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Avoidable & Unnecessary ER Visits: Emergency Room Diversion Strategies

Using the Emergency Department excessively is the fourth largest financial waste in US healthcare – it costs over $38 billion annually. Emergency departments are overwhelmed, and emergency physicians experience almost three times more burnout than other departments.

Health organizations are under increased scrutiny to lower non-emergent ER visits and implement solutions to encourage health consumers to seek the right level of care. Despite ongoing efforts and initiatives, emergency department overutilization continues to rise yearly.

Understanding and analyzing commonalities in ER utilization will enable deeper insight into how we can begin tackling this issue head-on.

Why do consumers go to the ER when it’s not an emergency?

There are many reasons why health consumers visit the ER. In more ways than not, the emergency department checks several boxes when it comes to convenience:

  • It’s open 24 hours, 7 days a week.
  • It offers patients immediate reassurance regarding their condition or ailment.
  • Patients receive a full range of services regardless of the severity of their condition or whether or not they can afford it.
  • Hospitals have financial and legal obligations to treat patients.

To deter consumers from visiting the ER, alternative care options need to become more accessible and outweigh the convenience of a visit to the ER. Shifting consumer paradigms is easier said than done, and health organizations need to adopt innovative solutions to educate and encourage patients to seek alternative care models.

Further consideration of commonalities in emergency room overutilization offers clues to designing solutions that address the why and offer insight into the how.

Commonalties in Avoidable or Unnecessary ER Visits

ER overuse is a nationwide issue with the highest prevalence among those who are uninsured or enrolled in government health programs, particularly Medicaid.

Nearly 53% of Medicaid members will have an avoidable or unnecessary ER visit this year. Those with health disparities are most likely to have an avoidable ER visit.

Risk factors include

  • being in a lower-income decile,
  • unemployed,
  • living in a single household,
  • less than high school educational attainment,
  • English speaking,
  • aged 27-54 or 65+,
  • limited internet access,
  • divorced or widowed,
  • female,
  • having a disability,
  • having one or more chronic conditions,
  • uninsured or having public health insurance, and
  • having limited or no transportation.

It is important to note that institutionalized and structural inequities cause these commonalities. Collecting data points and creating false attributions is easy; systemic racism and long-standing inequitable distribution of wealth and resources are to blame in this instance. Health organizations are taking responsibility for recreating a system in which diverse populations have greater access to the care and resources they need.

At the end of the day, health equity benefits all of us. Providing equitable opportunities for care availability and resources is foundational in lowering avoidable ER use, and understanding commonalities help address and overcome existing barriers.

The Difference Between Avoidable & Unnecessary ER Visits

There is an important distinction between the terms ‘avoidable’ and ‘unnecessary’ when it comes to the course of action and corresponding interventions needed for ED diversion.

For the purposes of this blog, avoidable ER visits are visits related to unmanaged conditions, such as diabetes or mental health/substance use disorders (MH-SUD). In fact, nearly 60% of all ER visits are from people with one or more unmanaged chronic conditions, with these individuals also having higher rates of ED recidivism.

Unnecessary ED visits are often due to a lack of accessibility and educational resources and typically account for visits that are urgent care or primary care treatable.

The top four ER diagnoses, in order, are as follows:

  1. Abdominal pain and digestive issues,
  2. Upper respiratory infections,
  3. Minor injuries, and
  4. Sprains.

Both avoidable and unnecessary ED visits require intervention; however, the methodologies and approaches vary. Healthcare isn’t one-size-fits-all, and meaningful behavior change requires personalization dependent on each consumer’s unique needs, preferences, and health status.

ER Diversion Strategies

Understanding why consumers seek care at emergency departments, coupled with commonalities in ER utilization, provides a deeper understanding of what’s needed to help support and educate consumers in seeking the right care for their health needs. The right education and support also depend on whether the ER visit is avoidable or unnecessary.

Education

Meaningful education incorporates behavioral science principles to motivate and empower behavior change. Simply telling a consumer they shouldn’t go to the ER unless they have to won’t work. Engaging with consumers in frictionless and meaningful ways requires expertise.

mPulse Mobile’s in-house instructional strategists, behavioral scientists, and health equity researchers develop cinematic streaming content experiences designed for optimal behavior change. Short-form content is designed to be relatable and educational, enabling consumers to realize the benefits of seeking alternative care.

See an example animation below.

Want to learn more about how streaming health content can drive behavior change? Download the complete guide »

Accessibility & Convenience

Providing personalized resources and support through frictionless calls to action will promote the utilization of better care options. Many health plans have resources available such as ride-share services and telehealth or nurse line providers for non-emergent cases. Despite these resources, utilization remains low, primarily due to a lack of awareness that they exist.

Engaging with members through an omnichannel approach, such as SMS, Email, and/or IVR, enables health organizations to meet their consumers where they’re at frictionlessly while providing accessible links to resources and support at their fingertips. When health organizations leverage innovative technology as a vehicle of communication with their consumers, engagement rates rise along with better health outcomes.

Avoidable ER Visits: Condition Management Solutions

Reducing avoidable ER visits begins with creating and maintaining meaningful relationships with health consumers. Because one size doesn’t fit all, understanding each consumer’s needs and preferences and their conditions and health status are crucial. mPulse Mobile creates individual member profiles in which each consumer’s protected data is leveraged to send tailored and relevant cadenced touchpoints. This becomes increasingly important for better condition management and medication nonadherence, accounting for billions in avoidable ER spending.

mPulse Mobile provides integrated and meaningful solutions for condition management, such as hypertension and diabetes, as well as MH-SUD and routine appointment reminders and scheduling.

Our solutions leverage an omnichannel engagement approach incorporating conversational AI and streaming content to educate and empower members to own their health while adopting healthier behaviors, including:

  • eating better and exercising,
  • regularly communicating with their care team, and
  • taking their medications as prescribed.

Educating consumers on where to seek the right level of care and providing resources and support are critical components of ED Diversion, but understanding individual consumer health needs and support will help health organizations reduce avoidable and unnecessary ER visits.

Visit mPulse’s condition management solutions to learn more »

mPulse Case Study

One of the nation’s leading health plans partnered with mPulse Mobile to lower unnecessary ER visits and redirect members to better, more affordable care options.

Goals & Execution: Automate and optimize digital communications to members using SMS text messages to redirect members identified as high-utilizers of the ER and provide meaningful messages and streaming content to redirect them to more appropriate levels of care.

A population analysis was performed to assess the intervention impact for members outreached. SMS messaging was deployed to engage and educate members to seek the right level of care for their health needs. A group of approximately 12,000 high-utilizers were enrolled in the program.

Results: 69.7% reduction in ER visits. Before outreach, there were nearly 19,000 total ER visits. Post outreach, that number decreased to under 5,700 visits. Assuming the average ER visit cost is $1,082, the program saved over $14 million in health plan and consumer savings during the program’s duration.

In Conclusion

Health organizations are uniquely positioned to engage meaningfully with their members and patients and have invested time, money, and resources into providing services conducive to bettering health outcomes.

mPulse Mobile is the leader in innovative digital engagement solutions and partners with 200+ leading health organizations to deploy over 1 billion conversations annually to inform, educate and tailor conversational engagement designed for health action across diverse populations.

 

To learn more about how mPulse Mobile can lower avoidable and unnecessary ER visits, lower costs, and improve health outcomes for your consumers, contact us to schedule a consultation.

Improving Maternal Health Outcomes with Digital Trends

Despite having a highly advanced healthcare system, the U.S. faces a concerning reality as it records the highest rate of pregnancy-related deaths among developed countries. Alarmingly, the maternal mortality rate surged by 40% in 2021 compared to the previous year. While part of this increase can be linked to the COVID-19 pandemic, it’s important to note that maternal mortality rates were already on an upward trend even before the pandemic struck.

Up to 60% of pregnancy-related deaths and adverse maternal health disparities in the U.S. can be prevented by

Proper preventive and continuity of both prenatal and postpartum care are imperative, and health organizations play a foundational role in improving maternal health disparities for our nation.

In an era where technology is pivotal in improving maternal healthcare outcomes, conversational AI in healthcare emerges as a key player. As the U.S. grapples with rising maternal mortality rates, integrating advanced conversational AI into healthcare strategies offers hope. This innovative technology can significantly improve maternal health outcomes by providing timely, personalized, accessible support to expectant and new mothers.

Our conversational AI solutions are designed to bridge the gaps in maternal healthcare inequalities, offering tailored guidance and vital information that can make a real difference in the lives of women during their pregnancy and postpartum journey.

In this article, we explore the transformative potential of conversational AI in improving maternal health disparities and reducing the alarming rates of pregnancy-related complications in the U.S.

The role of healthcare communication technology

Organizations continually lean on digital trends in an increasingly technology-driven world to drive growth and business efficiencies. 97% of U.S. adults own a mobile phone, and with generative AI platforms such as ChatGTP and social media AI photo filters becoming mainstream, we’re beginning to see the power and potential of healthcare communication technology.

But how does this tie into health organizations and maternal health? 

A lot more than you may think. mPulse Mobile has harnessed innovative technology and digital trends and applied them to the healthcare landscape to educate and empower health consumers to take action. We continually deliver best-in-class health outcomes by borrowing inspiration from the world’s most innovative digital trends. We create highly relevant and engaging digital health solutions experiences through:

  • Technology’s leading trends,
  • in-house learning and design experts, and
  • access to rich data and population insights

Our solution to prenatal and postpartum care leverages this expertise. It tackles the challenges associated with our nation’s poor maternal health outcomes, opening doors to accessibility, catering to care preferences, and building knowledge.

Maximizing mobile outreach with conversational AI to enhance maternal healthcare accessibility

conversational ai example for maternal health resourcesWe know 97% of American adults own a mobile phone, so leveraging this communication channel to reach more consumers is a great place to start. Scaling this resource requires automation, and to avoid abrasion, we lean on conversational AI and Natural Language Understanding (NLU) to direct consumers to the right tools and resources.

Step-by-Step Process to Enhance Maternal Healthcare Accessibility:

  1. Identify Nearby ObGyns and Clinics: Automatically send pregnant members a list of the closest ObGyns and clinics based on their residential location.
  2. Provide Easy Scheduling Options: Include a phone number for members to call and schedule their appointments easily.
  3. Recognize and Respond to Barriers: Utilize Natural Language Understanding (NLU) to detect if a member mentions a lack of access to reliable transportation.
  4. Offer Solutions for Transportation Barriers: In cases where transportation issues are identified, automatically respond with information about available resources that offer low or no-cost transportation options.
  5. Simplify Appointment Setting: Ensure the entire process, from providing information to addressing barriers, is streamlined to facilitate quick and easy appointment scheduling for members.

Addressing maternal health disparities with culturally competent and personalized solutions

conversational ai example relevant and relatable

The disparities in maternal health outcomes and the lack of representation and consideration for consumers who are disadvantaged by our health system are undoubtable and require prioritization. mPulse Mobile is committed to helping reduce maternal health disparities and inequalities by designing our programs to be relevant, relatable and address the needs and preferences of diverse communities.

Our pregnancy solution is culturally competent, with multilingual messaging, NLU tailoring, and inclusive replies and opt-outs (miscarriage opt-out, not saying “pregnant women”). For SDoH-level data, we factor in zip codes to deliver relevant resource links and inclusive visual and streaming content representation. To create a personalized and relevant experience throughout, the member’s due date is used to provide timely information, and custom keys (name, provider name, etc.) further enhance personalization.

How we leverage digital trends for enhanced maternal health education

Information sharing and access to the news today are more broadly available thanks to smart devices and the internet. With Americans spending an average of 1,300 hours each year on social networking platforms such as Facebook, Instagram, and TikTok, it’s critical to derive inspiration from these platforms to maximize engagement and remove friction.

More than 50% of expectant Americans download and use pregnancy-related apps for educational resources and pregnancy-related updates. Health organizations are perfectly positioned to harness these trends and provide a frictionless experience to expectant consumers to engage and deliver the right education and resources, close care gaps, and gather rich population insights.

mPulse Mobile’s prenatal and postpartum solution uses a combination of expert-led videos from Dr. Christine Noa Sterling, board-certified ObGyn, interactive modules, and short stories and animations to educate and empower members around key milestones related to their and their baby’s health.

Content is sent via SMS at key moments based on each consumer’s due date, encouraging them to schedule routine appointments and make healthier choices.

Our in-house behavioral scientists and instructional strategists leverage learning theory and high-quality cinematography and animation to produce content designed to drive action. See for yourself.

Overview of mPulse Mobile’s prenatal and postpartum solution

mPulse’s prenatal and postpartum solution

mPulse Mobile’s pregnancy solution is a 12+ month interactive SMS program designed to improve quality performance and deliver better health outcomes.

The solution specifically targets multiple HEDIS® measures and is proven to engage and deliver outcomes such as a 2X engagement rate with maternity care management services, a 7.1pp increase in the prenatal and postpartum care measure (PPC) owned by NCQA, and 61% engagement across 400,000 Medicaid members. By incorporating our behavior change methodology throughout all conversations and streaming content, our comprehensive approach broadens access, caters to individual preferences, and educates to improve health outcomes at scale.

How to Overcome Flu Vaccination Inequities This Flu Season

The stark reality of flu vaccines is that they save millions from illness and death, yet there remains a significant inequality in vaccine distribution, particularly affecting certain demographics. During the 2022-23 flu season, while 173.37 million Americans were vaccinated, saving nearly $2.4 billion in healthcare costs, a concerning 46% of eligible Americans remained unvaccinated. 

Solving vaccine inequity requires a deeper understanding of the social determinants of health (SDoH), such as age, race, and income, which play a pivotal role in these disparities. Notably, vaccination rates are considerably lower among Black, Hispanic, and American Indian/Alaskan Native adults, with hospitalization rates significantly higher among Black adults. Furthermore, adults with lower incomes and those in the 18-49 age group are less likely to receive the flu vaccine.

Identifying and addressing the root causes of these inequities is crucial for improving vaccination rates and ensuring equitable health outcomes for all in the upcoming 2023-24 flu season.

Understanding why these inequities exist is essential when designing programs to help overcome them.

Overcoming inequality in vaccine distribution through inclusive flu outreach

Addressing vaccine inequity requires tailored strategies that specifically target the underlying causes of these disparities. The CDC highlights a lack of accessibility, misinformation, and widespread distrust in the medical system as primary reasons for flu vaccine inequities. Crafting programs that focus on overcoming these barriers is crucial to enhancing flu vaccination rates and bridging the gap in inequality in vaccine distribution.

By implementing such targeted approaches, we can work towards ensuring equitable healthcare access for all member populations.

How to address and solve vaccine inequity through enhanced accessibility

Overcoming vaccine inequity necessitates addressing accessibility challenges that disproportionately affect disadvantaged groups. Many individuals face barriers such as unreliable transportation, disabilities, limited internet access, inflexible work schedules, and language or translation issues, making vaccination access difficult. These systemic issues often fail to accommodate all members’ diverse needs and preferences, creating an unequal landscape in vaccine distribution.

Fortunately, health plans have a significant opportunity to address these challenges. By implementing programs focusing on accessibility, they can identify individual barriers and provide customized resources to facilitate access. This requires an in-depth understanding of the target audience’s specific needs.

At mPulse, we utilize internal and external data to gain comprehensive insights into member needs, allowing health plans to create highly relevant digital touchpoints. Health plans can effectively identify and address individual barriers by engaging with members through their preferred communication channels, such as SMS, email, or IVR. The right message, delivered through the right channel, in the appropriate language, and accompanied by suitable resources, is key to meeting members where they are and improving flu vaccination rates.

Learn more about how to solve vaccine inequity and enhance vaccination rates by watching our on-demand webinar, “Double Flu Vaccination Rates for Your Health Population.”

Combating vaccine inequity with effective communication strategies

In the digital age, where misinformation and knowledge gaps about vaccines are prevalent, especially post-pandemic, it’s crucial to tackle vaccine inequity by providing trustworthy and pertinent vaccine information. Misconceptions about vaccinations, particularly the flu vaccine, have increased, underscoring the need for reliable information sources.

At mPulse, we aim to solve vaccine inequity by adapting the engaging formats of popular social media platforms. Our approach involves creating short-form content that is informative, educational, entertaining, and easy to consume. We focus on making content frictionless and engaging while ensuring it’s accessible to a broader audience. This includes featuring relatable characters representing diverse populations and offering multilingual options, which are vital to resonating with broader member groups and building credibility.

By sharing health content through each member’s preferred communication channels, we ensure they efficiently receive vital vaccine information. This method is particularly effective in addressing misinformation and bridging knowledge gaps, thereby playing a significant role in how to solve vaccine inequity. To see an example of how we bring this to life, view another fotonovela included in the mPulse Mobile Flu Vaccination Solution.

Building Trust to Address Vaccine Inequity

Addressing distrust in the medical system, often rooted in a history of structural racism and discrimination, is crucial in solving vaccine inequity. While health plans represent only one component of this complex issue, establishing trust with their members is vital. Utilizing digital trends for inspiration can significantly aid health plans in scaling their efforts effectively.

Creating multiple positive and meaningful touchpoints over time is key to developing and maintaining strong member relationships. At mPulse, we collaborate with health plans to provide empathetic messaging that conveys relevant and accessible information in each member’s preferred language and through the most appropriate channel. This approach helps ensure members feel supported and can rely on their health plan for essential care and resources, fostering greater trust and empowerment.

Simply notifying members about their due flu vaccines can be perceived as intrusive. Instead, our approach incorporates sensitive, culturally relevant messaging that leverages behavioral science techniques, cinematic educational content, and tailored resources. This strategy demonstrates an understanding of the member’s unique needs and genuine concern for their health.

When members feel that their health plan values and understands them, they are more likely to trust the plan and engage in healthier behaviors, thereby contributing to solving vaccine inequity.

Leveraging technology to overcome health disparities and boost flu vaccination rates

Technology is imperative in helping overcome health disparities and barriers to flu vaccinations. By leveraging innovative digital trends designed to serve vulnerable populations, health plans can begin broadening accessibility, educating and empowering members, and building trust at scale to improve vaccination rates and inspire healthier outcomes for the people they serve.

mPulse Mobile designs solutions that identify and overcome barriers to action. Our behavior change model incorporates health equity, behavioral science, and instructional strategy to deliver best-in-class outcomes.

Contact us to learn more about how our flu vaccination solution can help overcome vaccine hesitancy for your members.

Closing Gaps in Care: What Key Strategies Should Plans Consider?

$7 billion is saved annually from preventive health services, yet only 8% of Americans are attending all recommended preventive care visits. In a perfect world where all Americans received the preventive care they need, we’d be saving over $87 billion annually.

Diseases such as diabetes, cardiovascular disease, and cancer cause 7 in 10 American deaths every year and account for 75% of the nation’s health spending. It’s forecasted that by 2030 the United States will spend $6.8 trillion on healthcare annually.

Health plans are deeply familiar with the value of preventive care and continually invest time and money into programs and services that are designed to activate their members to attend important visits. Unfortunately, preventive screenings and care access plummeted throughout the pandemic and as a result, have become an even more important focus area going into 2023.

How do you solve the challenge?

Throwing money at a one-size-fits-all approach won’t move the needle. Your members are complex human beings with unique differences that require health engagement solutions that address their individual needs and preferences. Investing in a tailored gaps in care solution that helps target, identify, educate, and address each member’s barriers and preferences will yield better health outcomes at scale.

We’ve curated a checklist of key considerations that should be consulted when needing to close care gaps and achieve better health outcomes.

1. Implement a Frictionless Communication Approach 

No two members are the same and how we communicate with each member should reflect that understanding. Building solutions that leverage an omnichannel approach enables you to reach more members in the ways they prefer. A study from 2021 found 85% of members prefer receiving text message updates from their health plan and providers compared to email, phone calls, or portal messages. On top of awareness, building motivation is just as critical.

Enter Behavioral Science. Behavioral Science uses principles from neuroscience, psychology, and economics to encourage and empower members to act. By embedding these scientifically proven techniques within member communications and outreach, you’ll see improved compelling outcomes for preventive care visit completions.

Interested in seeing the impact behavioral science can have on your members? Watch the webinar series, Frictionless Healthcare, on-demand now »

Case Study: Over 5,000 New Preventative Screenings Completed

A leading Medicaid MCO partnered with mPulse Mobile to improve screening rates by enhancing previous outreach methods (mail, phone, and paid advertisements) with the addition of SMS text messaging. The program was run in both English and Spanish translation, using a combination of powerful behavioral science techniques and rewards incentives to drive members to attend needed screenings while uncovering and addressing key barriers such as transportation assistance, live agent scheduling support, and more.

As a result, 48% of targeted members completed their screenings. A prior opt-in approach enabled reach rates to exceed 80%.

2. Build Health Literacy

While creating awareness is the first step, educating members on why screenings are important, and helping them feel prepared for their visit is equally as vital. Think about it: if you don’t understand why you need to go to the doctor for something that doesn’t feel like it’s an issue, why would you spend the time and energy voluntarily going to that appointment? Providing members with educational tools designed to build knowledge and confidence will increase the likelihood that they’ll take action.

Read all about the power of education in our newly released guide, 6 Innovations in Streaming Health Content to Improve Member Experience »

Case Study: Streaming Health Education Triples Engagement

In partnership with a leading Medicare Advantage plan, mPulse Mobile launched an A/B testing program that sent messaging to members notifying them it was time to get their annual diabetic eye screening. The test group was divided in half, with group A receiving SMS messages only with a link to schedule their exam, and group B receiving the same message with a link to watch a 60-second educational video about the risks of not receiving routine diabetic eye screenings.

The results boasted a 274% increase in link clicks to schedule the eye exam when the streaming health video was used versus when it was not used.

Knowledge certainly is power. Building confidence to act using cinematic streaming experiences in undoubtably an impactful way to ignite outcomes.

3. Overcome Barriers and Create Accessibility

Factors such as income status, education level, location, access to reliable transportation, and race and ethnicity all play a significant role in accessibility to preventive care services as well as likelihood of receiving said care. Racial and ethnic minorities, particularly Hispanic and African American members, have statistically lower screening rates than white members for cervical, breast, and colorectal cancer screenings. To solve barriers for members with health disparities, you must first identify their barrier and how you can help overcome it.

By deploying multilingual omnichannel solutions, you can directly ask members what is keeping them from attending their preventive visit. Their response can determine next steps, while a customized call-to-action helps them overcome the barrier. 

Case Study: HEDIS® Measure Improvement

A Medicaid plan located in the Midwest partnered with mPulse to drive improved screening rates across multiple preventive care topics. Over 81 unique dialogs were deployed using dynamic tailoring that examined each member’s engagement rate, communication preferences, and socioeconomic data. The campaign positively impacted all targeted measures, and saw the following percentage point (pp) improvement rates:  

  • Well Child (years 0-11): +13.3pp increase 
  • Adolescent Well Care:  +9.8pp increase 
  • Dental Visit: +8.8pp increase 
  • Lead Screening: +9.5pp increase 
  • Breast Cancer Screening [BCS]: +12.6pp increase 
  • Colon Cancer Screening [CCS]: +11.5pp increase 

 

4. Continually Optimize Outcomes 

Because each member population is unique, the ongoing refinement of programs through data analysis and performance reviews will continually optimize outcomes. With a dedicated team of strategists, analysts, industry leaders, and both client and technology support experts, mPulse Mobile will help drive better preventive screening completions for your members 

In Summary  

As we head into 2023, plans will need to implement innovative solutions to increase preventive care visit completions. By leveraging omnichannel communication, educational tools and streaming experiences, and proactively addressing and helping members overcome barriers, we can begin empowering member action at scale. 

What Plans Need to Know About DHCS Latest Release of Guiding Principles

In March 2022, DHCS released key guiding principles and considerations Medi-Cal plans will need to consider when designing programs for their Medicaid members, specifically youth and families. With 1 in 3 Californians insured under Medi-Cal, and over 13 million members at stake, these principles will become key focus areas for plans in 2023 and beyond.

The Challenge

To set the stage, in 2019–20, Medi-Cal brought in more than $65 billion in federal funds and accounted for nearly 16% of all state general fund spending. People with disabilities comprise 9% of Medi-Cal enrollees, and account for 31% of total spending. Children account for 17% of enrollees, but only 6% of the total spend.

And quality measures haven’t seen much improvement, with more than half of the measures staying the same or declining from 2009 to 2018. In summary, quality of care has declined on four measures, and hasn’t improved on 12 measures. What’s worse, three of the four measures that did decline were related to the care of children covered under Medi-Cal. Six of the nine measures related to children declined or stayed the same, with only three measures seeing improvement. The decline in quality prompted state-wide action, which led to DHCS creating 8 guiding principles to improve health outcomes at scale.

This article will look at three of the eight principles and provide plans with insights and opportunities to apply DHCS strategy in supporting families and children covered by Medi-Cal while enhancing health outcomes for the nation’s most vulnerable population.

Want to read about all 8 of the Guiding Principles and recommendations for implementing each one? Download our Medi-Cal Brief »

Strengthen the Coverage Base for California’s Children

  • Premiums will be reduced to zero to ensure accessibility for all Medi-Cal families.
  • Presumptive eligibility will expand to ensure families and children in need can receive care more quickly.

Opportunity

California has ensured a simplified enrollment and eligibility process for Medi-Cal, which has enabled the state to rank among the top third in the county in its child health coverage rates. California reduced the uninsured rate for Latino children to less than half the national average. Unfortunately, progress has declined in recent years, and the uninsured rate is beginning to gradually increase. With zero-dollar premiums and presumptive eligibility, plans will need to onboard and educate members about their benefits faster.

mPulse Improves Member Knowledge of Plan Benefits by 91%

Strategy: Deploy 2-way text messaging to gauge new members’ understanding of plan benefits and available resources, educate and improve utilization of plan benefits.

By using demographic datasets from our SDoH Index, we assessed and segmented the target population. Interactive polls, on-demand resources and open-ended questions were sent to members to continually gather insights while pointing them toward tailored resources.

Outcome: 91% of members found the text messages helped improve their understanding of the plan’s benefits and services. The number of members who reported they would visit the ER for a minor condition dropped from 11% to 4%. The engagement score, based on response and sentiment, was 2.5 times higher than the control group.

Fortify the Pediatric Preventive and Primary Care Foundation

  • A new population health management (PHM) strategy will be implemented to establish a checklist for plans to identify and serve children in need of care coordination.
  • New resources will be implemented in practice transformation for pediatric providers and primary care providers serving pregnant and youth members.
  • An educational outreach campaign will be deployed for EPSDT for members, providers, and MCPs.
  • Improve criteria and procedures used to determine when children receive behavioral health services, specialty mental health services, and substance use disorder treatment.
  • Expansion of preventive pediatric dental benefits.
  • Participate in CMS infant well-child visits learning collaborative for health care payment learning and action network state transformation collaborative (STC).
  • Continued support for the ACEs Aware Initiative and provider training grants.

Opportunity

Early Periodic Screening, Diagnostic, and Treatment (EPSDT) is the foundation for necessary adolescent care. Contract requirements in the upcoming Medi-Cal MCP procurement will create greater visibility and enforcement of EPSDT services under DHCS. Ensuring members receive education and information on the importance of these services is essential in building member self-efficacy.

mPulse Drives 66% Well-Child Visit Attendance

Strategy: Better manage children’s health outcomes by driving awareness of well-child visits, immunizations, and primary care visits via 2-way text messages.

Outcome: 66% of members attended at least one well-care visit. 83% of targeted members had their child vaccinated. 29% of members aged 18-21 successfully transitioned from a pediatrician to a primary care provider.

Get more outcomes and guiding principle recommendations by downloading the complete content »

Strengthen Access to Pediatric Vaccinations

  • Deploy COVID-19 pediatric vaccines to meet California’s “Vaccinate All 58” goals.
  • Develop a Vaccines for Children (VFC) plan with CDPH to increase vaccinations and increase vaccine education.
  • Increase vaccination rate of pregnant Medi-Cal members.

Opportunity

The United States saw a country-wide decline in vaccination rates throughout the pandemic with a 40% reduction in childhood vaccination rates in April 2020. California saw a vaccination rate of 35% in children for 2020. To prioritize increasing the Medi-Cal vaccination rate, more work will be required by plans in developing programs and initiatives that support vaccine education and helping overcome vaccine hesitancy.

mPulse Uses Streaming Health Education to Increase Vaccine Readiness

Strategy: Build self-efficacy and increase vaccine readiness by providing visual storybooks and using behavioral science techniques to help overcome barriers and vaccine hesitancy. 2.6 million messages were sent, and 1.8 million dialogues were initiated in both English and Spanish translation.

Outcome: 18.9% of members replied to a message or clicked a link. 72% of members who interacted with our vaccine storybook were more likely to get vaccinated.

Why Plans Should Leverage Text Messaging Outreach

In 2019, more than 94% of California households had internet access, although significant gaps remain with families of color and lower incomes having less access than white households. With organizations like iFoster, the California Emerging Technology Fund (CETF), and California LifeLine working to provide internet access and cell phones to those who need it most, cell phone and internet access will only continue to increase.

Compliance Considerations

When it comes to healthcare, communicating with members through text messaging can be somewhat daunting. mPulse Mobile is HITRIST, HIPAA, and TCPA-compliant and has deployed programs with leading Medi-Cal plans while ensuring compliance and member privacy is top of mind.

The TCPA healthcare exemption enables health organizations to deliver messages without prior express consent, as long as they abide by the following rules:

  • Must be HIPAA compliant, and not promotional or soliciting.
  • Messages can only be sent to the phone number provides and must state the name and contact information of the sender.
  • Voice messages must be under 1 minute, and text massages less than 160 characters.
  • Messaging frequency needs to be less than once per day, and no more than three times per week.
  • Messages must offer an opt-out and opt-outs must be honored accordingly.

As a company 100% focused on health engagement, security and compliance are mPulse Mobile’s highest priority, and all our solutions are designed with compliance as the foundation.

Conclusion

To improve quality measures and enhance outcomes for Medi-Cal youth and families, DHCS will be enforcing these policies and principles alongside Medi-Cal plans to increase utilization of new resources and services. mPulse Mobile’s suite of solutions are designed to drive engagement and increase utilization of plan benefits. Our frictionless engagement methods are proven to empower health literacy and self-efficacy. By partnering with us, plans can proactively implement DHCS principles into their enterprise strategy to deliver outcomes that matter most: healthier communities and greater quality of care for California’s most vulnerable members.

D-SNP Spotlight, Part 2: Engagement Opportunities within the 2023 Ruling

The CY 2023 Medicare Advantage and Part D Final Rule places a magnifying glass on vulnerable D-SNP members with additional regulations that will require plans to integrate services, adopt new products designed to deepen engagement, drive growth and retention, and inspire meaningful behavior change. Plans must consider these new guidelines when designing their D-SNP engagement programs. Visit Part 1, D-SNP Spotlight: Engagement Opportunities within the 2023 Ruling, to read a summary of the ruling and related changes to D-SNP regulations.

Why D-SNP? 

D-SNP members offer plans a unique engagement challenge, particularly due to their hard-to-reach reputation and growth potential. There are roughly 4 million D-SNP members nationwide, with 7 million additional individuals remaining eligible. This rapidly expanding population saw a growth increase of 52% since 2018, with an increase of 16.4% in 2021 alone. 

This fast-growing member population qualifies for both Medicaid and Medicare due to their complex needs and requirements. D-SNP members often have a disabling condition, suffer from mental health disorders, receive care from multiple doctors for a variety of health conditions, and/or receive in-home care or other specialized health and social service care. D-SNP members also have access to additional benefits which often include dental care, discounted over-the-counter pharmaceuticals, hearing exams, annual eye exams, and no-cost transportation to health care visits.  

Despite their complex needs, D-SNP members open the door to several opportunities due to the requirements in place that enforce plan coordination and whole person care engagement models. Here are a few opportunities to consider.

Opportunities to Engage and Drive Outcomes  

Cut Through the Competition 

Creating meaningful relationships is the key to retaining members, and the stakes are high when it comes to D-SNP. To retain members, each individual needs to feel seen and addressed. Scaling communications across an entire population is no small feat, particularly when each member has their own unique needs and challenges. 

Personalized omnichannel messaging is essential to creating a valuable experience and allows for resources and services to be delivered on a case-by-case basis through each member’s preferred channel of communication. Conversational AI allows messaging to remain dynamic, while Natural Language Understanding (NLU) analyzes each response. mPulse Mobile uses a combination of industry, public and private data sets combined with plan data to create highly accurate predictions, and continually optimizes dialogs using conversational insights. By sending the right message at key moments, and providing resources and information each member needs most, we can begin building meaningful relationships that reduce churn. 

Break Down the Barriers 

Reaching and getting D-SNP members to engage is a great start, but instilling behavior change and self-efficacy to create action? Definitely a challenge – particularly when we consider the unique needs D-SNP members face. Members face a combination of mental health and physical health challenges, which can include ailments such as substance abuse and comorbidities. They often receive in-home care, reside in long-term care facilities, or have designated caregivers. These situations can create even more barriers to engaging and activating D-SNP members. Despite obstacles, providing relevant and critical care information and resources, particularly benefits they may not be aware they have access to, through their preferred communication channel is a great first step. But how do we create meaningful behavior change? 

We can begin building health literacy by providing powerful media experiences that include interactive and educational modalities. mPulse Mobile offers streaming health education across a variety of health topics. All content is designed by our team of production designers and learning strategists, with the goal to build skills that empower members to own their health and adopt healthier behaviors over time. Not only do we design for health literacy, we design for entertainment and boast a 71% member self-reported likelihood to take action after engaging with our streaming content.  

Drive Value Again and Again 

D-SNP members offer plans tons of flexibility. Because Medicare and Medicaid benefits are tied into a single member, premium dollars increase and open the door to curating much-needed exceptional member experiences. Allowing plan resources and benefits to reach, engage and educate this rapidly growing and vulnerable population is crucial. To attain and retain the market share, developing partnerships with organizations designed to drive repeated value is key. Understanding your member’s needs, using behavioral and learning science to engage and educate them, and driving action at key moments increases member retention, and delivers better health outcomes. 

How mPulse drove a 58% D-SNP Engagement Rate 

mPulse partnered with a national payer who serves over 17 million members nationwide, with D-SNP member eligibility available in 28 states.  

Goals 

The program focuses on welcoming new D-SNP members to the plan, with an emphasis on increasing awareness and utilization of available benefits and services. By providing a white glove experience, the plan aimed to increase retention of D-SNP members and create meaningful relationships with these members at scale. Additional goals included HRA completion. 

Execution 

Over the course of three weeks, more than 45,000 D-SNP members were enrolled into a 3-week SMS program. Each week promoted a different service offering, including healthy food card and over-the-counter pharmaceutical discounts, as well as assistance in finding a provider and ensuring members received their ID cards.  

Results 

SMS text messages saw a 99% delivery rate with 58% engagement. More than 30% of engagement included link clicks to related plan benefit offerings, which included over-the-counter pharmaceutical discount cards, healthy food cards, and provide finder links.

What’s next?  

By understanding how to reach members with complex needs, plans can cut through the competition and provide unrivaled experiences for D-SNP members. mPulse Mobile is the leader in Conversational AI solutions for the healthcare industry and operates to continually drive outcomes using tailored and engaging digital experiences. Our rich understanding of diverse populations enables our team of behavioral and learning scientists to curate highly tailored programs designed to impact the lives served by our 180+ client roster.

CMS 2023 Ruling’s Impact on D-SNP Populations, Part 1

The Centers for Medicare & Medicaid Services (CMS) released the Contract Year 2023 Medicare Advantage and Part D Final Rule. The ruling places a spotlight on the vulnerable D-SNP population, and places health plans in a challenging yet opportunistic position to engage these notoriously difficult-to-reach members.

2023 Ruling’s Impact on D-SNP at a Glance 

Enrollee Participation in Plan Governance 

MA organizations offering a D-SNP must establish at least one enrollee advisory committee in each state to solicit input from member experiences. The sample must include those enrolled in D-SNP and garner input from members regarding access to services, coordination of services and health equity. 

Opportunity: Feedback will help identify and address barriers to care, which will allow plans to further assess their series and processes to ensure a better member experience, while also collecting valuable data regarding their unique member population.

Standardizing Housing, Food Insecurity, and Transportation Questions of Health Risk Assessments (HRAs)

Initial and Annual assessments will be conducted to evaluate each member’s physical, psychosocial, and functional needs. HRAs must include one or more questions on housing stability, food security, and access to transportation.  

Opportunity: Visibility of member needs will enable plans to address the unique needs of each member, allowing better access and resource allocation of plan offerings and services.

Refining Definitions for Fully Integrated and Highly Integrated D-SNPS 

Beginning in 2025 and in years following, FIDE SNPs will have aligned enrollment and cover Medicare cost-sharing and Medicaid benefits for home health services, medical supplies, and behavioral health services between the state and the MCO, with the same legal entity as the FIDE SNP. Additionally, HIDE SNPs have service that overlaps the plan’s Medicaid managed care plan with the state. This rule will organize Medicaid long-term services while supporting Medicaid behavioral health services affiliated with FIDE SNPs and HIDE SNPs.  

Opportunity: Create better integration between FIDE SNPs and HIDE SNPs, whose definition and intricacies have previously lacked consistency.

Additional Opportunities for Integration Through State Medicaid Agency Contract

D-SNP contracts will be required through the state agency to provide benefits/ arrange a provision of benefits. New pathways will require aligned enrollment and establish contracts that only include one or more D-SNPs within a state and use integrated materials and notices for members. 

Opportunity: Members have clarity of their coverage and benefits. Star Ratings are assigned at the contract level, which means this rule provides greater transparency on D-SNP quality ratings and will allow CMS to identify disparities between beneficiaries and interventions. This will improve federal and state oversight and scale information sharing.

Attainment of the Maximum Out-Of-Pocket (MOOP) Limit

Plans must establish a limit on beneficiary cost-saving for Medicare Part A and B services after the plan pays 100% of the costs. Current guidance allows MA plans, including D-SNPs to not count Medicaid-paid amounts or unpaid amounts towards the MOOP limit, which results in increased state payments of Medicare cost-sharing and disadvantages providers serving D-SNP members. The MOOP limit within the plan will be calculated based on total cost sharing, regardless of whether it was paid by the beneficiary, Medicaid, secondary insurance, or left unpaid. 

Opportunity: More equitable payments for providers serving D-SNPs. This will result in increased bid costs, and increased Medicare spending, which will be offset by lower federal Medicaid spending. The net federal 10-year cost is estimated at $614.8 million. 

As plans heighten their attention and focus on D-SNP members with the new ruling in mind, several opportunities surface and a more robust engagement model that provides an exceptional experience becomes critical. Look out for Part 2, D-SNP Spotlight: Engagement Opportunities within the 2023 Ruling, to learn how plans can upgrade their engagement strategy to drive proven outcomes with D-SNP members. 

Closing Diabetes Care Gaps

Diabetes care often faces numerous challenges, including patient adherence to screenings and understanding of the condition’s implications. By recognizing these significant gaps and the barriers that prevent patients from taking crucial steps in their care, we can guide them toward becoming more proactive advocates for their health. Leveraging advanced tools like conversational AI for healthcare and Natural Language Understanding, mPulse uniquely supports each patient in navigating their diabetes journey, ensuring personalized and effective care.

We’ll discuss these solutions that bridge the gaps in diabetes care:

  • SMS Messaging: Using tailored conversations
  • IVR & Email: Catering to those with a landline
  • Streaming health content: video and podcast learning proven to educate your patients.

Background

According to the Centers for Disease Control and Prevention, over 34 million Americans have diabetes, and 88 million are prediabetic. Despite being one of the most common diseases in the U.S., it is still widely misunderstood. Providing education and resources to help those living with diabetes is critical to improving quality measures, managing diabetes, and preventing poor outcomes.

Adherence to diabetes medications alone reduces over 1 million emergency room visits annually, which accounts for approximately $8.3 billion in annual health spending.

Proper management of diabetes can be shown through data captured from routine blood work, A1c tests, specialist visits, prescription refills, and diabetic eye exam claims. However, many patients do not know they need to complete these visits or understand why they are important.

How to engage the hard-to-reach diabetes patients

You need to meet patients where they are. Through implementing a tailored omnichannel approach, you can engage with each patient in the ways they prefer while uncovering their barriers to care. This will help extend your reach, improve engagement at scale, and collect population insights to inform your enterprise strategy.

Each of your diabetes patients is on a different journey. Addressing the correct gaps and identifying each patient’s unique barriers will yield greater self-efficacy.

Using tailored health engagement to bridge gaps in diabetes care

SMS Messaging

Example:

Diane is a Type 1 Diabetic who is a new patient. Through SMS messaging, we can identify her barriers and provide her with care management to help support her and provide her with education on nutrition and resources to help her maintain routine care visits.

“At age 14, I was diagnosed with Type 1. My parents watched over and cared for me, but when I lived alone, I didn’t take care of my diabetes. I wasn’t checking my sugars and ate anything I wanted, whenever. I didn’t want to be the diabetic girl with her medical bag.” – Diane J. Type 1 Diabetic.

Interactive Voice Response and email

Example:

Charlotte is also a Type 1 Diabetic whose provided phone number is a landline. Through IVR and email, we can connect her to education on the importance of routine diabetic eye exams with a CTA (call-to-action) to schedule with her optometrist.

“I’ve been a type 1 diabetic for 30 years, and my hypo symptoms have changed. The first thing that happens is my vision starts to become abstract, and I have hallucinations; it’s terrifying! I don’t know if this is common or not cause it never used to happen to me during hypos.” – Charlotte L. Type 1 Diabetic.

mPulse, a digital health engagement solution provider, uses conversational Artificial Intelligence (AI) and Natural Language Understanding to fill gaps in diabetes care by overcoming barriers and providing the right support through the right channel to build trust with each of your patients. We deliver personalized interactions that inspire health literacy and behavior change over time.

The importance of health education and literacy

An essential part of building relationships with patients is providing more than appointment reminders, test results, and claims status updates. While tests and appointments are strong indicators that the patient is receiving recommended routine care, the management of diabetes goes beyond the doctor’s office. Living a healthy lifestyle with diabetes is just as essential as maintenance visits, especially when it comes to diet, exercise, and mental health. Investing in health and well-being resources, programs, and education throughout each patient’s health journey drives meaningful behavior change.

“People living with diabetes tend to focus on diet and meds (necessary, of course) that I think maybe we forget other important tools in this fight. I have found that stress, like an argument, financial worry, depression, etc., affects my bs. I’d love to hear some successful stress reducers that can help.” – Joey S. Type 2 Diabetic.

The Big Know is mPulse Mobile’s health education streaming solution. Our team of instructional writers and designers produces broadcast-quality content designed to inspire health literacy at scale. We leverage the expertise of nationally recognized health experts to teach video and podcast learning experiences that are proven to engage and educate your patients.

In addition to condition-specific content, we offer holistic well-being education that teaches the basics of living your healthiest life, with wide-ranging topics that include building resiliency, HSA planning, eating well, yoga, mental health, and more. Discover our content library by visiting The Big Know.

Dr. Reed Tuckson, a Doctor, Health Executive, and author, hosts our LiveWell Diabetes Podcast. In each podcast episode, he hosts a different health expert to discuss specific wellness topics related to managing diabetes, including eating well, movement, and understanding the science behind Type 2 Diabetes.

Listen to the podcast here: https://mpulse.thebigknow.com/home/audio-series/getbeing-podcast-livewell-diabetes/overview

Enroll in mPulse’s Newsletter to be notified when our Diabetes Essentials video series, taught.

by Ranelle Kirchner, launches in 2022.

Reimagining Health Engagement

mPulse Mobile partners with over 100 leading healthcare organizations and initiates 500+ million omnichannel conversations annually. As the leader in digital health solutions, including conversational AI, we help build relationships with your consumers that go beyond the transaction to inspire self-efficacy and health outcomes at scale.

Case Study: A1c Test Reminders

Client: Anonymous Health Plan

Goals: Encourage and remind Diabetic patients to get their monthly A1c Test to lower costs and increase self-efficacy and overall health.

Execution: Leverage SMS messaging to send tailored conversations to Diabetic patients overdue for their A1c test.

Outcome:

  • 29% Program Engagement
  • 32% of claims submitted were from previously un-engaged patients

Case Study: Insulin Rx Refills

Client: Anonymous Pharmaceutical and Medical Device Company

Goals: Increase conversion rate for diabetes insulin pump reorders.

Execution: Consumers reviewed and confirmed their supply reorder through SMS messaging and prior opt-in.

Outcomes:

  • 11pp increase in reorders after program optimization
  • ROI of >360%
  • 92% program opt-in

 

To learn more about mPulse’s digital health solutions and outcomes, contact us at info@mpulse.com.

To learn more about how to prevent and manage diabetes, visit The American Diabetes Association Website.

Overcoming Member Barriers to Breast Cancer Screenings 

1 in 8 women in the United States will get diagnosed with Breast Cancer in her lifetime. This means that every two minutes, someone in the U.S. is newly diagnosed. When detected early, the 5-year survival rate is 99%, but advanced stage breast cancer can be fatal. Early detection through annual mammograms can help treat breast cancer before it progresses, significantly improving outcomes and saving lives. 

Women in their 50s through 70s are at a heightened risk for breast cancer, and doctors recommend annual screenings for women in this age bracket. Unfortunately, only 35% of women 40 and older are attending their annual breast cancer screening. While an annual mammogram may seem simple, it’s easy to overlook if you’re too busy or don’t feel like you need it. Proactively reaching out to members due for screenings and educating them on the importance of preventive care is critical to ensuring they receive the best outcomes and care.  

Challenge

One of the most difficult challenges is reaching members and meeting them where they are. mPulse mobile uses an omnichannel approach while analyzing your unique population’s preferences to deliver communication through the channel that will resonate most. Aligning your communication models to meet the preferences of your members will allow for a frictionless engagement approach that will yield the best possible outcomes.  

The second critical challenge is identifying each of your members barriers and providing them with tailored dialogue and education. Using Natural Language Understanding and conversational AI to provide tailored responses to each member and continually creating personalized touch-points creates relationships and trust with your members which will enhance retention and loyalty. 

When we apply these solutions to overcome barriers to breast cancer screenings, we’re able to not only reach members, but engage them and provide them with the relevant resources and education that result in better outcomes. 

Case Study: Breast Cancer Screening Barrier Identification 

Anonymized MCO Health Plan 

Program Goal: Identify and address barriers to breast cancer screening 

Program Execution: Through tailored SMS messaging, mPulse delivered dialogue to members who hadn’t scheduled their annual mammogram. Individual responses were analyzed through Natural Language Understanding and sent automated replies that had been designed by our team of behavioral data scientists and strategists. 

Our Behavioral Science team crafts dialogues by pulling research that studies population demographics, belief systems, health attitudes, and more. Leveraging this data allows our communication to resonate with your unique population, build health literacy and inspirer behavior change through personalization. 

See below for example dialogues to unique responses. 

*Please note, these are example dialogues created for the purpose of this blog. 

By analyzing member response data, plans can begin implementing the resources and education needed to further help members overcome barriers. For this use case, we were able to identify the largest barriers based on responses for their member population. See below for most frequent barriers gathered from response data. 

Barriers

Gathering insights and data from your broader population helps inform a long-term strategy and allows a broader understanding of your populations needs.  

Supporting barrier identification by providing relevant information and additional CTAs will continue to reinforce healthy behaviors throughout the member journey, while reinforcing self-efficacy. 

The Big Know by mPulse Mobile

The Big Know is mPulse Mobile’s streaming health education capability. Our team of instructional writers and designers produce broadcast-quality content designed to inspire health literacy at scale. We leverage the expertise of popular health experts to teach video and podcast learning experiences that are proven to engage and entertain your members. For one of our leading health plan clients, our average engagement time was 52 minutes per member.

Our streaming content includes a combination of video, animation, polls, quizzes, interactive modules, and embedded links to your related programs and resources. We average a 51% click-through to in-lesson client related programs.

Our breast cancer screening course is taught by Archelle Georgiou, MD, a leading physician, business executive, advisor, author, and speaker.  

 Lesson Title: Get Screened for Breast Cancer 

Lesson Description: Every person with breasts needs to know the facts about breast cancer and their risk for it. The recommendations for breast cancer screening can be confusing. This lesson helps you make sense of them and make your plan to get screened.  

Watch a short video from the breast cancer screening lesson: 

Click here to watch the full course. 

At mPulse Mobile, we leverage omnichannel conversational AI and streaming health education to inspire healthier populations while lowering costs to serve. Through personalized member journeys, we help build relationships that uncover barriers and facilitate healthier behavior change at scale.  

 To learn more about mPulse Mobile’s solutions and programs, contact us.

 

Flu Season 2021-2022: New Challenges Require New Approaches

The rapidly evolving COVID-19 situation brings new challenges for engaging members around this year’s flu. Vaccinations are at the forefront of public health news, and with many Americans remaining hesitant or on the fence about receiving a COVID vaccine, it is more critical than ever to drive education around the simultaneous importance of flu vaccines, which may not be top of mind for healthcare consumers. Health plans and providers must take an agile approach to ensure individuals are empowered to make the best and most informed decisions for their overall health.

COVID-19 and the Flu: Lessons from Last Year

During the 2020-2021 flu season, the CDC reported that only .2% of respiratory specimens tested were positive for influenza, which was significantly lower than in previous years. In the past, we have seen anywhere from 26-30% of tests returning positive results. This decline is likely attributed to the increased health and safety measures that resulted from COVID-19, such as social distancing, face masks, washing hands, etc., and could also be the record number of influenza doses distributed in the US (193.8 million).  

Several other studies have found an interesting correlation: people who received the flu vaccine were less likely to experience major health complications from COVID-19, if infected.  

The importance of maintaining these healthy habits and vaccinating against the flu regardless of COVID vaccination status must be emphasized to members with thoughtful, coordinated education and outreach.  

Predictions and a Plan of Action 

Some experts propose that since we effectively “skipped” last year’s flu season, the 2021-2022 season could be much worse. We may not have been as exposed to these pathogens throughout the past year, so our immune defenses may be weaker, and as the country reopens, we may see a significant surge in respiratory viruses.   

The flu can be challenging to predict even without the added complication of a global pandemic, so it is difficult to say what it will look like this year. Additionally, restrictions and safety mandates change frequently due to the Delta variant surge and vary state by state, which will affect exposure.     

The only constant is change, and healthcare organizations must be ready to tackle new developments and challenges that will inevitably arise throughout the course of this year’s flu season.  

 Effective flu engagement solutions for 2021-2022 should: 

  • Address barriers and questions at the individual level around both COVID-19 and the flu
  • Proactively educate with several types of content to resonate with diverse populations 
  • Adjust programs in response to the latest information   
  • Understand individual needs and provide resources on the preferred channel   

Learn more about the mPulse Mobile Flu Engagement Solution Here >>