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Key Takeaways from RISE West and the mPulse Mobile Roundtable

During the RISE West conference earlier this month, there were a lot of conversations about the changes that face healthcare in the new year. 2020 brought on a lot of changes to CAHPS measures and weighting that will not only affect the new year, but transform the way Medicare plans will be evaluated and rewarded for the foreseeable future. mPulse Mobile focused on 4 strategies to prepare for 4X CAHPS ratings during our roundtable at RISE West, and it fell in line with what the conference presented overall. Here are our takeaways from the event both the roundtable and the conference.

Focus on Creating a Relationship

Plans will need to keep up with the changing quality guidelines, including the change of CAHPs survey scores to 4x weighting. Everyone knows running a successful Stars program has always been more of a marathon than a sprint. Plans do everything they can to improve member experience and health outcomes on a daily basis, year over year, in an effort to maintain and attain high performing status. It comes as no surprise, COVID 19 has thrown a wrench in those plans and now the marathon has become a decathlon – hurdles around each corner, new sprints to the finish, jumping over and through an ever changing regulatory landscape while throwing everything you have left at anything you can hit.

What’s interesting about these changes are how plans will have less focus on traditional priorities as they are weighted differently. The opportunity here is to think beyond traditional HEDIS and medication adherence improvement strategies and deploy solutions that will engage members in a way that builds a rapport between member and plan or provider.

Creating new touchpoints with members where they can respond and feel heard is critical. mPulse uses automated “check-in’s” and follow ups after customer service interactions to create scalable conversations with members. By listening to member responses and answering back, we both gather key data and give members a chance to have 2-way interaction with their plan on their terms.

In the roundtable, we noted that all of those best laid plans for 2021 Stars don’t have to fail or be seen as all for naught. Even though CMS has recycled last year’s CAHPS and HEDIS rates for 2021 Stars, the hard work and efforts put in over the last few years are likely still improving member experience and health outcomes, it just won’t be displayed as such on Medicare Plan Finder.

Be Proactive

Engaging members about their experience with their plan via automated message helps gather necessary data to respond to the member, but also provides an opportunity and touchpoint to share good news about plan changes. Sharing new information that may affect the way the member interacts with their plan will build trust and help further establish that onboarding process that will lay the groundwork for future conversations. A proactive approach around potentially negative news or changes helps eliminate surprises for members who may not be otherwise aware of a formulary change until they get to a pharmacy.

Act on the Experience Data You Have

2021’s changes require MA plans to listen to what members are saying more than ever before: the good, the bad, and the in-between. Taking stock of every member touchpoint and the data it generates is key to tailoring communication with the member. And while plans usually think of experience information as call center or appeal/grievance data, virtually any information the plan has can be used to create a meaningful interaction or make an existing one more impactful. Just member date of birth and date of joining the plan create opportunities for birthday reminders, health plan anniversaries, or milestones and shows that the plan is interested in the member. mPulse takes member responses to surveys or automated outreach and applies sentiment and intent analysis. This takes a strong initial data point and enriches it so that the plan can see, for instance, how members respond to gaps in care outreach, as well as those who are consistently negative or positive in their interactions with the plan. And by building personas around trends in experience data, plans can better predict “look-alikes” who may be more likely to have a neutral or negative opinion of the plan but have not filed a grievance or complaint.

Understand the Member Experience Impact of Telehealth

Plans can implement CAHPS improvement strategies and customer service operations to optimize member experience around digital care. The last six months have essentially forced beneficiaries, carriers, and providers to embrace innovations and technology. Now there is a need to improve member experience with digital and remote care and how its value is communicated to members. Plans who engage and support their membership through this new and ever evolving space will come out on top. It takes more than just letting a member know they have coverage for telehealth visits, it takes an extra effort to educate and encourage them. Creating interactions where members can share barriers, hesitations or concerns with telehealth will be key to an effective CAHPS strategy in 2021.

Plan for a Second Wave of COVID-19 and Strategies to Close Gaps in the Meantime

It is difficult to predict the lingering impact of COVID-19 in late 2020 and early next year. However, when plans begin to shift towards post-COVID strategies, they will need to remain agile and ready to accommodate shifts in public health guidance and CMS rules. In general, plans should not wait to encourage members to complete key preventive care visits and screenings if possible and stay adherent with medications. Knowing that more changes from CMS are coming, plans should continue both maximizing their performance now, and putting processes in place to be successful when Stars returns to “normal” and COVID-19 rule changes no longer protect ratings.

Plans who make an effort to build stronger connections with members and execute a deeper CAHPS strategy now will be more likely to see a successful Stars season in 2022. Since better relationships with members do not necessarily reset every measurement year, it’s also the area where plans can see the most value for their quality improvement efforts now.

The Challenges and Opportunity for Technology and Health Equity

We know that COVID-19 has amplified many underlying issues in healthcare and beyond. Health equity was already an important topic in healthcare, but COVID-19 has brought it into sharp focus as cases, hospitalizations, and deaths from the virus disproportionately impact disadvantaged groupsTechnology use in delivering healthcare is another long-time trend catalyzed by the pandemic, as millions were left with virtual care as their only option for the first time. Iseems apparent that these advances in technology use create the capacity to meet people where they are with information and care that is quickly and easily accessible. But it will take careful effort and consideration to ensure that access is improved for those that most need it in an inequitable system. And with new technology, there will also come new challenges and barriers that may not have existed in the past. 

Understanding Technology Across Segments 

At mPulse, we naturally look closely at technology adoption rates in healthcare’s most important populations. When we look at the disparities in technology use and access, they tend to line up with the negative outcomes we see in healthcare. Black and Hispanic communities have faced a disproportionately higher fatality rate than other races due to COVID-19 and suffer from higher rates of chronic conditions. The Pew Internet Research Center’s statistics show black and Hispanic communities more than twice as likely to be dependent on smart phones for internet access than white Americans. This means that they are more likely to rely on smartphones as their sole access to the internet, as opposed to a tablet, laptop, or desktop computer. Telehealth platforms that are optimized for desktop/laptop use and not mobile phones could disadvantage these groups disproportionately. Furthermore, populations who may not have access to stable and high-speed broadband in their homes would only be able to interact with telehealth that is mobile-optimized and can be supported on a cellular data connection 

Though smartphone dependency and internet access disproportionately impact minorities and low-income groups, mobile phone adoption presents an opportunity to connect hard-to-reach populations with tools and information to access and maintain their healthcare. Overall cellphone adoption rates in the US have converged across demographics, with Black, Hispanic, and white Americans equally likely to own a cellphone (over 96% of all adults do). So while internet and broadband-reliant technology may create new barriers hat must be overcome if telehealth is to become a long-term solution for improving access, engagement solutions that focus on cellphones have the potential to reach oft-neglected populations just as effectively as any other 

The role technology can plan to help address health disparities will be a key area covered by our keynote speaker – Dr. Gail Christopher- at our Activate 2020 virtual conference. Dr Christopher is the Chair of the Trust for America’s Health. 

Language Barriers: A New Version of Old Challenges

Telehealth and virtual care in general must be able to support multicultural and multilingual populations effectively. According to a poll from the Associated Press-NORC Center for Public Affairs Research, “half of these Hispanic adults age 18 and older rely on family or another health care provider to help resolve language or cultural difficulties in the health care system, while more than a quarter have relied on a translator, public resources in their community, or online sources for assistance. Understanding that language barriers in traditional care delivery may have been managed more than successfully bridged will be vital as systems and plans roll out new models. Beyond language, there can be significant cultural differences in attitudes and use of the healthcare system across populations.  mPulse has seen in cases with several multi-cultural populations that tailoring content to account for language as well as culture can be just as important as tailoring based off of health status or age. In cases like the COVID-19 pandemic, where organizations need their entire populations to understand important prevention and system navigation information, closing gaps between language and cultural groups becomes critical. Configurable and engaging content that can be fully adapted to different languages or populations, such as the fotonovelas we’ve used with some of our customers are just one example of the effort required to get key information to people in these diverse populations equitably.    

Preconceived Notions of Telehealth 

Studies have shown Black and Hispanic communities may feel more uncomfortable interacting with health professionals via camera and having facial pictures taken – practices that are common in telehealth appointments. This discomfort could be a factor for low engagement, or appointment no-shows. So while these two communities are likely to be among the most at risk for negative health outcomes, if they do not feel comfortable engaging with their plan in the new virtual or telehealth environment, they may be a lot less likely to move forward or seek out careBuilding trust becomes crucial. One of the advantages to the kinds of asynchronous and automated conversations that the mPulse platform supports is that the patient or member can engage on their own time and terms. Whether through solutions like ours, or other types of outreach, organizations should find opportunities to create meaningful touchpoints with the people they care for that do not initially require new technology navigation, app downloads, or unfamiliar forms of interaction. In fact, some of our leading plan partners have used mPulse as the primary means of driving awareness and adoption of their telehealth platforms. The key has been that members who are used to getting important and relevant engagement from our solutions about their benefits, medications, and preventive care, are being directed to telehealth by an established and trusted line of communication with their plan. Helping to meet members at their comfort level and introduce new technology with compassion and understanding will be vital to ensuring the widest access.  

How can healthcare achieve the triple aim of managing cost, access and quality of care when it comes to virtual care and other new technologies? How can we embrace connected health and the power of the Internet of Things when smart device use is not embraced or even feasible across all populations? And how can technology create opportunities to solve disparities and inequities in healthcare? These questions will take a central role as we move toward an end of the pandemic and the healthcare system reckons with its long-term impact on how we deliver healthcare in the US. And while we can’t always expect definitive answers, being aware of challenges and watching for opportunities is the first step to making that impact as positive as humanly possible.