Several solution advances continue mPulse’s focus on integrating streaming content into digital health engagement strategies, creating an industry-leading combination of conversational AI that drives two-way SMS messaging campaigns and powerful health streaming content to engage, delight, and move consumers to adopt healthy behaviors. New capabilities include “Stories” Videos and Health Educational Courses.
“Stories” Video Format
mPulse launched the stories video format to deliver more impactful content experiences in consumer-focused outreach programs. The format adapts video “stories” commonly seen in social media platforms like TikTok and Instagram Reels to deliver captivating content on important healthcare topics.
New Health Educational Courses
mPulse has also launched new streaming health courses that address key health issues and improve health literacy in a consumer-friendly digital format. Produced with proven learning techniques and behavioral science, these courses allow healthcare organizations to extend the digital experience from initial outreach to deep, relationship-building experiences.
$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.
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.
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.
The public is composed of numerous groups whose cry to us writers is: 'Comfort me.' 'Amuse me.' 'Touch my sympathies.' 'Make me laugh.' 'Make me shiver.' 'Make me weep.' 'Make me think.'
Dear reader, have you ever wondered why you remember a story you heard better than an article you read? Once again, it comes down to the power of behavioral science. This next installment in our Frictionless Healthcare blog series will focus on the concept of storytelling effect. Storytelling effect is around the finding that people remember stories better than facts alone.
The desire for stories isn’t new. Researchers and scholars alike have often written about the extent to which humans rely upon stories for processing complex information, for entertaining and empowering people, and for communicating with individuals and the public more generally [1-3]. Volumes of research have been devoted to understanding what constitutes the core elements of a story, how stories affect human behavior, and why stories evoke different responses than other methods of sharing information.
A story has five basic but important elements. These five components are: the characters, the setting, the plot, the tension, and the resolution. These essential elements keep the story running smoothly and allow the action to develop in a logical way. A place to look for a clear illustration of these elements is in fairy tales. Fairy tales are universally accessible stories with clear stakes, effective story structure, and memorable characters. Let’s take Snow White as an example.
Plot: The Evil Queen has a very unhealthy level of jealousy and obsession with Snow White and wants to kill her (quite extreme)
Characters: the villain is obviously the Evil Queen, our protagonist is Snow White, and we have supporting characters (the seven dwarfs, the prince, and the forest animals).
Setting: a house in the forest in a faraway fairy tale land
Tension: The Evil Queen spends most of her time plotting a way to kill Snow White, which understandably causes quite a bit of tension. Ultimately, she succeeds in poisoning her and sending her into a coma.
Resolution: the prince wakes Snow White, and they live happily ever after.
Neuroscience imaging has shown that facts and figures activate just two areas of the brain: those responsible for language comprehension and processing.
But stories activate up to eight areas of the brain: those having to do with touch, movement, scent, sound, color, and shape in addition to language comprehension and processing. The research shows that stories “light up” more of the brain than factual reporting. Part of this is because storytelling connects listeners to the storyteller emotionally and motivates cooperative behavior.
According to Stanford Graduate School of Business, stories are 22 times more memorable than facts alone. This is likely because stories universally activate brain regions dealing with emotional processing and memory.
The research implies that the brain responds to the story events as if they were happening to the listener. If you’re skeptical, think about why you cry while watching a movie, even though logic tells you that the story and characters are fictional. The medium of video engages and allows viewers to envision a reality in a manner not captured with verbal communication.
In health engagement, however, we aren’t telling stories just to entertain. While entertainment is a respectable goal and key part of the equation, our main objective is to drive a specific action, such as getting that gap closure or convincing someone to set an appointment. Because the goal is loftier for healthcare, the formula gets a little more complex. There are a few more elements to consider: your target audience, the barriers they’re facing, your key messages, and a call to action.
To illustrate the application of story bias in healthcare, we’ll stick to our own advice and use a story:
On the eve of 2020, all through the country, Americans were partying, drinking, setting off fireworks, and celebrating the beginning of a new decade. All were blissfully unaware of the troubles on the near horizon. We had all heard of the ominous coronavirus, but that was a problem brewing in the far reaches of China, and we were safely on the other side of the world.
Fast forward to the end of January 2020, and coronavirus had now touched our shores, news of the impending pandemic was spreading, and the first Public Health Emergency (PHE) declaration was made by the white house. This declaration gave the government powers to guide and assist the country in fighting the pandemic and included in it was a pause on redetermination for Medicaid.
For the last two years, Medicaid members have enjoyed continuous enrollment, meaning they retained their benefits without having to reapply annually as they usually would. But the Medicaid market knows that is soon coming to an end. Plans will now have the mountainous talk of restarting the redetermination process for their entire member base and ensure nobody falls through the cracks and losses coverage.
That’s where it becomes critical to engage and educate your members using all tools at your disposal, and we recommend storytelling be a part of that. Listen to Tom Godfrey, our Vice President of Instructional Strategy and recent webinar host, explain the use of a target audience, barriers, key messaging, and a call to action all tied into storytelling in the form of a Fotonovela (a quick bite-sized animated story).
Behavioral scientists have found that in order to make a decision, people use both the rational and emotional parts of their brain. This means the most effective marketing messages will contain elements that appeal to each. Decisions of all types are often first made emotionally, and then later justified with rational reasons. Fotonovelas and other storytelling devices are our way to use that to our advantage.
We’ve Now Reached the Resolution
The human brain has a strong tendency to lose focus. In fact, it is estimated to engage in up to 2,000 daydreams a day and spend up to half its waking time wandering. In the presence of a compelling story that creates tension, however, the brain snaps to attention due to the release of a stress hormone known as cortisol.
At mPulse, we use stories because they command attention, which we need from members and patients to drive action. Fotonovelas, animations, interactive experiences—these all serve to engage the brain, motivate the person, and create healthier individuals. If you’d like to learn more about the ways in which we use storytelling to drive action, watch the companion webinar to this blog, Stories that Move: Exploring the role of storytelling in behavior change design.
Resources: 1. Gottschall J. The Storytelling Animal: How Stories Make Us Human. New York, NY: Houghton Mifflin Harcourt; 2012. [Google Scholar]
2. Cron L. Wired for Story: The Writer’s Guide to Using Brain Science to Hook Readers from the Very First Sentence. Berkeley, CA: Ten Speed Press; 2012. [Google Scholar]
Binder JR, Frost JA, Hammeke TA, Cox RW, Rao SM, Prieto T. Human brain language areas identified by functional magnetic resonance imaging. J Neurosci. 1997 Jan 1;17(1):353-62. doi: 10.1523/JNEUROSCI.17-01-00353.1997. PMID: 8987760; PMCID: PMC6793702.
mPulse Mobile recently wrapped up its fifth annual Activate conference with the Activate Awards, which provided yet another celebration of healthcare leadership, innovative program design, and improved health outcomes amidst various health engagement challenges.
The theme of Activate2022, The Power of Behavioral Science to Drive Health Action, was reflected throughout the conference with captivating speaker sessions and expert panel discussions. Networking inspired exciting conversation around innovative technology, behavior change design, and consumer experience, and the Activate Awards surely brought those conversations full circle.
The awards help illuminate health plans, health systems, health service providers, PBMs and other types of healthcare organizations that utilized new strategies or unique tools to activate their consumer populations. The companies highlighted each year typically face barriers with engaging a certain population or driving specific health actions, so they search for innovative solutions to tackle those challenges.
For example, in 2019, CountyCare saw drastic rates of members losing Medicaid coverage, so the managed care organization (MCO) implemented automated text dialogues and saw their Redetermination rates improve by 3.3 percentage points in just one month, subsequently running away with the Most Improved Consumer Experience award. Last year, CareSource incorporated secure surveys, SMS, and streaming video to significantly impact their hard-to-reach members – they won 2021’s Best Use of Conversational A.I.
The same story is true for this year’s winners.
The remaining 3 award categories are Achieving Health Equity, Most Innovative Solution and Most Significant Outcome. Like the teamwork and critical thinking generated from breakout workshops and Q&A during the conference, the awards are a celebration of two companies that partnered together to overcome consumer barriers or gaps in care by building uniquely tailored engagement programs.
Here are the winners of the 2022 Activate Awards:
Achieving Health Equity
Program Goal
Increase Colorectal Cancer Screenings
AltaMed Health Services is one of the largest Federally Qualified Health Centers (FQHC) in the United States and provides a range of health services to Latino, multi-ethnic and underserved communities in Southern California. After seeing a steep drop in colorectal cancer screenings during the COVID-19 pandemic, the health center sought a solution that could help patients overcome barriers like language and lack of awareness of services.
AltaMed partnered with mPulse to deliver multi-lingual, educational health content to patients using mobile fotonovelas tailored to both males and females who had not completed a screening. Patients received and digested vital communication about getting screened, where to find the nearest screening site, and more through culturally sensitive stories delivered in a familiar format.
A randomized control study found that 63% of patients who responded to the fotonovelas either liked or loved it, and 39% reported it positively impacted their willingness to act. By educating patients with curated content, AltaMed closed a key screening gap, lifted health literacy and perhaps most importantly – made significant progress toward health equity.
Notable Outcome
Patients that viewed the fotonovelas (19%) were more likely to submit a sample for cancer screening than patients in a control group (11%)
Best Use of Conversational A.I.
A Technology-Enabled Health Services Company
Program Goal
Promote smoking cessation among teen vapers
This leading health services organization employs over 210,000 employees globally and utilizes technology-enabled solutions to promote consumer wellness and population health.A major public health problem facing young adults, particularly teens, across the U.S. is the use of e-cigarettes, or vaping. Thecompany sought to promote smoking cessation among teen vapers, a cohort still widely understudied, by implementingintelligent conversational solutions and educational content.
They collaborated with mPulse to build a personalized SMS program, lasting 4-6 months, that leveraged Natural Language Understanding (NLU) to deliver automated, interactive text dialogues to a targeted teen population. Individuals were also provided custom-built streaming health videos that offered tips on quitting and even an option to connect with an SMS coach.
The use of NLU enabled the delivery of automated messaging based on text responses, which helped the organization direct each individual to the appropriate resource. The program yielded an 85% engagement rate, and ultimately 69% of participating teens completed the program. The key result, that 73% of teens in the program set a date to quit vaping, demonstrates the value in utilizing automated text conversations and on-demand content to promote smoking cessation in vulnerable teens.
CalOptima Health is a County Organized Health System that provides health insurance coverage for low-income children, adults, seniors and people with disabilities. As Orange County’s largest health plan, the organization includes a network of over 10,000 primary care doctors and servesover 900,000Medi-Cal beneficiaries.The health system looked to address a gapthey hadidentified withlow-income families enrolling inthe state’s food assistance program, CalFresh, federally known as SNAP.
CalOptima and mPulse partnered to launch a two-way texting campaign, which utilized interactive SMS powered by NLU and tailored to 7 different languages. The health plan addressed language barriers by delivering vital information about CalFresh’s food security benefits to underserved families and Medi-Cal members in their preferred language.
Through automated text workflows, members could respond in their native language with answers like: “I already have CalFresh” or “I want to apply.” The program has continued to expand, having delivered over 5 million messages in 2022 already. Communicating with members according to their preferences about important CalFresh benefits helped CalOptima both improve consumer experience and reduce food insecurity for an at-risk population.
Notable Outcome
Over 5 million messages delivered to members in 2022 about CalFresh benefits
Humanais one of the five largest health plans in the countryaccording to member enrollment and has been partnered with mPulse for over 10 years. With more than20 million members, includingover 5 million Medicare members, the planlooked to close a gap withtheir members scheduling the annual diabetic eye exam.
The plan worked with mPulse to launch an SMS texting campaign to increase awareness around the importance of the eye exam and to drive members to schedule an exam. The program featured A/B testing, in which one half of members was provided a 30-second streaming health video in the initial message while the other half received only text.
The educational video enabled a learning experience that was easily accessible and familiar, concluding with a URL for members to learn more about scheduling the eye exam. Humana saw a remarkable 270% increase in clicks to schedule an exam when outreach included the streaming video. The test demonstrates that using streaming health content alongside two-way conversational solutions can significantly help activate hard-to-reach members with diabetes.
Notable Outcome
270% increase in clicks to schedule a diabetic eye exam when outreach included 30-second streaming video
Most Significant Outcome (tie)
A Technology-Enabled Pharmacy Services Company
Program Goal
Improve member experience and pharmacy engagement
The leading PBM and pharmacy services company is nationally recognized and fills over 1 billion prescriptions annually for millions of healthcare consumers across the country.With a rapidly growing population, the healthcare leader sought a solution to improvepharmacy patient engagementby utilizing a new communication channel for its home delivery pharmacy and prior authorization programs.
The pharmacy leader partnered with mPulse to roll out more than 50 outbound-dialer Interactive Voice Response (IVR) campaigns. The IVR messages notified members about prior authorization approvals/denials, refill reminders, shipping details and doctor responses.
Ultimately, over 5.8 million IVR records were exchanged and the outbound dialer launched over 5.1 million total calls. By offering a new avenue for members to complete a healthy action like ordering medications, the pharmacy enterprise initiated meaningful conversations to help enhance member experience, improve self-service capabilities, and close pharmacy engagement gaps.
Notable Outcome
Reached over 2.2 million members with 55,000+ members giving SMS consent
Most Significant Outcome (tie)
Program Goal
Improve refill adherence for HIV patients
MetroPlus Health Plan is a subsidiary of NYC Health & Hospitals, the largest municipal health system in the country. The insurance organization serves a diverse group of over 600,000 New York residents across Medicaid Managed Care, Medicare, D-SNP, MLTC and more plan types. A big challenge for the plan was getting HIV patients to refill medications that are pivotal to managing their condition and avoiding complications.
MetroPlus partnered with mPulse to educate the vulnerable population through interactive text messaging about the importance of medication adherence and reducing their unmedicated days. Texts were delivered one week apart and provided members with vital resources like phone numbers of a pharmacy or a member of the HIV care team.
The plan measured results based on whether or not a patient completed a refill within 7 days of initial outreach. The program yielded a 69% improvement in medication refills when SMS text reminders were deployed, indicating that text nudges inspire self-efficacy and action within this vulnerable population. Through targeted, mobile intervention, MetroPlus helped positively impact medication adherence for over 1,000 patients living with HIV.
Notable Outcome
69% improvement in medication refills with mPulse text reminders
Health Challenges in 2023
The 6 winners of this year’s Activate Awards showed that even when a new barrier is identified with engaging a population, healthcare organizations must adapt to adhere to their consumers’ needs. Whether utilizing a new communication channel, adding streaming video or incorporating multiple languages, the awards demonstrate that providing healthcare consumers with tailored, learning experiences can significantly impact how they engage with a program.
As the needs and preferences of healthcare consumers continue to evolve, so too should the capabilities of the healthcare organizations that serve them. Next year’s awards ceremony will surely exhibit a new string of engagement challenges with complex populations and niche use cases – let’s see what type of healthcare innovation surfaces in 2023!
How do we unlock digital to get more people enrolled, lower costs to serve, and improve health outcomes at scale?
That question sums up a major challenge and business imperative to lift programs and people. To frame up that challenge, three key gaps must be considered for meaningful innovation:
The Health Programs Gap
There’s no shortage of solutions or investment focused on the problem. By 2027, the global corporate health and wellness market is expected to exceed $100 billion.
From health coaches to wellness programs, EAPs to DPPs, 401k to HSA, there’s a lot of shorthand around programs that are too often short on utilization.
Meanwhile, better convenience and reduced risk of illness are driving more health consumers to telemedicine for mental health and routine care than ever before.
Bottom Line
You likely have many programs in place to support the rising need for total-person care. The opportunity is now to connect your offerings and streamline the digital path to serving the right ones based on need.
By aligning your human services alongside your digital experience journey, you can start shifting from push-based efforts across disconnected programs to a pull-based model that assesses and adapts to the individual’s needs.
The Health Literacy Gap
Patty Starr at Health Action Council sums it up: “Health literacy is the key to lowering healthcare costs and better education is the key to health literacy.”
By the Numbers
As just a sample of an increasingly global problem, 88% of U.S. adults lack health literacy skills needed to manage their health and prevent disease or other illness. 70% of healthcare costs come from lifestyle choices, and people with lower health literacy report worse outcomes.
Bottom Line
Back up. Nearly 9 in 10 adults lack health literacy? That’s a huge number. And part of the problem is that people don’t know their numbers, from reading nutrition labels and measuring medications to understanding lifestyle factors and personal health history.
So if education drives lifestyle choices and choices drive costs, shouldn’t we invest in better education? Yes. But that’s not the problem. From Dr. Google to a WebMD article (designed to sell ads) to a pamphlet to take home, most health “education” is built to inform not to teach.
We know from adult learning theory that simply telling someone to read, watch or listen is not enough. These are inherently passive ways to impart information. If we want real learning and change to occur, we need to design learning experiences that give us ways to reflect, process and apply what we’re learning.
Across need state or wellbeing dimension, a properly designed digital learning experience can personalize to the individual’s needs and guide them to the right programs. In doing so, it can help us solve the health program gap and the health literacy gap at the same time.
The Latent Health Gap
When we look at health programs and services offered today, we see a spectrum from prevention to intervention.
On one side, wellness and benefits offerings are trying to expand beyond hand raisers to help more people quit smoking, move more, or talk to a health expert to start us down a healthier path.
On the intervention side, disease management, care coordination and a host of point solutions are trying to reach people before major issues occur.
That movement to the middle is by no mistake. The vast majority of people show up in the middle. Except, they don’t show up. That’s the problem.
So now that we’ve covered key gaps behind health disengagement, how can we align with evolving consumer behaviors to lift engagement at scale?
In part 1 of this blog series, we looked at the power of Fotonovelas, Interactive Content, and Animations to drive action in health consumers. All this content does the same thing: it goes beyond just telling a member or patient that taking an action is important. It teaches someone why it’s important and what can be gained or lost by action or inaction.
There are more types of content that can be used to solve some pervasive health challenges, though. In this post, we’ll tackle four of the top performing content types that can be used to do this: Courses, Expert Led Lessons, Stories, and Self-Assessments.
Courses to Manage Anxiety and Depression
The World Health Organization estimates lost production as the result of anxiety and depression costs the global economy over $1 trillion every year. And, of course, it isn’t just a productivity issue. Mood disorders make it harder for people to stick with treatment plans, manage chronic conditions, and keep doctor appointments, which can have an overall impact on health and cost of healthcare treatment in the long term.
This makes it an important topic for plans and providers to discuss with their health consumers. Our 5-part course, Living with Anxiety and Depression, taught by author and mindfulness guru, Elisha Goldstein, PhD, teaches self-care strategies for navigating the negativity loop that can serve to keep many of us stuck in negative patterns and behaviors making it a truly powerful learning experience. Healthcare organizations can license the content to provide it any number of ways, including in their own branded content portal.
And anxiety doesn’t just affect adults. According to the CDC, approximately one out of every 10 kids (ages 3-17) have a confirmed anxiety diagnosis. The Parenting Kids with Anxiety course led taught by child psychologist and author, Renee Jain, contains five lessons focused on helping parents help their children transform their feelings of anxiety so they can all find calm, courage, and resilience.
Expert Led Lessons to Empower Consumers
Patients can often feel powerless when they engage in the healthcare system. They leave appointments confused. They have care plans they don’t want or know how to follow. They might not know how to advocate for themselves.
To address this and help them take charge of their care, healthcare organizations can provide expert-led video lessons from trusted experts to educate their members and patients on how to take control of their health. For example, Preparing for a Diagnostic Conversation features Dr. Archelle Georgiou who teaches members how to ensure every health decision is their decision, they leave every interaction feeling heard, and that the decisions made reflect their values and priorities.
These lessons can be embedded online, delivered via SMS messaging, or available on a streaming platform. Giving access to content led by reputable and trusted professionals is the first step to ensuring your members and patients take ownership of their healthcare.
Interactive Stories Encourage Diabetes Eye Exams
Started by Snapchat and copied by Facebook and Instagram, stories are now everywhere. Optimized for mobile delivery, they are auto-advancing snips of videos and images which healthcare plans and providers can take and use on social media as another channel to communicate with their populations or repurpose them for SMS delivered solutions. Our diabetes eye exam story below was promoted to at risk populations and is a great example of how the use of stories can educate.
A quick eye exam can detect early signs of diabetes or pre-diabetes. Because of that, getting members to their eye doctor every year is a priority. To help members really understand why doing so matters to them, we could simply send a text or an email telling them it’s that time, and that might work.
We want to help members really connect to the reality of life with eye disease, though, so to take it a step further and ensure the member or patient really understands the reason behind these exams, you can embedd this video you’re your communication program, and it includes a powerful, easy to follow call-to-action.
Self-Assessment to Determine a Need for Preventive Care Screenings
Increasing regular health screenings is an important goal for every health plan. We have an entire library of assets to help members understand when, why, and how to get the most common health screenings (like mammograms, colonoscopies, eye exams, and more).
Below is an example of a simple interactive self-assessment we provide to help members identify which health screenings are most appropriate for them based on what they tell us. Plans may already know what screenings the member is due for, but by providing this activity, it helps the member connect how their personal characteristics connect to their screening recommendations. Once the member receives their recommendations, we then connect them to additional content to help them better understand how the screening works and what their options may be.
The Bottom Line
Health content in the past has largely been underwhelming where pamphlets, brochures, and information documents were the norm. In today’s environment of social media, streaming content, and digital-first experiences, that won’t work. Healthcare organizations have a wide-open world of rich media experiences they can take and adapt for health education, and it’s imperative they do so! Consumers are not impressed with static (and oftentimes boring) content when the rest of their life is starkly different from that.
These are the top 7 content experiences we’ve seen work, but there are more than just these at healthcare’s disposal. Reach out to us to see what else is available for health outreach!
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.
Don’t forget to catch up with Part 1 and Part 2 of this blog series first!
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So, readers, let’s talk more about theory and research. Robert Cialdini has been studying the science of persuasion for over forty years. In 1984 he wrote Influence, which reveals 6 principles of persuasion. It was an instant success and sits on the desks of advertising executives, copywriters, and marketeers everywhere, and reciprocity is the first of Cialdini’s six universal principles of persuasion. Why? Because the evidence shows that it works.
Free coffee and donuts help car salespeople close deals. A couple of unexpected candies in the check at a restaurant gets the server a bigger tip (particularly if they come back to the table and hand deliver the second candy to “you lovely, special people”). When the hotel donates to charity on your behalf, you reuse a towel that you’d normally throw on the floor.
Reciprocity in Healthcare
You are probably thinking to yourself, “Cool, but what the heck does this have to do with healthcare?” Healthcare organizations have a real need for information or action from members, and it’s not always easy to get. By using a value first design to your approach (which means you provide the member with something valuable first and ask for the return favor later), you increase the likelihood of success.
We don’t just think and talk about these concepts, though. We put it into practice, and the Health Outcomes Survey (HOS) for Medicare beneficiaries is a perfect example of a healthcare initiative in which reciprocity can play a big role.
We innovated on the standard HOS solution by applying value first design, so instead of asking members to answer a questionnaire by telling them that it’s very important (it’s important to the health plan, not the member, by the way), we first provide them with a fun, engaging digital experience designed to be valuable, personal, and unexpected. Most importantly, it includes changes members can make easily and quickly in their own lives. It’s only after we provide this experience that we ask members to provide their feedback, allowing us to identify high risk members so the plan can act.
Useful tip: Don’t only give first (it isn’t enough). Aim to also give a gift unexpectedly. In a study, customers who were given surprise discount coupons upon entering a shop spent on average 11% more than those who were given the coupons in advance. The unexpected nature of the gift amplified customer responses. Ensure that what you give is unexpected relative to the norm of what’s expected.
Enter streaming health content. It’s something unexpected from healthcare but familiar to the member because it resembles media they consume every day, such as Tik Tok and Instagram stories. In this HOS example, the unexpected and helpful gifts are Fotonovelas, which are stories told through auto-advancing images (much like the snapchat or Instagram story experience).
One of the biggest mysteries of neuroscience is how we create meaning out of the world. Stories are deep-rooted in the core of our nature and help us create this meaning.
Information presented in a story-based format is more easily remembered than plain statistics or facts. According to Stanford Graduate School of Business’ research, stories are 22 times more memorable than facts alone. This is likely because stories universally activate brain regions dealing with emotional processing and memory.
A powerful communication tool, stories can capture attention, build trust and credibility, and deliver messages and insights with impact. In the next installment in our Frictionless Healthcare blog and webinar series, we will go more in depth into storytelling effect, the psychology behind storytelling, and how to leverage it within your organization, so stay tuned and maybe sign up for our newsletter below (nudge nudge).
Speaking of attention, dear readers, I’m probably losing yours. So, let’s wrap things up with some key takeaways about reciprocity.
It’s how relationships are built
It’s not a trade or negotiation
Follow the order of events: give, then ask
Give something unexpected, personal, and valuable to increase the impact
To learn more about using reciprocity in healthcare outreach, watch the full webinar below.
The logic behind streaming health content is simple. Just telling someone that it’s time to get a mammogram or renew a prescription isn’t always enough to get them to do it. There are numerous barriers to consider: social determinates of health (SDOH) factors, health beliefs, the health literacy gap, apathy, and more. Sending a well-timed, well-written text message can sometimes do the job, but often we need to go further and help the health consumer understand why taking an action matters and how they are benefiting from it. Or we simply need to get their attention for long enough to even hear us out.
Streaming health education, when thoughtfully integrated into engagement solutions, can achieve all of these things. It infuses current and innovative types of content into member outreach in new ways. The same way we have seen the biggest brands integrate streaming content into the consumer experience, healthcare can mirror and change the way they interact with their populations and, more importantly, change the way their populations interact with them.
6 Innovative Best Practices in Streaming Health Content
Innovation 1: Types of Content
The most innovative aspect of content in the last few years just may be the format it’s delivered in. Overall, there are four major content categories we’ve seen work well when brought into healthcare outreach.
Gifs
A lot can be said with a well-timed gif, and using humor to capture attention, as gifs usually do, are an effective way to focus the member on a very real issue, such as fall safety in our example above.
Self-Produced Videos
Self-produced videos are often short, recorded in selfie mode, and have less focus on production value. These qualities make them more personal, fun, and more able to capture attention and connect the creator with the audience.
Licensable Streaming Content
Spotify, YouTube, Netflix, and more! Streaming is the main delivery method for content today and used by a huge amount of the population. With the option of licensable libraries of streaming health education content now on the market, healthcare organizations can enter the game and have a better chance of meeting members where they are and in the ways they already live their lives.
Stories
Started by Snapchat and copied by Facebook and Instagram, stories are now everywhere. Healthcare can take stories and use social media as another channel to communicate with their populations or repurpose them for SMS delivered solutions.
Innovation 2: Making the Ask
Now that you have your content format ready to go, you’ll want clear, robust calls to action embedded within the streaming health experience, which is our second innovative best practice. Think about it this way: all the content delivered quickly falls short if you aren’t ultimately making the ask.
When crafting your call to action, make sure it is not only closely tied to the content being delivered but it is also specifically based on that recipient’s needs.
Innovation 3: Integrating Your Content into Your Programs
When you combine conversational AI capabilities with health content, you can uncover barriers to action through the consumer’s response and in turn deliver bite-sized educational clips to address their specific obstacle. This way, you are not only educating them on why they should take a certain action, but you are delivering tailored content which educates around the specific reason that individual is not complying. And because this is built on conversational AI technology, all of this is done at scale, yet individualized, for your entire population.
Innovation 4: Creating Surround Sound
Most of the daily lives of health consumers is digital– emails, websites, apps, social media, text messaging, phone calls, streaming content, and more. This makes it easy to apply our fourth innovative technique: create surround sound by producing a digital omnichannel experience.
In action, it might look like this: If we were heading into winter and you were trying to drive flu vaccinations, you might post an interactive FAQ to your organization’s social media story, send the mini lesson video through email or text message, and have the full vaccine lesson available through your website portal. Your audience would likely run into your content multiple times, which serves to reinforce the educational message and makes it more likely they’ll act on it.
Innovation 5: Targeting Your Content to Clear Business Goals
Your streaming health content is only as effective as it is in line with your goal. So, when producing and deploying content, you should tie it to the areas of your business you want to see an impact on—Health Outcomes Surveys (HOS), preventive screenings, diabetes prevention, and gaps in care just to name a few. Plainly, if your content isn’t addressing the action you’re trying to drive, you won’t drive that action.
Innovation 6: Data, Data, Data
Metrics regularly tracked still apply, such as text messages delivered, response rate, and completion rate of the desired action. Integrating streaming health content into your outreach, though, broadens the data you have access to for outreach performance and reporting. Now we can look at clickthrough rate to videos or activities, total views, engagement time, pages or lessons viewed per person, average number of course enrollments, average view time per piece of content, and so much more.
Integrating Health Content into Your Engagement Programs
When healthcare organizations take the innovative approach of creating educational health content (videos, bite-sized content, interactive FAQs, polls, quizzes, and more) and incorporate it in their outreach, we see much longer engagement times, the underlying problem of health literacy improve, and the fostering of better relationships between healthcare organizations and health consumers.
Our hope is this new frontier of educational health content creates a change in the health literacy of our society as a whole and improves the engagement and investment of individuals in their own health and well-being.
Flu season is coming back around, and in a post-COVID world, that means changes in how members engage when it comes to being vaccinated. Lingering perspectives related to vaccine hesitancy may influence members’ reluctance to be vaccinated for the flu despite vaccinations being even more critical to their continued health. Health plans, providers, and pharmacies will have to work harder this year to ensure their health consumers are vaccinated and protected against the flu than they have in years past.
With the unpredictability of flu severity from season to season, outreach and patient engagement to provide information and identify resources for access to vaccinations is integral to a health plan’s ability to proactively communicate with diverse populations through targeted content.
Annually, unvaccinated individuals will cost the healthcare system over $10.4 billion and an additional $17.6 Billion in lost worker productivity.
Flu vaccine patient education can help to prevent:
5 million flu-related illnesses
7 million flu-associated medical visits
105k flu-associated hospitalizations, and
3k flu-associated deaths
So, what can the healthcare industry do to combat this? With tools like behavioral science, interactive flu vaccine education, and conversational AI at their disposal, it’s possible to see significant increases in flu vaccination rates among members.
Let’s take a closer look at why.
The Foundation: Science of Human Behavior
Let’s start with the basics for any outreach program we run: behavioral science. In this mega-study conducted by The University of Pennsylvania and Walmart, 22 different behavioral science techniques were tested. These 22 varied techniques were embedded into messages delivered through SMS to over 650,000 Walmart pharmacy patients to determine which boosted vaccination rates the highest. Overall, including all these techniques increased flu vaccination rates by an average of 6.7% over a three-month follow-up period.
However, the endowment effect was the most effective technique, which encouraged patients to visit Walmart for a flu vaccine reserved specifically for them. By telling a person a particular flu shot is ‘reserved for you’ and already belongs to them, the vaccine becomes a tangible thing of value that they own. The Endowment Effect is an emotional bias to put a higher value on owned objects. This approach also uses the technique of Loss Aversion, a bias that makes us care nearly twice as much about avoiding loss than receiving an equivalent gain. In this case, if you don’t claim your flu shot, you’ll lose something you own.
We use behavioral science in every program we deploy for our clients, but this study specifically and the endowment effect itself was the basis with which we built our flu vaccination solution for the 2022-2023 flu season. What UPenn and Walmart didn’t have, though, was the following few factors that pushed our flu program beyond even this study.
Streaming flu vaccine patient education
With so much flu vaccine hesitancy in our post-COVID world, flu vaccine patient education about the safety and efficacy of vaccinations is a necessary step, and departing from the mundane pamphlets and brochures of the past by utilizing streaming health content is an extremely effective way to do this.
The content we’ve produced for flu vaccine education is a series of fotonovelas, which are auto-forwarding image-based stories with a visual interface similar to the stories feature on Instagram. Fotonovelas are ultimately a health literacy tool, but at the same time, they make learning fun and easy (80% of learners on our platform report liking or loving the fotonovela content type).
In this specific flu fotonovela below, the characters featured resonate with diverse audiences, the storylines detailed transcend linguistic and cultural barriers to deliver essential information, and the tone provides empathy and support on the path toward the desired call to action. The best part is that health patients who view a Fotonovela are 72% more likely to get vaccinated.
2-Way conversations uncover barriers
Having 2-way conversations allows you to gather insights about your members that can inform future communication.
What is their sentiment toward the program and plan?
Why haven’t they been vaccinated?
Have they already been vaccinated, and we don’t know?
Knowing why they haven’t been vaccinated allows the plan to respond with education and resources to assist.
Do they need help figuring out where to go? Send them the information to their nearest pharmacy.
What about if they’re not sure they need a flu vaccination? Send them a Fotonovela to educate them!
Multiple channels, multiple languages
The UPenn and Walmart mega-study tested SMS messages, but why stop there? A large part of an effective engagement strategy is meeting members where they are. As such, our solution includes SMS, IVR, and email channels. Take the concept of meeting members where they are one step further, and you’ll get the ability to deploy this vaccination solution in both English and Spanish. This means reaching more of your population in the way they want to communicate.
Tackle flu early and effectively
The CDC recommends that everyone six months and older, especially people at higher risk, should get a flu vaccine annually to reduce their risk of contracting seasonal flu, alleviate the severity of symptoms, and decrease the likelihood of experiencing major health complications if infected. The importance of each individual vaccinating against the flu needs to be communicated to members through targeted, succinct, and easily understandable materials delivered through channels to reach them where they are most apt to respond and be motivated to act. Studies have found that patients who are informed and effectively motivated are also more likely to adhere to their treatment recommendations.
Our flu vaccination solution
mPulse Mobile’s flu vaccination solution uses proven behavioral science, dynamic content, and an omnichannel approach to overcome common vaccine barriers and get more members vaccinated. With over 15M Flu vaccination touchpoints sent to Medicaid, Medicare, and Commercial members by mPulse in the last two years using its 2-way Natural Language Understanding platform, we have learned from millions of past vaccine conversations in both Spanish and English. We use behavioral science in a relatable and quick experience and employ Fotonovelas to empower members to act. We can help overcome common barriers and resistance by listening for vaccine readiness.
