Case Study

Summary

Nava is supporting the Centers for Medicare & Medicaid Services (CMS) on an initiative to help Medicare beneficiaries understand the importance of preventive care and find a primary care provider in their area who can offer crucial preventive services. Preventive care such as annual check-ups, screenings, or immunizations helps detect serious medical problems before they become life-threatening. As CMS provides healthcare for 64 million people, this initiative has the potential to improve long-term health outcomes for a large swath of the public.

Approach

Preventive care is crucial because it can lead to people spending less time in hospitals, hospice, and home health care. However, some research suggests that fewer than 50 percent of adults 65 and older are up-to-date with preventive care services. There are many reasons one might not receive preventive care, including not having a primary care provider or being unaware of preventive services. 

That’s why we are supporting CMS to help Medicare beneficiaries understand and connect with a primary care provider for preventive services covered by their plan. This work is part of a larger vision that aims to help millions of aging Americans make informed decisions about their healthcare. 

At the center of this initiative is Care Compare, a tool on Medicare.gov where 64 million Medicare beneficiaries look for and compare healthcare providers of all kinds. With Care Compare, Medicare beneficiaries can find and compare providers in their area, assess quality of care, and understand financial considerations when choosing their care. 

Our team has been tasked with helping CMS develop a more integrated experience across Medicare.gov. Long-term, our shared goal is to deliver the best experience for beneficiaries and caregivers to help them make informed decisions at every stage of their healthcare journey. 

Outcomes

In just six months, our team launched a minimum viable product (MVP) for a customer service experience that helps beneficiaries understand preventive services covered by their plan, and then helps them find a provider who can give them that preventive care. 

The MVP helps meet beneficiary care needs by providing a seamless and personalized customer service experience. Specifically, Medicare.gov users can now leverage Care Compare to search for primary care providers and receive all valid results in their area. 

Care Compare supports the nearly 3 million healthcare providers in the U.S. that are covered by Medicare, acting as the gateway of consumer-facing provider data across all of Medicare.gov. Our team helps make sure this data is usable and digestible for Medicare users.

Process

We began with a series of working sessions with CMS to define the scope of the MVP. These working sessions unveiled what areas of the customer experience we might want to address with our MVP and ultimately informed our MVP goal: encouraging beneficiaries to take advantage of preventive services. Once we defined our goal, we delivered an MVP proposal to CMS that detailed four initiatives we believed would improve the Medicare.gov experience: 

• Enabling beneficiaries to search for primary care providers and preventive services using Care Compare

• Sending beneficiaries personalized messages that direct them toward preventive services through a primary care provider

• Adding a call-to-action to find a primary care provider and/or preventive services within beneficiaries’ Medicare.gov accounts

• Adding a call-to-action to find preventive services on Medicare.gov’s Preventive & screening services page

Next, our team focused on helping beneficiaries find and receive in-network preventive care. For the most vulnerable populations who may not have a primary care provider, encouragement to find one and take advantage of the preventive care they are eligible for may prevent the need for emergency services. We also wanted to make sure these new initiatives helped those with Medicare.gov accounts and those without. 

My takeaway is that you all are doing a phenomenal job; I’m really pleased. When we were putting together criteria for the MVP, we didn’t know how to start and broach this, and you all have worked through that. So I’m really appreciative.

Care Compare Product Owner at CMS

Next, we got to work on developing the MVP. We collaborated across teams working on Medicare.gov to create a more cohesive experience that highlights the importance of preventive and primary care. We did this through a series of design explorations and cross-functional collaboration sessions, which helped us align on the ideal user experience for Medicare beneficiaries. This process also revealed the technical requirements for making applications work together. 

For example, we wanted users to be able to click on a link from various pages across Medicare.gov and be directed to Care Compare, where their location and desired care type would auto populate in the search bar. To achieve this, we worked to understand how different parts of the site function. Next, we collaborated with each respective team to understand how we could transfer a beneficiary’s location from their Account Home to Care Compare. This would allow users to find relevant care in their area. 

A screenshot of Care Compare. When a user clicks on “find a provider,” they land on this page, where their location and desired care type auto populate in the search bar.

We also added nearly 30 new search keyword terms to the tool. In order to add new search terms to Care Compare that fit people’s needs, we conducted extensive research and dug into Medicare claims data to determine the appropriate mappings of preventive services to different provider types and specialties. For example, we wanted to make sure that someone who chose the “diabetes screenings” preventive service would be mapped to providers with this capability. We then verified that these mappings were accurate with a clinical subject matter expert before adding the new search terms to Care Compare. 

This is especially important because one of the main reasons people go to Care Compare is to find primary care providers. However, until recently, people couldn’t search Care Compare using the term “primary care provider.” Now, that search term pulls up providers in several specialties such as geriatric medicine, family practice, and internal medicine. People can conduct these searches in English and Spanish. 

To enhance the user experience, we added “Find a Provider” buttons to the My preventive services page. Each button maps to a specific preventive service type, and when beneficiaries click on one of the buttons, it auto-populates the name of that service into the Care Compare search. This process allows beneficiaries to find a provider in their area who can support their particular health needs. 

A screenshot of the My Preventive Services page with buttons mapping to specific preventive services.

We also added a link to the top of the Preventive & screening services page to help beneficiaries find a provider on Care Compare who can support the preventive service they need. Finally, we integrated a reminder of preventive service eligibility in personalized messages to beneficiaries. These messages guide beneficiaries to Care Compare, where they can find a provider if they don't already have one.  

Closing summary

Now that CMS has achieved a more integrated Care Compare/Medicare.gov experience that promotes the importance of primary care access, we can look toward the future. We’ll continue to work toward our goal of making Care Compare more personalized, integrated, and supportive of beneficiaries and their caregivers at every stage of their health journey.