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Key Takeaways from AHIP: Conversational Member Engagement Session

mPulse Mobile is a leader in conversational AI solutions for the healthcare industry. We work with 100+ healthcare partners and have deployed over 300 million messages to healthcare members. mPulse’s CTO, Ram Prayaga, sat down with VP of Marketing, Brendan McClure at AHIP’s Consumer Experience & Digital Health Forum 2020 last week to discuss how we execute Conversational Member Engagement: Data, Experience, and Outcomes. Here are our key takeaways:

Orchestration of AI Conversational Engagement

At any given time, plans have multiple departments that are prioritizing topics of interest for their members, so how does a plan coordinate those touchpoints and maintain a relevant member-centric strategy? The answer is data. Plans that utilize the data collected from conversations and interactions with their members and leverage tools that incorporate that data to tailor content and frequency will be more successful at reaching large populations with an approach that meets each plan and member needs. While it may be difficult to curate messaging for each member, with an omnichannel and AI-enabled system, plans are able to implement tailored content and promote a more coordinated outreach cadence for each member or population segment.

How do Plans Gather Conversational Engagement Data?

Although conversational data is a newer type of data, it has become a valuable tool when reaching out to members at scale. Brendan mentioned in the session that insights from conversational outreach can be used in a number of ways to “Give the plan an important read on experience.” A plan can analyze member responses to understand sentiment and intent, as well as see how members navigate through interactive programs to identify opportunities to optimize future outreach. Ram guided the audience through primary touchpoints that conversational engagement data impacts in the member experience. He talked through mPulse’s barriers assessment, which allows a plan to learn the why behind a member may not be meeting their health goal and the plan’s target outcome. He talked about mPulse’s analysis of sentiment and intent of member responses, which can scale from positive to neutral to negative, which gives a plan more data to tailor messaging and meet preferences. All of this information is gathered by engaging in a natural dialogue via interactive messaging – such as text messages – versus deploying a full off-cycle CAHPS survey, for example. The plan can also glean this experience data needed from conversations, rather than relying on survey questions asking the member for it directly.

How Can Plans Engage at Scale?

Utilizing artificial intelligence in text conversation allows plans to deploy messages to millions of members with  a more natural, conversational experience. In order to maintain a good connection with thousands of people at the same time, plans need to understand what people are saying, measure it and store that information for future touchpoints. Conversational AI, integrated with an omnichannel approach, is the perfect tool for that goal. Most members have access to a mobile phone and text regularly, including senior populations, but for the members who are most engaged through IVR, mailers, and other alternative routes of communication, plans will still need to consider meeting their members where they are. Adding an automated conversational solution can help support a multi-pronged communication approach to reach members in the channels they prefer with impactful dialogue.

How Do you Maintain the Human Touch?

The best engagement feels natural and easy for members. A simple act like listening to the members preference on the best time of day to initiate a conversation, or starting the conversation with content that is relevant to the individual will make a difference in the members response. How a plan manages members preferences is vital. When thinking about member-centric outreach, a plan can look at different ways to engage a member in a dialogue that listens versus putting them on a one way automated track. When we think about human conversations, we do not converse in a linear manner. Often times the conversation will jump from one topic to the other in a short period of time. A truly conversational solution should be able to listen to those pivots in the dialogue and accommodate its workflow to respond with relevant information that follows along with what the member is saying in real time. This means having a deep and well-indexed library of content for each conversational solution, as well as a thorough response-handling process – whether via Natural Language Understanding, or human support of automatically-launched programs.

Tailoring Outreach Once a Plan Has the Data to Work With

It is important to understand the challenges that members are facing, and then to target their outreach to address those barriers. Making sure to account for the hard-to-reach members in any population is vital to the approach as well. Outcome data that shows what works and what does not within certain demographics based on their SDOH impact gives the plan more insight into how to build trust within that plan-member relationship. For example, if a plan only reaches out about its benefits to their members right before they need to renew their plan, it is much less effective and meaningful than had a plan been initiating those conservations all along. But if a plan engages in those conversations about what benefits may be a good fit for that particular member based on past experiences and their demographic, then when the time comes to renew, the member is more likely to trust and value the reminder because the plan has shown to have their best interest at the core of their outreach. The member will feel more compelled to stay because they know they can rely on their current plan to address their immediate and long term needs. Maintaining the trust between plan and member is probably one of the most valuable ways conversational data can help impact the plan-member relationship.

COVID-19’s Pressure on Digital Experiences

Plans were forced to evaluate and evolve their digital outreach approach quickly with the onset of COVID-19. For a lot of plans, they had to adopt strategies to pivot into virtual care as quickly as possible. They also had to provide additional resources to help their members navigate through virtual platforms that they themselves may have been adjusting to. When a plan is able to curate a digital journey, they have an opportunity to build awareness around solutions that are relevant to members specific needs. Curating the journey helps hold their hand, helps them navigate a new digital landscape in addition to sustaining the relationship. During the pandemic, mPulse positioned the need for digital therapy to our client’s members suffering from social isolation. Before initiating an ask to the member to engage in the program, we communicated the value. This strategy was effective because we were able to educate around the need for digital therapy and gauge the members interest, which gave the member the opportunity to come to the plan on their own instead of pushing them to sign up for a new virtual care program.

As we look ahead to 2021, what we have learned in the past year and throughout our most successful programs, is that trust between member, provider, and plan is crucial, especially as we transition through one of the most pivotal moments in healthcare. But the better prepared a plan is to respond to members and their immediate needs that also doesn’t burn a lot of resources on the plan’s end, the better relationship between member and plan will be. Focusing on approach, collecting all data from those use cases, and keeping the member at the center of all strategic communication is key.

Key Takeaways from the 6th Annual Star Ratings and Quality Assurance Summit

mPulse Mobile’s Government Programs Strategic Market Executive, Reva Sheehan, had the opportunity to discuss Member Engagement, Now and Post Pandemic, at the 6th annual Star Ratings and Quality Assurance Summit alongside Noreen Hurley, from Harvard Pilgrim Healthcare, and Bill Gaynor, from Change Healthcare on Wednesday December 2nd. During their discussion they reflected on how plans engaged their members at the early stages of the pandemic, but also what worked well and what is here to stay as we move into 2021.

The Pandemic’s Impact on Member Engagement and How It Changed Some Processes for the Better:

The pandemic highlighted many longstanding member engagement challenges and created new ones. Health plans had to think about services and resources that were impacted and how to communicate with their members as quickly as possible. An omnichannel approach was crucial in deploying messaging for many health plans that needed to reassure and inform members quickly. Information regarding COVID, CMS changes that affected members access to care, telehealth services, and impacted resources and  programs were all vital pieces of information that members welcomed and appreciated. Plans relied heavily on the communication channels and strategies they knew their members would engage with, and adapted as the situation and member engagement levels evolved. As we look forward to 2021, plans will need to continue to double down on the channels their members respond to at scale so they are able to meet the challenges of the next phase of the COVID-19 pandemic.

Using Data and Internal Agility to Adapt to Member Needs

One of the panelists Noreen Hurley, from Harvard Pilgrim Healthcare, shared how the situation at the beginning of COVID-19 forced their team to look inwardly at their own operations. “Urgency drove us to some internal coordination and to look inside our own organization and find what resources, what technology, we can use…to smash through the silos and reach as many people as we can quickly.” At mPulse, a major concern for our customers centered on getting member feedback and data quickly, to make better decisions in an evolving situation. Collecting engagement data, member responses to outreach, and analyzing member sentiment and intent all helped get actionable feedback to plans that were trying to understand how best to reach at-risk or underserved populations.

Noreen also noted that plans had to constantly monitor their engagment efforts and change strategies quickly. In mPulse’s case, we had deployed our COVID Rapid Rollout toolkit but still had to adapt as programs launched as stay-at-home orders extended beyond the original three-week timeline. We also experienced a higher need for social isolation education solutions which addressed the need to stay active, as well as resources for easily accessible healthcare options. mPulse deployed several solutions to address what we thought would be the need for COVID-19 related challenges and needed to pivot quickly when some solutions become more important than others.

Member Engagement Will Become Personal

A number of factors are converging to shift member communications further away from a one-size-fits-all strategy for Medicare plans. The emphasis on CAHPS as part of Stars going forward means that every member touchpoint, no matter how transactional, needs to be assessed through the lens of member experience.  Just as there is no copy-and-paste solution for gaps in care or med adherence, plans will have to think about what will work best for their specific member population when it comes to experience-focused engagement. No matter what population you’re looking at, personalizing content to make it relevant and useful to the individual member is always important. Technology is helping plans to pull in real-time data on experiences and sentiment and member interactions with providers, pharmacies, member services, etc and build a better picture of what their happy and dissatisfied members look like. This allows them to tailor content and align resources where they can make the most potential impact.

Placing members in context is vital in ways that go beyond CAHPS scores. For example, even with the newly added accessibility to telehealth, many members still faced language and technology resource barriers that made it nearly ineffective for hard-to-reach members to manage their care virtually. A generic “sign up for our telehealth portal” email or text message would have resulted in frustration or inaction for those members. So gathering those barriers up front via conversational outreach, and tailoring follow-up with education and support resources to help overcome them was crucial for many of mPulse’s clients’ telehealth success in 2020.

A Vaccine and 2021 is Right Around the Corner. What will Plans do Differently to Improve Member Engagement?

Aside from OEP and the more-normal member engagement strategy that plans will be rolling out next month, plans face the challenges of vaccine communication and navigating another Stars Measurement Year that will be impacted by the pandemic.

A vaccine will take time to distribute to the general public and the lines will be long when it gets here. Plans will need to focus on continuing education around the fallout of the pandemic, vaccine distributions, and what regulatory changes will mean to member’s health management. Educating members swiftly and timely must remain a permanent change within the industry. Using data and insights about what worked and what did not during 2020 will become necessary when planning future communications. So will having tools readily available to collect new data and adapt as the vaccination effort continues. Plans need to show members that their health plan is listening, concerned with keeping them healthy, and ready to address whatever the new year presents.

One key strategy we’ve seen throughout COVID-related outreach is the success of quick, actionable touchpoints with members, supported by richer educational materials when necessary. mPulse is already adopting this strategy for communication about vaccines and the FAQs that will be vital to driving vaccine uptake in large populations. We use data and member responses to tailor content to different personas – from “ready and willing” members who just need to know when and where to go get vaccinated, to “unsure and uneasy” members who need more information from authority figures and richer content to help drive them to act. We think this approach is vital, as polls continue to show a very divided population when it comes to attitudes around the vaccine heading into January.