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5 Key Takeaways from Speaking at the 11th Annual Medicare Market Innovations Forum

On Thursday, July 16th, 2020 our VP of Marketing, Brendan McClure, Bill Jenson from Independent Health Care, Linda Roman, and Brenda Mamber from Cenaturi Health, spoke at the 11th Annual Medicare Market Innovation Forum. BrendanBillBrenda, and Linda explored designing unique member experience and how leveraging data can build loyalty. 

Here are our 5 Key Takeaways:



 Bill and Brendan both noted that the COVID-19 pandemic has accelerated a number of existing trends in member engagement. Telehealth access outreach, check-ins with members about their wellbeing, and conversational engagement to both inform and uncover insights all took on much greater importance. For plans where these member-centric touchpoints and engagement procedures were already in place, the trust between member and plan was greater once the crisis started. Early COVID engagement strategies from the plans already engaging conversationally have given plans a unique advantage to build even deeper connections with membersBrendan gave a real example where an automated check-in with a Medicare population prompted a response from one member who said that he had not heard from anyone in two weeks and deeply appreciated the care and concern from the plan.  



When a plan can ask the right questions and supply the proper resourcesmembers are more likely to engage and leave the conversation feeling heard. Plans often have underutilized resources and interventions due to a lack of member awareness, or because plans do not know who needs what. But simply asking members in conversational channels if they are experiencing issues like social isolation or food insecurity both create the opportunity to connect them with resources and identify members who may need follow-up. By asking the right questions, a plan can uncover barriers to action such as transportation, health literacy, language, and the like. Asking and then providing the member with the appropriate resources will not only drive engagement and drive behavioral change, it will help build the trust needed to engage in future conversations. 



Loyalty is a product of building trust. A member is more likely to engage in future conversations when they feel like the plan is invested in their health as much as they are. Brendan noted that trust comes from a plan who communicates accurately, timely and quickly. In addition to the example of COVID-19 outreach from plans that were already having conversations with members regularlythe panel noted how important building trust over time was when it came to SDOH barriers. Members are more likely to share barriers and more likely to accept help and interventions when there’s trust in an established relationship. The stronger that relationship, the more confident a plan can be in retaining that member over time, and counting on them to engage in the future. 



 Because trust is established during ongoing conversations over an extended period of time, when a member is ready to transition into Medicare they are more likely to accept information and resources from their planThat level of trust will keep members open and willing to communicate with their plan on a regular cadencemPulse has found that members who received text outreach from their plan previously about health or services were much more likely to request information on their payer’s Medicare plan options via text. Leaning on the trust built throughout the relationship to continue to ask questions about their experiences with their healthcare and using that data from past conversations with the member to tailor age-in outreach can be a winning combination for both retention and member experience. 



Brendan reminded the audience that the data you get from engagement depends on the questions you askThere is value in all variations of member responses. Discovering whether a member is happy or unsatisfied with their plan creates the opportunity to tailor further engagementSentiment and intent analysis of member responses to automated outreach provides valuable feedback to the planAsking member directly how they feel about their plan, or measuring positive and negative responses to questions about their health or the COVID-19 pandemicgives plans insight on retention risks, hotspot geographies that may have provider network issues, or topics where members seem to be dissatisfied. Uncovering these potential blind spots and quantifying members’ expressed feelings toward their plan gives payers actionable data to impact everything from future engagement strategies to benefit design.

Strong Outcomes Require Strong Relationships

So much of the human experience is built around relationships. Family units, loved ones, friends, colleagues, local communities, and others we interact with on a regular basis (like the barista down the street) are the fiber of our outward experience in the world. Without relationships, we begin to function differently and suffer. The current pandemic has highlighted the negative impact of social isolation as millions of Americans feel it more acutely than ever beforeSimply put, relationships are fundamental to our health and survival.

Trust goes hand-in-hand with relationships. If you think about people you trust the most, odds are you have a long-established relationship with them. They’ve demonstrated over time that they can be trusted and are reliable. Once established, trust helps us bypass a lot of analysis and consideration when given advice or taught something. We more quickly internalize and implement recommendations and processes when they come from someone we trust, which is immensely valuable. Don’t believe me? Ask your mother.

How do relationships impact quality healthcare?

Just like any other community, it’s crucial that healthcare organizations build and maintain positive relationships with their consumers. Consumers rely on trusted relationships to help them make decisions on their care. A 2017 Oliver Wyman study showed that US healthcare consumers are more likely to consult close friends and family on whether to seek healthcare treatment than they are to ask their providers. Health insurers ranked dead last. When consumers feel like they have a positive, trusting relationship with their health plan, provider(s), or other organization, the barriers to sharing information, activating them in health behaviors, seeking appropriate care, and ultimately taking any action all shrink. The strength and sentiment of the relationship between each healthcare organization and their individual consumers is a key indicator of how effectively the organization can impact each consumer’s life and quality of care. Additionally, happy consumers make a direct impact on CAHPS scores and Star ratings.

It may be no surprise that relationships take time and investment to build. You probably can’t walk up to a random stranger on the street and ask for a ride to the airport. But you probably have friends or family that would be willing to take you. In part, it’s because they know you will be there when they need you, too. You have been there before; you will be there again. So how do you create this same feeling and dependability between your organization and your consumers?

Start now. Build meaningful connections with your consumers. Build trust with your consumers. Begin that positive relationship. Ask them questions in your outreach, and listen to their answers, either through staff or with technology like Natural Language Understanding (NLU). If you feel like you already have a strong relationship with your consumers, then make sure you are nurturing that relationship. The more they trust and rely on you, the more they will heed your advice or take the action you recommend. You cannot wait until the moment you need them to do something to start engaging them because consumers don’t see their relationship with you as a series of campaigns. It needs to be an ongoing, two-way relationship to create the best health and business outcomes.

Some great examples of this challenge can be found in COVID-19 outreach. Many organizations increased the amount and type of consumer outreach to inform them about rapid changes to policies, benefits, care instructions, and a lot of other information as things rapidly changed. In some instances, consumers were confused. This type of outreach and interaction was new. It felt like it came out of nowhere. If they had a stronger relationship with the organization communicating with them, and if communication like this was more typical, they would likely be more receptive and trusting.

Takeaway: start building valuable relationships now so they are there when you need them.

mPulse prides itself on helping healthcare organizations communicate with their members with the content they need through the channels they prefer. If you would like to learn more about how we can help you connect more deeply with your consumers, please contact us.

5 Key Takeaways from Speaking at Rise National

mPulse Mobile’s CEO, Chris Nicholson, spoke alongside Rex Wallace at RISE national on the Engaging Hard-To-Reach Members to Drive Action Around Quality and Risk speaking session. Chris and Rex explored how to define hard to reach Medicare members, the importance of trust in engagement, some proven strategies and results, and how the new weight on Star Measures will impact how plans think about these populations.

Here are our 5 key takeaways:  


Members who do not engage or act after multiple outreach attempts tend to face several factors that make building a connection more difficult. Sometimes the issue is a matter of access to the content or channel. Language or cultural barriers can severely limit engagement with English-only outreach, and members who rely solely on smartphones for internet access can be much harder to reach via email and web portals. Our research shows that lower engagement tends to correlate with higher impact from Social Determinants of Health (SDOH). That impact can take many forms, from housing insecurity which causes mail to be delivered to old addresses, to lower overall health literacy that makes one-size-fits-all reminders to close care gaps less meaningfulBut the area that Chris and Rex explored the most was the members who simply did not trust their plan 


Data from Oliver Wyman suggests that trust is vital when members consider taking action on their health. A 2017 study that Chris and Rex discussed in the session shows that consumers are just as likely to consult with friends and family on whether to seek medical care as they are to ask a provider. And they were less than half as likely to check with their health plan. The difference is the level of trust and strength of relationship. Plans have an opportunity to build trust in their outreach by making it more conversational and tailored to the member.  


 Asking members questions – Why haven’t you visited the doctor? Why didn’t you refill your prescription last month? – and listening to their responses creates a twofold impact: You build trust by letting the member guide the conversation, while also uncovering barriers to action. Members who identify barriers feel heard and can be connected to plan resources to overcome them like ridesharing, appointment scheduling assistance, or health literacy-building content. And gathering barrier data can give vital insight to your quality improvement strategy.  


Rex and Chris dove in on how to define and measure trust in a member’s relationship to the plan. They used a four-part definition of trust from the American Psychological Association to explore how plans can measure something so qualitativeFirst, trust is based on past experiences and prior interactions, so plans should take steps to treat engagement as a long-term relationship rather than a series of campaigns and monitor engagement rates over time and across touchpoints. Second, trusted partners are seen as reliable, dependable, and concerned, which makes analyzing the sentiment of member responses to outreach a possible proxy for measuring how members view their plan. Third, trusting parties disclose information to each other and take on risk by relying on the other. This is where measuring and analyzing member responses to questions that ask for them to disclose things like barriers, SDOH impact, or other challenges can help plans understand the level of trust members place in them. Finally trust means confidence and security in the caring responses of a partner – which means members lose trust in plans that ask questions but don’t seem to listen or act on answers. Chris noted that when plans ask a member if transportation is a challenge but don’t correctly understand their answer (or don’t provide a remedy if they say yes), they damage the relationship they were trying to strengthen. 


Rex noted how the major changes from CMS to emphasize Member Experience and Complaints measures in formulating overall plan Star Ratings are a game changer for MA plans’ engagement strategies. These changes make the importance of each member’s relationship with their plan all the more critical to understand and improve. Previously, outreach focused on driving specific member actions to complete screenings, refill prescriptions or control a chronic condition. CAHPS measures making up over 50% of the 2023 Star Ratings measurement weights will mean that outreach should shift to measuring member experience and coordinating interventions based on their responses. Rex reminded the audience that one of the most important factors in member satisfaction and experience is what happens during provider encounters, which has traditionally been a blind spot for most plans. Chris and Rex said targeted and two-way outreach to gain insight about those blind spots is a great first step to incorporating the new CMS rule into engagement strategies.