returns a doctor-signed form to Cigna Medicare during the eligible program timeframe. Customer forms have a unique barcode. All returned customer forms are scanned and processed by a vendor. The vendor provides a weekly file of all returned forms via sFTP to the internal program mamangement database. Database logic confirms customer eligibilty, approval or denial based on set program criteria, and when appropriate it triggers gift card fullfilment.	6529	1368
H9730	WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC	2019	1	Medicare Healthy Rewards Program	Breast Cancer Screening, Colorectal Cancer Screening - Fit kit, flex sigmoid, colorectal screen, Comprehensive Diabetes Care - Eye Exam, HbA1c, Nephropathy, Bone Density Screening, Arthritis Management, Annual Wellness Visit, Flu Vaccine, Taking Care of Your Overall Health	Rewards vary from $10 - $30 depending on service completed.  Members were able to choose from a variety of gift cards including: Walmart, Visa, Amazon, Target, Subway	Reward values are calculated based on data supporting certain values being associated with member participation.  We also analyze member utilization across the program to determine values to remain within program budget.	We review monthly data files receveived from the vendor to understand enrollee participation.  We review this against claims data on our side and complete our analysis.	14043	8883
H9808	CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA	2019	1	 	 	 	 	 	0	0
H9811	MAGNOLIA HEALTH PLAN, INC.	2019	1	MAGNOLIA HEALTH PLAN, INC.	ANNUAL FLU VACCINATION, HBA1C SCREENING, ANNUAL WELLNESS VISIT	VISA PREPAID DEBIT CARD	REWARD VALUES ARE CALCULATED BASED ON AVERAGE COST OF SERVICE FOR THE HEALTH PLAN	WEEKLY CLAIMS SWEEP OF INTERNAL SYSTEMS	907	919
H9834	QUARTZ HEALTH PLAN MN CORPORATION	2019	1	 	 	 	 	 	0	0
H9869	PARTNERS HEALTH PLAN, INC.	2019	1	Yes	Flu Shot, Dental Checkup, Preventive Screenings	Tote Bag, Backpack, Tshirt, $10 CVS Gift Card	All items were $10 or under. $4.49 per tote bag, Tshirts between $3.44 and $5.74 per shirt depending on size, $8.92 per backpack, $10 per gift card	Claims and enrollment data	578	138
H9870	UNIVERSITY HEALTH CARE, INC.	2019	1	 	 	 	 	 	0	0
H9877	VIRGINIA PREMIER HEALTH PLAN, INC.	2019	1	 	 	 	 	 	0	0
H9878	BRIGHT HEALTH INSURANCE COMPANY OF OHIO, INC.	2019	1	MA Annual Wellness/Physical Rewards Program	Annual wellness visit or physical	Visa gift card	20 USD	Mail-in form completed by member and signed by provider	19	13
H9952	MEDICA HEALTH PLANS	2019	1	 	 	 	 	 	0	0
R0110	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	50	3
R0110	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	40602	78135
R0110	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	691	107
R0802	MARTIN'S POINT GENERATIONS ADVANTAGE, INC.	2019	1	Grocery Gift Card for completion of Home Risk Assessment or attend Mobile Health Center event	Annual Wellness Visits and preventative screenings	$15 Hannaford Gift Card	$15 Gift Card per year per person triggered by the completion of a visit	Vendors send weekly reports indicating which members have participated in the program	70	70
R0865	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	294	33
R0865	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	41077	95435
R0865	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	785	126
R0923	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	26	3
R0923	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	9585	9880
R0923	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	175	24
R1390	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	135	17
R1390	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	62374	148945
R1390	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	1269	233
R1532	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	78	6
R1532	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	6278	5090
R1532	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	77	13
R1548	UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY	2019	1	HouseCalls Program, Step Therapy	HouseCall and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	24198	22055
R3175	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device).	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued.	2064	1850
R3332	BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.	2019	1	HealthyBlue Rewards	The health care activities and reward values were as follows: Annual Wellness $50 or In Home Assessment $50, Annual Flu Shot $20, Breast Cancer Screening $25, Colon Cancer Screening (Fecal Occult Blood Test/Fecal Immunochemical Test/Flexible Sigmoidoscopy Colonoscopy) $10 to $50, Diabetes Care Eye Exam $25, Diabetes Care Kidney Exam $15, Diabetes Care A1C $20, Osteoporosis (BMD Screening) $25, Men's Wellness or Women's Wellness or Diabetes Health programs $50.	Members were rewarded with gift cards to complete the specified health care activities. The members had the option of receiving an e-gift card immediately or having a physical gift card mailed to them. These were merchant gift cards that were not convertible to cash.	The reward value is based on Chapter 4 CMS guidelines pertaining to the value of the health related service and the status of members completing their health activity in the 2019 plan year based on a combination of claims data received by Florida Blue and member self-reported activity.	Members interact through the HealthyBlue program via telephonic and digital channels. Member interactions across the channels were captured in Welltoks CMS-compliant data storage as activations and redemptions (participation)	27351	12194
R3392	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	175	24
R3392	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	43331	96440
R3392	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	826	139
R3444	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	47765	46213
R3887	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	308	32
R3887	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	12418	12495
R3887	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	219	31
R4182	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	178	23
R4182	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	55206	86910
R4182	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	1247	191
R4487	ANTHEM INSURANCE COMPANIES, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	38	36
R4487	ANTHEM INSURANCE COMPANIES, INC.	2019	2	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	2280	2036
R4845	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	20	1
R4845	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	7169	3160
R4845	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	90	16
R5329	SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	2514	2344
R5342	UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	37895	39080
R5361	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	446	34
R5361	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	19790	33035
R5361	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	346	60
R5495	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	238	17
R5495	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	10222	12770
R5495	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	163	25
R5826	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	99	11
R5826	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	34165	51340
R5826	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	537	69
R5941	ANTHEM INSURANCE COMPANIES, INC.	2019	1	Bone Mineral Density Screening	Bone Mineral Density Screening	$50.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	30	25
R5941	ANTHEM INSURANCE COMPANIES, INC.	2019	2	Rewards for Health	Breast Cancer Screening,  Diabetic Retinal Eye Exam, Colorectal Cancer Screening	BCS $50.00, COL $50.00, DRE $25.00 Visa Card	Value of Gift Card, one gift card for each incentive	Member Self Attest	2038	1872
R6694	AETNA LIFE INSURANCE COMPANY	2019	1	 	 	 	 	 	0	0
R6801	CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	66123	63407
R7220	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	16	4
R7220	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	8364	11575
R7220	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	104	16
R7315	HUMANA INSURANCE COMPANY	2019	1	Humana Rewards	Welcome to Medicare Routine Physical, Annual Wellness Visit, Cardiovascular Disease Screening, Diabetes Screening Test, Mammogram, Bone Density Test, Colorectal Cancer Screening, Flu Vaccine Depression Screening, Medical Nutrition Therapy, Diabetes Self-Management Training, Diabetic Retinal Exam, Kidney Tests/Nephropathy Screening, Diabetic Foot Exam, Adult BMI Assessment	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	With the completion of 4 preventive activities the enrollees earn $50 in gift card(s) to be selected from various vendors	Participation is tracked via claims processing for the specific CPT codes for the preventive activities listed above.	109	18
R7315	HUMANA INSURANCE COMPANY	2019	2	Go365 by Humana	Fitness: rewards for completing monthly workouts, Social/Lifestyle: rewards for completing monthly volunteering, athletic event, education class, or community nutrition program Prevention: Annual Wellness Exam, Mammogram, Colorectal Screening, Cardiovascular disease screening, Bone density, Flu Shot.	Medicare members can earn Rewards for participating and engaging in the program, such as completing preventive screenings and exercising.  Rewards can be redeemed for various items in the Go365 Mall. Members can choose gift cards from a variety of retailers, in amounts ranging from $10.00 - $100.00 as program rewards.	Go365 collaborates with the Humana Medicare team to identify the value of preventive services awarded in the program and then assigns a reward value that does not exceed the value of the service. For social, lifestyle and athletic activities, rewards are calculated to be of sufficient value to motivate participation (based on prior program data), but of a lower value than disease prevention services.	Program participation is tracked for each member through the completion of activities on the web or submitted via paper, uploads from fitness devices, incomings feeds from Silver Sneakers and screening data abstracted from medical claims, etc. As activity data feeds into the system, members are rewarded, both the activity completion and the reward are posted to the member account.	19944	37220
R7315	HUMANA INSURANCE COMPANY	2019	3	DM-CCP by Humana	DM-CCP Consult: The drug management care coordination program (DM-CCP) consult includes the following activities: interactive medication review, Part B drug education, and adherence support, with follow-up if necessary.	Part B Step Therapy members can earn a $60 Walmart Gift Card for completing the DM-CCP Consult.	The DM-CCP reward amount is calculated using at least 50% of the value of the preferred Part B drugs negotiated price concession or rebate associated with the Part B drug step therapy program and is distributed as one gift card for full completion of the care coordination program (i.e. DM-CCP).  Humana uses the average across all drug classes included in the Part B Step therapy program and includes the cost of administering the rewards program in the calculation. Estimated per member savings ~$60.	Program participation is tracked for each member through reporting pulled from the Pharmacy workflow tool used to document the DM-CCP consult activities. Once reporting is generated and activity completion is noted, a gift card is issued.	335	58
R7444	UNITEDHEALTHCARE INSURANCE COMPANY	2019	1	HouseCalls Program, Renew Rewards, Step Therapy	HouseCall, Annual Physical or Wellness Visit, Diabetic Eye Exam, Colon Cancer Screening (iFOBT, Colonoscopy, Flexible Sigmoidoscopy, Cologuard), Breast Cancer Screening, Osteoporosis Screening, Rheumatoid Arthritis Visit, Reducing Risk of Falls Visit, Urinary Incontinence Visit, Flu Shot, Device-Based Activities (Step, Sleep, Connect Device) and the following  medications are eligible for rewards: Inflectra, Renflexis, Retacrit, Neupogen, and Neulasta. A member who is enrolled in an eligible contract and has one of these medications administered by their physician under their Part B benefit will be eligible for rewards.	Gift Card	HouseCalls Program:The reward is a gift card of a set monetary amount that must be spent down. Reward amounts and gift card options vary based on the health care activity, but are determined based on the amount expected to impact enrollee behavior, but not exceeding the value of the health related activity itself. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: The reward is a gift card of a set monetary amount based on 50% of the net plan savings for each claim. Reward amounts and gift card options vary based on the medication administered and are determined at the individual claim level for each member.	HouseCalls Program: The HouseCalls program contacts eligible members who then agree to participate in an in home visit.  Members can receive information about the opportunity to have a HouseCalls visit by outbound phone outreach from our scheduling agents, mailed materials, or email.  The clinician performing the visit will enter member information into the eHouseCalls app housed on the tablet our clinicians use in the field.  Once the HouseCalls system receive s confirmation of a completed visit, the reward is issued. Renew Rewards Program: Enrollees initiate the redemption process by activating into the program through any of three channels (Customer Service, Online/Member Portals, IVR) if they have not done so previously. Members self-report completion of eligible activities through any of these three channels by providing certain required data (e.g., appointment date). Once UHC validates the eligibility period for the activity, the reward is issued. StepTherapy Program: Enrollees are initiated into the program with their first submitted and paid claim for a preferred product in the Part B Step Therapy program. For preferred products administered to treat Rheumatoid Arthritis and Red Blood Cell disorders, enrollees will receive notification of their enrollment via mail (care coordination packets) and by phone to discuss the program and the shared savings they will receive. Upon completion of care coordination, members will receive their reward in the form of a gift card. For members receiving a preferred product for white blood cell therapies they will automatically receive a reward without care coordination required. The White Blood Cell therapies are not subject to step therapy, and therefore neither are the members or providers. UnitedHealthcare will be sharing 50% of the savings obtained from Pharma on the White Blood Cell therapies	240209	236265
