Arizona Physicians IPA, a Medicaid HMO based in Phoenix, had a problem.
Executives wanted more of the plan's 130,000 enrollees to bring their children in for routine examinations and immunizations, but they weren't sure how to persuade them to do so.
Then lightning struck during a management meeting.
"We were discussing the results of a recent member survey," says Jack Nock, president and chief executive officer at the independent practice association. "We had asked them what they wanted to see in our member newsletter, and we got some unexpected results. They wanted help writing resumes, finding jobs, getting clothes-issues that never occurred to us before."
Swapping ideas. After some brainstorming, Arizona Physicians managers decided that one way to encourage immunizations was to hold their own clothing "swap meet." Enrollees would go to their physicians and have their children immunized. The physicians would then give the enrollees coupons they could trade for secondhand clothing donated by employees and a local used-clothing store.
So far, Arizona Physicians has conducted 12 such swap meets since May 1996, with another scheduled for December.
"We've given away more than 15 tons of clothes to more than 18,000 people," Nock says. "We've increased the number of well-child checkups, and immunizations are up. That's based on an independent review on behalf of the state Medicaid agency."
Vaccine rates in 1997 were up 4% to 7%, depending on the vaccine. In 1996, the most recent year for which data were collected, well-child visits for children ages 1 and under were up 10%, and wellness visits for adolescents jumped 23%.
Based on information published by the federal Centers for Disease Control and Prevention regarding the cost-effectiveness of vaccinations, Arizona Physicians estimates its efforts have saved $1.8 million to date.
The creative twist on risk management-not to mention the results realized by the plan-earned Arizona Physicians the Excellence in Healthcare Risk Management Award in the health plans category.
"It encourages parents to get involved in their children's care," says Anna Marie Hajek, executive vice president at MMI Cos. "It represents significant savings of public healthcare dollars. And they went overboard to be inclusive, to really make it a community project."
The swap meets have evolved into a bonding experience for Arizona Physicians employees, the Phoenix community and the plan's enrollees, Nock says.
"All the events are staffed by volunteers, and that includes employees, myself and people who can be totally dissociated with us," he says.
Donations keep coming. Nock says real estate developers and schools have donated space for the swap meets. Grocery stores have donated film so children can be photographed with Santa Claus at the holiday swap meets.
"People in all areas of the company are interacting with each other," Nock says. "Claims technicians get a chance to work side-by-side with the CEO, and the customer service staff can put down their headsets and meet the members they talk to on the phone."
Enrollees who come to the swap meets are also asked to enter a raffle by filling out a short form with their name, address, phone number and other information. Prizes donated by local businesses are raffled throughout the day.
"We get about 75% of the people to fill them out," Nock says. "We can get a lot of data from that."
What Arizona Physicians has done can be replicated by other plans serving a large Medicaid population, Nock says.
"This is not rocket science," Nock says. "It's about paying attention to detail and tapping the resources of your employees."