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:
1. UNDERSTAND WHAT MAKES MEMBERS HARD-TO-REACH
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 meaningful. But the area that Chris and Rex explored the most was the members who simply did not trust their plan.
2. TRUST IS CRITICAL
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.
3. DESIGN PROGRAMS TO BUILD A RELATIONSHIP WHILE DRIVING THE OUTCOME
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 two–fold 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.
4. MEASURE TRUST AND MEMBER EXPERIENCE
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 qualitative. First, 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.
5. MEMBER EXPERIENCE MEASURES CREATE NEW PRIORITIES FOR HARD-TO-REACH ENGAGEMENT
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.
