Our mission in 2021 continued with a keen focus on improving the health of Central Texas residents by offering affordable, high-quality health insurance.
Our mission in 2021 continued with a keen focus on improving the health of Central Texas residents by offering affordable, high-quality health insurance.
MAP / CHAP Partnership
Plan Year 2021 marked the third year of the very successful partnership between the Medical Access Program (MAP) and Central Health Access Program (CHAP) to meet the needs of community members in great need of medical care. Central Health’s MAP provides for the basic health care needs of low-income residents of Travis County, while the CHAP program was developed by Sendero and Central Health to address the needs of community members with particularly acute medical conditions.
CHAP is very highly regarded by the program’s participants. CHAP members gave the program extremely high marks in Sendero’s internal surveys, with a Net Promoter Score (NPS) of 80 and satisfaction of 96.8%.
As a result of this care partnership, Sendero received a payment of $32.6 million from the federal risk adjustment program. The vast majority of these funds were used to provide care to residents in Austin’s most underserved communities and especially East of IH 35. The funds help to offset the cost of care in 2021 to low-income Travis County residents, and it marks the third consecutive year of receiving funds from the risk adjustment program and the highest amount to date.
Community Engagement
Sendero is committed to finding new and better ways to serve the people of Central Texas. As Central Texas’s only community-based, non-profit healthcare plan, we take an innovative approach by developing community partnerships to identify, target, and effectively address the greatest healthcare needs of our members.
Plan year 2021 marked the 10th year of Sendero’s Sponsorship of the “Boo the Flu” vaccination event and the first anniversary of a 1000 turkey giveaway event. These events are part of Sendero’s community engagement efforts to give back to the community that has supported us this past decade.
Better Serving Our Members
Our dedicated focus on giving Central Texans the tools they need to stay healthy did not waver as the pandemic spread. This year we worked with our members to identify how we could improve their care, and as a result, we are investing in solutions to improve member interaction and engagement with the healthcare system and Sendero.
Following the 4th Quarter 2020 launch of a new web portal for members to access their plan features, make payments, and track claims history and status, we began a pilot program to receive feedback from members on the effectiveness of our marketing and new-member onboarding programs and our members’ experience with our call center and member-service representatives. The results showed a baseline NPS of 34 from all surveyed members with an industry average of 16-27 in 2021.
Outstanding Employees / Best Places to Work
In 2021 Sendero again achieved a “Best Places to Work” award from the Austin American Statesman. All Sendero employees are dedicated to outstanding service, and the fruits of these efforts were realized when we received a 4-Star rating from the Centers for Medicare and Medicaid Management – the regulator for the Affordable Care Act – ranking Sendero the highest-rated and only 4-Star plan in Texas in 2021.
Thank you again for the continued trust you place in Sendero for providing for the medical needs of you and your families.
Sincerely,
Wesley Durkalski, President and CEO
Sendero Health Plans, Inc.
Partnering with Central Health to Provide High-Quality Coverage for the Most at-risk Community Members
Central Health’s Medical Access Program provides for the basic health care needs of the Travis County Community. To address the needs of community members with particularly acute medical conditions, Central Health and Sendero partnered to create CHAP, which involves purchasing a Sendero Health Platinum level plan, thereby enabling CHAP participants to access Sendero’s large network of primary care and specialty doctors to address their medical conditions quickly and effectively.
The program has the added benefit of enabling Sendero to be eligible for payments from the Affordable Care Act risk adjustment program. For Plan Year 2021, Sendero received a payment of $32.6 million* from the risk adjustment program.
The funds help to offset the cost of care in 2021 to low-income Travis County residents, and it marks the third consecutive year of receiving funds from the risk adjustment program and the highest amount to date. Being a recipient of the program demonstrates that Sendero is providing care to residents who need it. Receiving a risk adjustment payment also reaffirms the wisdom of the Sendero and Central Health boards in expanding the CHAP program to include Travis County residents with greater healthcare needs.”
In the fall of 2018, Sendero and its parent company, Central Health, agreed to have Sendero provide health insurance to Travis County residents with complex medical needs. Central Health, the local public agency that connects Travis County residents with low-income to quality health care, pays the insurance premiums for Travis County residents through CHAP.
In return for covering these sicker patients, Sendero receives millions of dollars for care reimbursement rather than pay into the ACA’s risk adjustment program. The risk adjustment program is designed to stabilize health insurance markets so that insurance companies with sicker customers can keep or draw down money from a pool of funds paid in by companies with healthier customers.
Receiving funds from the risk adjustment program is not the only measure of the success of the CHAP. Looking at CHAP participants who were Sendero members in 2021, a June 2022 satisfaction survey found an 80% satisfaction level “with Sendero Health Plans IdealCare health insurance” among CHAP participants, with two-thirds indicating they were “highly satisfied.”
Additionally, Sendero received a Net Promoter Score (NPS) of XX from 2021 CHAP program participants. The NPS questions enable benchmarking within and across industries. By comparison, the health insurance industry NPS in 2021 ranged from 16.1 to 27, depending on the company compiling the data. According to NICE Satmetrix, a leading voice of consumer solutions providers, the highest reported NPS score for a health insurance company in 2021 is 48, ranking Sendero’s Health Insurance Program for CHAP participants substantially higher than the top-rated health insurance company.
The funds help to offset the cost of care in 2021 to low-income Travis County residents, and it marks the third consecutive year of receiving funds from the risk adjustment program and the highest amount to date. Being a recipient of the program demonstrates that Sendero is providing care to residents who need it – especially participants of our Central Health Premium Assistance Program (CHAP). Receiving a risk adjustment payment also reaffirms the wisdom of the Sendero and Central Health boards in expanding the CHAP program to include Travis County residents with greater healthcare needs.”
In the fall of 2018, Sendero and its parent company, Central Health, agreed to have Sendero provide health insurance to Travis County residents with complex medical needs. Central Health, the local public agency that connects Travis County residents with low-income to quality health care, pays the insurance premiums for Travis County residents through CHAP.
In return for covering these sicker patients, Sendero receives millions of dollars for care reimbursement rather than pay into the ACA’s risk adjustment program. The risk adjustment program is designed to stabilize health insurance markets so that insurance companies with sicker customers can keep or draw down money from a pool of funds paid in by companies with healthier customers.
Receiving funds from the risk adjustment program is not the only measure of the success of the CHAP. Looking at CHAP participants who were Sendero members in 2021, a June 2022 satisfaction survey found an 80% satisfaction level “with Sendero Health Plans IdealCare health insurance” among CHAP participants, with two-thirds indicating they were “highly satisfied.”
Additionally, Sendero received a Net Promoter Score (NPS) of XX from 2021 CHAP program participants. The NPS questions enable benchmarking within and across industries. By comparison, the health insurance industry NPS in 2021 ranged from 16.1 to 27, depending on the company compiling the data. According to NICE Satmetrix, a leading voice of consumer solutions providers, the highest reported NPS score for a health insurance company in 2021 is 48, ranking Sendero’s Health Insurance Program for CHAP participants substantially higher than the top-rated health insurance company.
The week before Halloween in October 2021, Sendero Health celebrated the 10th year of sponsorship of the annual flu-shot event that now includes COVID-19 vaccinations and boosters.
With flu season expected to again add a layer of complication to the COVID-19 pandemic impact, Sendero Health Plans helped equip the Central Texas community with tools to stay healthy. The event featured voluntary drive-through flu and COVID-19 vaccinations for the community, especially uninsured or underinsured Travis County residents with limited resources. The event was held at the Travis Early College High School and The Graduation Preparatory Academy.
The Boo the Flu event is in its 14th year, and Sendero began sponsoring the event when the company began operations in 2011.
In November 2021, just before Thanksgiving, Sendero gave away 1,000 turkeys and Thanksgiving dinners to elderly, disabled, and low-income residents in collaboration with Austin Public Health’s East Austin Neighborhood Center.
At the “Turkey Fest/Fiesta del Pavo,” Sendero paid for the turkeys, and Austin Public Health provided additional holiday-meal side items that included three cans of peas, three cans of green beans, three cans of pears, two boxes of Mac & Cheese, four pouches of instant mashed potatoes, and one large bottle cooking oil. Some households also received a dozen eggs.
Recipients of the turkeys drove up to volunteers who loaded a turkey and sides into their cars. Free flu vaccines were also provided to those wanting one. Other participating organizations, in addition to Sendero Health and Austin Public Health and its East Austin Neighborhood Center, were Austin Public Works, the Central Texas Food Bank, and Austin ISD.
With financial support from Central Health, the Health Alliance for Austin Musicians (HAAM) expanded enrollment to 400 local musicians on a Sendero Silver Plan in 2021. Sendero also developed a new and deeper relationship with HAAM to promote health initiatives to improve the lives of area musicians.
Sendero continues to engage in research that benefits our members and the community. One key area of interest at the end of 2020 and beginning of 2021 was in identifying our member’s concerns and interest in receiving the COVID-19 Vaccine, which at the time of the survey, in Fall 2020, had just begun to roll out.
Nearly two-thirds of Sendero Health Plans members responding to a survey said they plan to get the COVID-19 vaccine when it is available to them. However, some 47 percent of Blacks or African Americans; 19 percent of Females; and 15 percent of Mexican, Mexican American, and Chicanos reported they were less likely to get COVID-19 Vaccine.
A total of 1,648 Sendero Health Plans members in Central Texas responded to the survey, which was conducted between November 11 and December 22, 2020.
The results were presented in a March 2021 webinar briefing: “Equity Gaps in COVID-19 Vaccine Uptake: A Community Conversation” and included comments from panelists Cynthia Valadez, of LULAC and the Central Health Board of Managers; Stephanie Hayden-Howard, Director, Austin Public Health; and Dr. Mary Carol Jennings, Chief Medical Officer, Sendero Health Plans.
The full set of findings from this study are scheduled to be published in a peer-reviewed public health journal in XXX.
In addition to Covid vaccine research, Sendero built onto the success of an August 2019 publication on opioid abuse in BMC Public Health. Sendero’s senior healthcare leadership continued to publish ground-breaking studies on important issues facing community-based public health plans and those they serve. Below is a list of the peer-reviewed papers Sendero’s team published in 2020 and 2021:
Sendero began a pilot program to receive feedback from members on the effectiveness of our marketing and new-member onboarding programs and our members’ experience with our call center and member-service representatives. We worked with Qualtrics Experience Managment, a leading member and customer experience expert to provide the survey platform to measure feedback. The results showed a baseline NPS of 34 with an industry average of 16-27 in 2021. Following the successful pilot effort, we have rolled out ongoing member feedback surveys to gauge our member’s experience interacting with their non-profit health plan.
Sendero also continues to engage in research that identifies opportunities to improve the health of our members by identifying programs and strategies that can encourage members to seek preventive screenings. The result of Sendero’s research efforts were presented in three health journals that help to raise awareness of Sendero’s work in improving health outcomes.
Overview: Diabetic retinopathy, an eye condition that can cause vision loss and blindness in people who have diabetes, is a leading cause of blindness worldwide. This study reports on the results of a randomized controlled trial with Sendero members to determine how using specific types of action combined with a free eye exam might positively influence the rate of diabetic retinopathy screening among individuals with diabetes.
Findings: This study supports the use of targeted efforts to encourage screenings combined with the offering of a free eye exam to increase the rates of diabetic retinopathy screening among Sendero members with diabetes.
Overview: Screening mammography is a preventive exam used to detect breast cancer in women without cancer symptoms. This pilot project sought to determine if outreach, education, and financial incentive would increase screening mammography among women aged 52 to 74 years who are members of Sendero.
Findings: This one-time, time-limited pilot project consisting of outreach, education, and incentive increased the screening mammography’s by Sendero members.
Overview: Infection with the hepatitis C virus (HCV) is the most reported bloodborne infection in the United States. Individuals born between 1945-1965, the baby boomers, account for approximately 75 percent of all chronic HCV infections in the United States. The purpose of this study was to determine if a 6-week intervention, including outreach, education, and incentive, by Sendero Health Plans could improve uptake of HCV antibody screening among their members in the 1945-1965 year of birth range.
Findings: Using an outreach, education, and incentive approach, Sendero Health Plans improved uptake of HCV antibody screening by 6 percent compared to a similar period of a year earlier without an intervention among Sendero’s high-risk baby boomer population. Put another way, Sendero baby boomers were 3.36 times more likely to be screened during the 2018 intervention period as compared to a similar period in 2017, when no intervention occurred.
The crucial component of ensuring overall Sendero member satisfaction is to make sure our team members have the necessary tools and training to deliver a positive member experience. With this in mind, Sendero hosted workshops and roundtable discussions with staff to understand the opportunities and obstacles to bringing the highest-quality service to our members.
Employee Satisfaction Survey
Our employees shared that the three areas of highest satisfaction are:
I am passionate about my work; I like to help my community and in this place, I have found it.
- an employee in Health Services
I am passionate about my work; I like to help my community and in this place, I have found it.
- an employee in Health Services
I plan to be with your company as long as I am in Texas. Thank you!
-Sendero Member
I plan to be with your company as long as I am in Texas. Thank you!
-Sendero Member
Improving the health of our community through affordable, quality health care coverage.
Sendero Health Plans received a 4-Star Quality Rating from the Centers for Medicare and Medicaid, making Sendero the only four-star and highest-rated health plan in Texas and the first and only to achieve that distinction in Central Texas. Open enrollment for Affordable Care Act health plans is underway now.