Request a Demo

Improving the Patient Experience: Solving the Top Four Healthcare Challenges 

Patients are currently going through a transformation in the healthcare system. They are less like the patients we’ve always known them to be and are starting to act more like consumers. And what is the primary trait of a consumer? Choice.

Patients today are fully fledged, active participants in their own healthcare and are making choices between different services and providers the way they make choices between brands. This changing dynamic requires that the healthcare system makes that shift right along with them. The goal of physicians, health systems, and accountable care organizations should be to ensure the patient’s experience is personalized, relevant, and on par with what they have come to expect from consumer experiences in all areas of their life. There are, however, some common challenges that we see healthcare organizations grappling with while moving toward this new normal, which can only be solved with the right mix of expertise and technology. But they can be solved for—with the result being a more valuable patient experience and relationship.

HealthCare is Challenging 

It is. And these challenges are pervasive across many organizations we work with. We’re talking about gaps in Data, Technology Capabilities, Engagement Strategy, and Organizational Alignment. 

Let’s dive into each one.

Data Gaps 

Do you have the right cell phone number? Do you know if the number you have is even for a cell phone? Is it a land line instead? Do you have the correct contact preferences? Do you have information on their social determinants of health (SDoH) and the barriers to care they’re facing? This data can make all the difference when outreaching to patients and attempting to drive them to a specific action. How can you reach out to someone if you don’t have the right number? How can you affect someone’s behavior if you don’t understand their circumstances?

Solving for Data Gaps 

In all aspects of your outreach, you need to be data driven. This starts with the ability to collect and harness your data. An SDoH Index like mPulse Mobile has is the kind of data that allows you to tailor conversations to a person’s circumstances. Specific capabilities, such as two-way automated conversations, allows us to understand what people are doing and why they’re doing it. By being able to ask people directly and receive an answer, we can take that information, record it as data, and do analysis on it to identify trends. The most valuable insights you can have will come directly from your patients themselves. Of course, this can only be done at scale with the right technology.

Technology Capability Gaps 

Having all the data in the world is little help if you don’t have the technology to use it at scale. You might be deploying one way messaging programs, which means you aren’t collecting information back from your patients to help personalize the conversation and further improve your interactions with themand forget trying to do this on a 1:1 basis without the ability for your technology to automate these conversations.

Solving for Technology Capability Gaps 

Conversational AI and Natural Language Understanding are two important foundational capabilities that can help close this gap. Conversational AI ensures you can tailor your conversation to the individual you’re speaking with, making it more likely you’ll connect with them and drive the desired action. With National language understanding, we can communicate with patients in a way that feels familiar, conversational, and natural. You get at the intent of what your patient is saying and account for humanness (such as typos or slang). At mPulse, we have linguists and computer programmers on staff who work together to come up with scripting that can interpret different combinations of languages, typos, and slang to get to the intention.

Gaps in Engagement Strategy 

Maybe you do have the means to connect with your patients with two-way automated conversations. But are you saying the right things? Are your engagements tailored and optimized to ensure maximum outcomes? How often are you messaging? What’s the tone? Do you have a team dedicated to refining all these different aspects of your strategy?

Solving for Gaps in Engagement Strategy

When you understand how people think and make decisions, you can craft your outreach in a way that predicts their response and uses that prediction to nudge them in the direction you’d like. This is the reasoning behind the behavioral science techniques we bake into our solutions. Humans are fairly predictable, and we mostly react the same. Let’s use that predictability to push them toward healthy behaviors! Many behavioral science techniques are used to build our programs: cognitive overload could determine the pacing of our program; authority bias may dictate who we have giving the information; and storytelling effect could dictations how we give the information;

Don’t know what these behavioral science techniques are? Watch our on-demand behavioral science webinar series to learn how they can transform your engagement strategy! »

Gaps in Organizational Alignment 

Your patient has gotten your messaging, they’ve made the appointment. Now, are you guiding them through transition of care in the most effective way possible? For example, ensuring they’re scheduling an appointment with a PCP after an ER visit.

Solving for Gaps in Organizational Alignment 

The goal is to produce trust-building patient experiences consistent across the entire experience with a brand. For this, we have enterprise engagement, which allows us to handle the scale necessary for organizations which can have 100,000+ patients.

We need experiences consistent across that member base while also personalized to match each individual’s needs. That’s a tall order. And this comes back full circle to data and technologyboth are needed to ensure this patient experience is protected.

The New Normal

Digital trends are changing the game. Patient expectations are changing the game. The choices they have and the experiences in everyday life they’ve grown used to are creating new rules of the road in healthcare. As it should. We have technology in the market today that allows these experiences to be exceptional, so why should they (and we) settle for anything less? 

2023 Star Ratings Update: Digital Engagement’s Role in Closing Diabetic Care Gaps

38% of all eligible Medicare Advantage plans saw a decrease in the Diabetes Care – Kidney Disease Monitoring measure performance from 2022 to 2023 Star Ratings. The year 2022 marks the final measurement year for this measure, with Kidney Health Evaluation for Patients with Diabetes (KED) being the proposed replacement. Acknowledging this, plans are uniquely positioned to raise performance scores and improve kidney health for diabetic members using digital health engagement solutions for condition management as they prompt their member populations and provider groups to manage a new measure.

Kidney health evaluation for patients with diabetes

The Kidney Health Evaluation for Patients with Diabetes (KED) is a newer HEDIS® measure that tracks the percentage of adults with diabetes who have been screened annually for kidney disease.

The measure includes two components:

  1. A urine albumin-to-creatinine ratio (uACR)
  2. A blood test to determine the estimated glomerular filtration rate (eGFR).

This measure is important because it can screen and diagnose kidney disease, and early detection and treatment can help prevent or slow down its progression.

Interested in closing this gap? Learn more about our Diabetic Screening Solution.

While this change intends to provide a more accurate and comprehensive assessment of a member’s kidney function, preventing downstream complications and risk, it presents a behavior change challenge for Medicare Advantage plans as improved health outcomes also support better Star Rating performance.

One way members could satisfy the previous measure requirement was via a urine test in the comfort of their own homes. Now, they will likely need to visit a lab or their healthcare provider to also complete the blood test, which can be inconvenient, time-consuming, and, sometimes, intimidating, potentially impacting member compliance and overall plan performance. Routine in-clinic lab work requires behavior change that can be nearly impossible to achieve without strategic intervention.

A multichannel engagement solution to activate diabetes patients

Using a multichannel digital engagement solution that leverages tailored conversations intentionally crafted with behavioral science to activate members is proven to empower members to overcome barriers and get tested.

Rooted in neuroscience and psychology, behavioral science uses cutting-edge techniques proven to empower and inspire members to act. As a matter of fact, a leading Medicare Advantage plan saw an 18% lift in members taking action when behavioral science was used in SMS messaging in mPulse programs versus when it was not.

Here are a few examples of behavioral science principles that mPulse incorporates into messaging to inspire member self-efficacy:

  • Social Proof: Highlighting that a member’s peers are undergoing the exam can increase the likelihood that they will schedule their appointment.
  • Loss Aversion: Highlighting the potential negative consequences of not undergoing the exam can motivate members to take action.
  • Default Bias: Making the in-person exam the default option for members can reduce the effort required to schedule the appointment and increase compliance.

Education is critical in activating and empowering members to complete a desired health action. Streaming a captivating piece of healthcare content or even a link to an existing resource can help educate members about why going in-clinic is a better way to monitor their diabetes, driving sustainable behavior change in combination with behavioral science-backed dialogue. That’s why Streaming Content and Instructional Strategy make up one of mPulse Mobile’s proprietary engagement strategy pillars.

Our team of instructional strategists and healthcare industry experts creates compelling learning experiences to close gaps in healthcare inspired by trends from consumer products and aligned with key STARS measures, like Diabetes Care – Kidney Disease Monitoring. Streaming educational health content and messaging are developed alongside thought leaders and industry experts to ensure members feel empowered, inspired, and informed to take action to improve their health and health literacy.

In fact, mPulse observed a 274% increase in retinal eye exam completions when streaming content was used in SMS versus when it was not. Powerful right? The data speaks for itself.

While the addition of a blood test to the Kidney Disease Monitoring measure presents a challenge for plans, an omnichannel digital health engagement solution utilizing behavioral science strategies and streaming content can successfully drive members to receive the necessary care, improve the overall member experience, and improve measure performance. At the end of the day, everybody wins!

The Return to Normal: Medicaid Redetermination Edition

By the time the end of March rolls around, we will have seen just over 1,100 days of continuous Medicaid and CHIP enrollment. Federal guidance within the 2023 Consolidated Appropriations Act effectively decoupled continuous enrollment provisions from the Public Health Emergency (PHE) and will allow states to resume their redetermination process as soon as April 1st. 

Most states and many plans have already completed the first phase of the unwinding by encouraging enrollees to update their contact information to ensure they receive their renewal paperwork when it arrives in the mail. And while most all of us reading this piece are well aware of where we’ve been over the last year and what the next one might look like, a recent Urban Institute study in December 2022 found 6 in 10 adults in Medicaid-enrolled families were not aware of an upcoming return to the regular Medicaid renewal process.

You’re probably thinking, “How is this possible? It’s all we’ve been talking about and planning for months and months!” Well, maybe we shouldn’t be so surprised. Medicaid/CHIP enrollment increased by 20 million individuals since February 2020 accounting for nearly 30% of all covered lives. That’s 20 million individuals who likely have never completed a traditional or pre-pandemic redetermination and three years since the last time everyone else has. Lest we forget a lot has changed and occurred over the last three years in general.

Stats and surprises aside, we still have a long road ahead of us and a lot of work to do. Thankfully our regulatory friends like CMS and the FCC have stepped up to help keep individuals from slipping through the cracks. CMS has provided a strategic toolkit calling for states and plans to work together in timely sharing of enrollment data and contact information, for states to expedite content approvals or provide pre-approved language for member outreach, and for enhanced processes for moving individuals who no longer qualify for state-based programs to marketplace offerings. The FCC’s recent declaratory ruling that clearly states the provision of a phone number on an enrollment form constitutes as express consent allowing federal and state agencies and their partners to make Medicaid enrollment calls and send text messages without violating call or text prohibitions. Plans should take full advantage of the resources provided to them by incorporating each toolkit and clarified regulation into their overall member engagement strategy.

Learn more about outreach strategies for the end of continuous enrollment by viewing our redetermination webinar series featuring Kaiser Permanente and Mostly Medicaid »

Key Engagement Factors for the Return of Redetermination

Now let’s talk engagement strategy. Most plans will be using CMS or state-approved content and timelines are tight, so there may not be as much room for the creativity we see when dealing with other engagement topics like closing gaps in care or encouraging timely rx refills. That doesn’t mean, however, that you can’t still take a strategic approach in areas where you can still have an impact, such as channels, personalization, and branding. 

Channels: We know one single communication channel isn’t going to be enough, and it’s just not how people are consuming information or connecting to resources. Adult Medicaid beneficiary smartphone or tablet ownership rates are similar to the general US adult population, and 47.4% of dually eligible Medicare beneficiaries report using the internet to get information. An effective and successful engagement strategy is delivered through multiple channels by combining digital outreach like SMS and email with traditional modes of communication like mail and phone calls. mPulse is currently working with over 30 Managed Care Organizations across more than 20 states within different phases of their redetermination efforts to support engagement on all channels and channel combinations.

Personalization: After selecting your channels, be sure the messages you are sending are personalized and relevant to the member. Even if you are using pre-approved language for your redetermination outreach, make sure your salutation and any other merged fields are in the proper case and not all caps. Even an Excel novice can easily convert cells in all caps to proper case by applying a =PROPER formula to your selected cells. Proper case is easy, but what about language preferences? Reaching your Limited English Proficient (LEP) members can be difficult, especially when you don’t know who they are or what their preferred language is. For example, mPulse technology allows for you to go beyond typical language challenges or compliance required taglines by automatically transitioning between English and Spanish in our two-way SMS conversations.

Branding: Brand awareness and recognition leads to trust. You want your members to automatically know who all messages are coming from so they will not only trust it but also complete the desired request or action. Consider other communications that may be coming from your organization around the same time and coordinate your naming conventions to maximize brand awareness. Help get your brand on the right side of the inbox or in their known contacts by encouraging your members to store your phone number or SMS short code on their device or enhance those efforts by deploying mPulse Virtual Contact File (VCF) messages. 

The New Normal for Medicaid

The return to normal, or rather the return to the new normal is here, and there is no slowing it down. This is still uncharted territory with a lot of work yet to be done, but if we have learned one thing here today, it is that working together, maximizing resources, and leveraging technology to provide a personalized member experience will be the key to successful redetermination efforts.

For more insights into how to deliver this experience to your medicaid population, view our on-demand webinar series for Redetermination.

Health Equity, Part 1: How Can Digital Engagement and Conversational AI Promote Health Equity?

When COVID-19 overwhelmed our nation’s healthcare system, a stark reality emerged: health inequity. As people of color experienced a disproportionately high burden of COVID-19 cases and deaths, highlighting a gap in our system, the topic of health equity surfaced across public health agencies, policy makers, healthcare systems and providers, and employers alike, and the possibility of digital health solutions bridging these gaps and make quality healthcare more accessible came to the forefront. 

To promote health equity, it is vital to begin with a universal definition. The Centers for Disease Control and Prevention defines health equity as “the state in which everyone has a fair and just opportunity to attain the highest level of health.” Achieving this aspiration requires uplifting communities that have been minoritized and excluded and promoting affordability and accessibility to quality healthcare and other social services. First, let’s start by looking at equity and how it is different from equality.

Equality vs. Equity: The Road is Long 

While these terms may sound similar, equality and equity are not synonymous! Creating equitable solutions over equal solutions has the profound impact to uplift marginalized populations. 

Imagine that you must go five miles down the road. In an equal society, everyone who needed to travel this distance would be given the same bicycle. What determines who makes it down the road and who makes it quickest?

  • Personal conditions, such as their biking skills, what they are carrying, and whether they have the ability to pedal with their feet.
  • Circumstances of the environment such as whether the road is bumpy, inclined, or flat.

In an equal society, while everyone may have a bicycle, they are not truly equipped with the resources they need to succeed

In contrast, in an equitable society, everyone is set up to reach the end of the five miles at the same exact time, regardless of conditions. In a scenario of equity, each person has a bicycle that has been developed for their unique needs, such as a motorized vehicle for wheelchair users or a bicycle with more traction to endure the bumpy roads.

Visualizing Health Equity: One Size Does Not Fit All Infographic
Robert Wood Johnson Foundation, 2022

When it comes to healthcare, the same logic follows: a uniform approach will not work across populations. True health equity will require providing each member with the tools they need to overcome barriers and ultimately achieve their highest level of health. There are a few key digital engagement strategies that can be especially effective in addressing health inequities among member populations. 

Streaming Health Content

diabetes eye exam streaming health content in SpanishHealth illiteracy is one of the biggest barriers to equitable healthcare, and in response, streaming health content is an effective method for health literacy promotion. It borrows from the best of digital content strategy, behavioral science, and instructional design to create powerful learning experiences to address health literacy barriers in a consumer-friendly format and to encourage hard to reach members to take control of their health outcomes. Instead of telling people what they need to do, we are educating them on why it’s important, which serves to develop intrinsic motivation to get care and take healthy actions. Everyone has the knowledge needed and everyone can make health decisions with all the information available.

Interested in learning more about our approach to health literacy? Register for Activate2023: Designing Customer Journeys for Health Equity »

Conversational AI and Natural Language Understanding

With the use of artificial intelligence, conversations can be programmed to understand responses in any language and intelligently respond in that same language. It can also allow plans to respond automatically to barriers created by inequitable circumstances, such as transportation, cost, or health literacy issues. Then it can provide real time solutions to move the member forward toward the desired action. This serves to create more equitable health experiences for those members who aren’t starting on a level playing field.

Social Determinants of Health (SDoH) 

Research shows SDoH have a greater impact on health and well-being than medical care. This is because where a person lives, learns, works, and plays can affect their health in many ways. There are many non-medical factors that affect health and wellness:

  • Economic Stability: employment, income, expenses, debt, medical bills, and support 
  • Physical Environment: housing, transportation, safety, parks, playgrounds, walkability Education: literacy, language, vocational training, pre-schools, higher education 
  • Food: hunger, access to healthy, affordable options 
  • Community: social support systems, community engagement, discrimination, stress 
  • Healthcare System: health coverage, provider access, provider cultural competency, quality of care

These factors commonly overlap to affect health outcomes (health status, mortality, and morbidity).

Technology can bridge the gap created by SDoH. At mPulse mobile, we believe SDoH can be addressed directly using disaggregated data, which ensures representation of marginalized populations. We created a proprietary SDoH Index which leverages a weighting system to maximize its predictive ability. Factors such as food insecurity, transportation access, neighborhood, and environment are taken into account for each individual member to provide a more tailored, relevant, and empathetic conversation.

Bridging Gaps: Our Commitment to Equitable Health

Digital interventions can also be a powerful tool to bring communities together during a crisis (such as quick response to the COVID-19 pandemic), spread education, send interventions in multiple languages, and find different ways to get people the resources they need.

The digital platform can be used to spread health education in engaging ways (e.g. videos, courses), utilizes behavior science to break down fears and misinformation, and uses a multicultural lens to provide multiple languages and ensure cultural sensitivity. Together, this technology can bridge inequities early on, and in turn, can help mitigate preventable, deadly health consequences. 

Ultimately, we aim to close gaps in care and eliminate preventable health disparities by integrating health equity competencies across all of our work, and allow all people a fair and just opportunity for the highest level of health.

To learn more about the impact digital engagement can have on health equity, register for Activate2023: Designing Customer Journeys for Health Equity.

Delivering Equitable Health Experiences Among Medicaid Populations

Earlier this month, four of mPulse Mobile’s best and brightest subject matter experts packed up and headed to sunny Florida to attend The Strategic Solution Network’s (SSN) 14th Annual Medicaid Innovations Forum. A huge topic of conversation was, not surprisingly, the FCC’s Declaratory Ruling on phone outreach for redetermination. Released in late January, this ruling opened the door for plans to utilize texting in their efforts to maintain coverage for millions of Medicaid members. 

Texting, however, has always been a big topic of conversation for us. 97% of US adults own a cell phone, and it seems everywhere you go people are glued to their devices. That is what makes SMS texting such an incredibly effective tool to add into your mix of channels. We spoke about just that during our session at the conference. 

Healthcare Experiences Powered by Technology

For that session, Reva Sheehan, mPulse Mobile’s Senior Director of Customer Insights, had the opportunity to present onstage with Sammie Turner, Quality HEDIS Manager for Maryland Physician’s Care. Maryland Physicians Care, a customer of mPulse Mobile and the third largest Managed Care Organization in the state of Maryland, administers healthcare services to Maryland’s HealthChoice enrollees. 

Maryland Physicians Care and mPulse partnered together to deploy a two-way SMS text campaign targeting multiple preventative care screenings, including Breast Cancer Screenings, Well-Child Visits, SSI, and Lead Screening in Children, and we delivered the results of that program to the audience.  

With reach rates ranging from 83% to 95%, we were able to target and communicate with thousands of their customers. The main metric we wanted to observe, however, was the success of texting compared to outbound calls. Is texting a more effective method of outreach to obtain scheduled appointments?

We focused on breast cancer screenings and found strong evidence that it was. After 30 days of outbound calls, 123 breast cancer screenings were scheduled. But with the texting program, we found that we were able to schedule 94 screenings in just four days.  

The texting program was able to get 76% of the screenings scheduled that outbound calling did in just a fraction of the amount of time and did so without the manual work of call center representatives. 

But why is this so? How is texting, which may seem less personal, able to have so much success so quickly?

Three Core Capabilities for Texting Outreach

Texting allows us to reach a large population in a single event and assists in reducing the volume of outbound calls and or letters. If you have the right technology powering your texting program, however, it turns into more than just a text but into a dynamic two-way conversation that can be used to connect with a member, break down barriers to healthcare, and deliver better outcomes.  

There are three core components that enabled this experience for Maryland Physicians Care’s members: two-way text capabilities, natural language understanding, and educational content. 

Two-way Conversations Identify and Address Barriers to Care 

When you have dynamic, interactive conversations with your members, you truly address the barriers they face when trying to get care. Lack of transportation, inability to get time off work, cost, and other factors all play a role in creating an inequitable health experience.

When a plan has the technology to have a real conversation with its members at scale, it can not only identify the reasons members aren’t scheduling screenings, but it can take it a step further to provide solutions and education for the member, such as helping them find a doctor like you see in the example below from Maryland Physicians Care’s program. When the door for care is opened a bit wider for one person, it makes the healthcare system a little bit more equitable for all.

Interested in these capabilities? Learn how these same concepts can be applied to outreach around the end of continuous enrollment » 

Natural Language Understanding and Culturally Appropriate Content 

Natural Language Understanding (NLU), a type of artificial intelligence, is the ability for our system to interpret the responses from the member (even if they are non-standard responses or slang) and respond back in an intelligent manner. mPule Mobile’s NLU is available in 7 languages with translation services for 13.  

One example of NLU in Maryland Physicians Care’s program focuses on creating a more culturally sensitive experience. For this program, the two-way SMS content automatically converted from English to Spanish if the member responded in Spanish. Their language preferences were then reported back to the plan for future interactions. The ability to communicate with your health plan in the language that you are most comfortable with makes it much more likely that they’ll keep communicating and take the desired action.

Leveraging Educational Content to Promote Health Literacy 

One thing we all know is how vital health literacy is to the concept of health equity. The ability to understand not only the care system, but your own body and healthcare needs is critical.  

Videos can leverage educational content to help overcome barriers and inspire action by delivering bite-sized stories and entertainment straight to the member’s phone during a text exchange. The below example was used for a diabetes eye exam program run with a large national health plan. There was a 274% increase in link clicks to scheduling when this video was used in the text outreach vs when it wasn’t.

Equitable Healthcare for All 

The dynamic conversational engagement used by Maryland Physicians Care enabled them to reach more members and deliver tailored resources and calls-to-action to empower members to act and deliver better outcomes at scale. When each member has the opportunity for a personalized and relevant conversation about their health with their plan, they’re receiving a more equitable experience.  

Interested in these capabilities for a redetermination program? Learn how these same concepts can be applied to outreach around the end of continuous enrollment!