Case Study: Healthways achieves 36.7% higher enrollment than CMS goal (17.1% above its target) with FICO Segmentation Models

Health care provider surpasses marketing goals using FICO Segmentation Models

Healthways, Inc., the nation’s leading disease management company serving more than two million people, ran a three-year CMS pilot targeting 20,000 fee-for-service Medicare beneficiaries with complex diabetes or chronic heart failure. Because the program was opt-in and CMS required a 5% reduction in average costs (with opt-outs still counted), Healthways needed to maximize enrollment and retention—ideally on the first contact.

Healthways partnered with FICO, which used Segmentation Models to combine attitudinal survey data with readily available demographic data, identify six beneficiary archetypes, and prescribe tailored message sequencing for the critical opening seconds of enrollment calls. By assigning each beneficiary to a segment and guiding nurses’ outreach, the program exceeded CMS’s projected signup by 36.7% and Healthways’ internal goal by 17.1%, surpassing stretch targets and improving results on a second pilot.

Healthways

Michael F. Montijo

Senior VP, Government Operations