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mPulse Recognizes Innovative Healthcare Organizations in the Sixth Annual Activate 2023 Awards

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. The company sought to promote smoking cessation among teen vapers, a cohort still widely understudied, by implementing intelligent 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.

Notable Outcome 
73% of participating teens set a quit date
 
 

Check out a new streaming health course for smoking cessation. »

 

Most Improved Consumer Experience

 
CalOptima Health
 
 
Program Goal 
Increase Awareness of SNAP benefits (CalFresh)

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 serves over 900,000 Medi-Cal beneficiaries. The health system looked to address a gap they had identified with low-income families enrolling in the 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

Like what you’re reading? Join us next year for Activate2023! Secure your spot now. »

Most Innovative Solution

 
 
Program Goal 
Drive members to schedule a diabetic eye exam

Humana is one of the five largest health plans in the country according to member enrollment and has been partnered with mPulse for over 10 years. With more than 20 million members, including over 5 million Medicare members, the plan looked to close a gap with their 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 improve pharmacy patient engagement by 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 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.

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

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

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

Equality vs. Equity: The Road is Long 

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

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

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

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

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

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

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

Streaming Health Content

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

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

Conversational AI and Natural Language Understanding

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

Social Determinants of Health (SDoH) 

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

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

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

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

Bridging Gaps: Our Commitment to Equitable Health

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

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

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

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

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. 

Frictionless Healthcare, Part 4: Stories that Move

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.

Haven’t read part 1 – 3 of this blog series yet? Go back to the beginning with Frictionless Healthcare, Part 1: Fueling Behavior Change »

Starting with the Foundation: Good Storytelling

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.

Want to learn more behavioral science basics? We’ve got you covered! Watch the entire Frictionless Healthcare webinar series on-demand »

Storytelling for Health Engagement 

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). 

Interested in more? Read part five of the Frictionless Healthcare blog series.

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

3. Olson R, Barton D, Palermo B.. Connection: Hollywood Storytelling Meets Critical Thinking. Los Angeles, CA: Prairie Starfish Productions; 2013. [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.

Celebrating Achievement in Health Equity and Technology Innovation at the Activate Awards

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. The company sought to promote smoking cessation among teen vapers, a cohort still widely understudied, by implementing intelligent 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.

Notable Outcome 
73% of participating teens set a quit date
 
 

Check out a new streaming health course for smoking cessation. »

 

Most Improved Consumer Experience

 
CalOptima Health
 
 
Program Goal 
Increase Awareness of SNAP benefits (CalFresh)

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 serves over 900,000 Medi-Cal beneficiaries. The health system looked to address a gap they had identified with low-income families enrolling in the 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

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Most Innovative Solution

 
 
Program Goal 
Drive members to schedule a diabetic eye exam

Humana is one of the five largest health plans in the country according to member enrollment and has been partnered with mPulse for over 10 years. With more than 20 million members, including over 5 million Medicare members, the plan looked to close a gap with their 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 improve pharmacy patient engagement by 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! 

7 Ways to Use Streaming Content in Your Health Communication, Part 2

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!

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.

mPulse Mobile Celebrates Health Equity with Third Annual Activate Awards

UPMC, Priority Partners, Premera Blue Cross, Inland Empire Health Plan and others receive awards recognizing their innovation and results in improving health consumer activation and health equity.

mPulse Mobile announces winners of the Activate Awards each fall during its annual Activate conference. The Activate Awards recognize customers and partners that have driven impressive results like most significant outcome, best use of Conversational AI and achieving health equity.

Winners of the Activate Awards are on the forefront of healthcare consumer engagement, leveraging Conversational AI and omnichannel engagement solutions to build meaningful relationships with their consumers and activate them in their health. Award submissions were evaluated on both qualitative and quantitative results.

2020 Activate Award winners include:

UPMC – Most Significant Outcome (tie)

A world-renowned health care provider and insurer, Pittsburgh-based UPMC is inventing new models of accountable, cost-effective, patient-centered care. It provides more than $900 million a year in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution. UPMC Health Plan, the largest medical and behavioral health service insurer in western Pennsylvania, offers health insurance to all Pennsylvanians regardless of their life situation, including employer-sponsored plans, Medicare, Medicaid, Children’s Health Insurance (CHIP) and plans offered through the Affordable Care Act.

mPulse’s solution supported a 10-week Home Run for Health program to over 2,400 Health Plan members who signed up through their employer group plans. After kickoff messaging, members received weekly check-ins and surveys with an end-of-program survey after completion of touchpoints, all via interactive text message. Outreach connected members to curated content around healthy eating, exercise tips, and other weight-loss topics.

Member engagement rates were very high, with over 72% of members engaged during the program. Program retention was strong, with only a 1.5% opt-out rate in spite of the challenge faced with the growing concern surrounding COVID-19 and the nationwide shutdowns.

Priority Partners – Most Significant Outcome (tie)

Priority Partners is a Medicaid Managed Care Organization that serves individuals throughout the State of Maryland.

Priority Partners sends out notices to Medicaid members to remind them it is time for them to complete their renewal (Redetermination) with the State of Maryland. In previous years, notices have been sent by mail and email, but this audience is often transient and hard to reach.

The mPulse Mobile solution engages members about renewal through mobile channels and was able to reach an average of 78.9% of members who were due for redetermination. Combined with the other traditional methods of communication, an average of 75.9% of members renewed their eligibility each month and kept their membership with Priority Partners, a significant improvement that helped more members maintain continuity of coverage.

Premera Blue Cross: Most Innovative Solution

Premera Blue Cross is a leading health plan in the Pacific Northwest, providing comprehensive health benefits and tailored services to about 2 million people, from individuals to Fortune 100 companies.

Premera’s main goal is to make healthcare easier to use. Premera’s messaging mission is to provide members with information about their healthcare and benefits quickly, educate them about Premera tools to navigate their health, empower them with actionable messages that lead them to self-service tools that lead them to solutions, and ultimately change their members’ behavior so they get the most out of their health plan while decreasing the need to call customer service.

The mPulse Mobile Engagement Console provides an avenue for 2-way communication between Premera and members via text. The Engagement Console became the communication channel that allows customer service representatives to text back and forth with members from these plans to assist them with booking appointments with high quality providers as well as answer questions within privacy and legal constraints.

The Engagement Console was also used to send confirmations via text when a member uses the Premera mobile app or the Premera Pulse website to schedule an appointment.

Since deploying the program to 5 top plans, a significant portion of members have scheduled appointments with top providers and have an average of 1.5 appointments per member who engages with the Premera team via the program.

Inland Empire Health Plan: Achieving Health Equity

Inland Empire Health Plan (IEHP) is a not-for-profit Medi-Cal and Medicare health plan located in Rancho Cucamonga, California. With a network of over 4,000 providers and more than 2,000 employees, IEHP serves more than 1.3 million residents in Riverside and San Bernardino counties who are enrolled in Medi-Cal, Cal MediConnect Plan (Medicare), or the Healthy Kids Program.

IEHP launched an important solution with mPulse Mobile aimed at addressing social isolation over 6-7 weeks with 92,000 Medicare and Disabled members of IEHP. The Conversational AI solution was used to identify self-reported social isolation levels and challenges of staying at home during the COVID-19 pandemic.

The solution consisted of 15-30 automated conversations that offered support and provided tips and resources to combat social isolation and “stay at home” challenges. These included the use of Fotonovelas to communicate a visual story on the challenges of staying at home. Members received an average of 20 tailored, conversational touchpoints. Program satisfaction was very high; over 86% of members found it helpful, with higher satisfaction in Spanish-speaking segments than English speakers.

Midwest Medicaid Managed Care Plan – Best Use of Conversational AI

This Medicaid Managed Care Plan worked with mPulse to increase and improve the number of well-child, dental, and lead screening visits required to achieve quality, state, and plan operational goals. Since a large number of members are under 18, these EPSDT and HEDIS gaps are very important in managing the preventive care and overall health of the population.

Using mPulse’s conversational AI solution, members were targeted to remind them to complete their visit with a series of automated touchpoints. Outreach was orchestrated to match the best reminder content to each individual member. In total, approximately 100K gaps were targeted by the mPulse solution, successfully driving over 65,000 provider visits and making significant improvements in screening and visit completion rates.

Southeast Medicaid Managed Care Plan – Most Improved Customer Experience

This Medicaid Managed Care Plan leveraged a mobile outreach strategy that included implementing 2-way, automated text messaging solutions to improve overall health engagement as well as improve a hard-to-reach population’s completion rates of Health Risk Surveys. They use mPulse’s platform to reach these members using a new channel (SMS + Secure Survey). The new solution uses high-reach channels and optimized content, resulting in significant improvements to completion and member satisfaction. With ongoing optimization of content and conversational flow, completion rates have more than doubled and initial member engagement rates have improved by 75%.

“On the other side of these solutions are meaningful outcomes that are really impacting people and their health,” said Chris Nicholson, Co-Founder and CEO of mPulse Mobile. “Seeing so many wonderful partners leveraging our solutions like Conversational AI, the Engagement Console, and Fotonovelas to engage their members in meaningful ways to build valuable relationships that in turn lead to positive outcomes motivates our team every day. The Activate Awards are such an important reminder every year why we do what we do.”

The Challenges and Opportunity for Technology and Health Equity

We know that COVID-19 has amplified many underlying issues in healthcare and beyond. Health equity was already an important topic in healthcare, but COVID-19 has brought it into sharp focus as cases, hospitalizations, and deaths from the virus disproportionately impact disadvantaged groupsTechnology use in delivering healthcare is another long-time trend catalyzed by the pandemic, as millions were left with virtual care as their only option for the first time. Iseems apparent that these advances in technology use create the capacity to meet people where they are with information and care that is quickly and easily accessible. But it will take careful effort and consideration to ensure that access is improved for those that most need it in an inequitable system. And with new technology, there will also come new challenges and barriers that may not have existed in the past. 

Understanding Technology Across Segments 

At mPulse, we naturally look closely at technology adoption rates in healthcare’s most important populations. When we look at the disparities in technology use and access, they tend to line up with the negative outcomes we see in healthcare. Black and Hispanic communities have faced a disproportionately higher fatality rate than other races due to COVID-19 and suffer from higher rates of chronic conditions. The Pew Internet Research Center’s statistics show black and Hispanic communities more than twice as likely to be dependent on smart phones for internet access than white Americans. This means that they are more likely to rely on smartphones as their sole access to the internet, as opposed to a tablet, laptop, or desktop computer. Telehealth platforms that are optimized for desktop/laptop use and not mobile phones could disadvantage these groups disproportionately. Furthermore, populations who may not have access to stable and high-speed broadband in their homes would only be able to interact with telehealth that is mobile-optimized and can be supported on a cellular data connection 

Though smartphone dependency and internet access disproportionately impact minorities and low-income groups, mobile phone adoption presents an opportunity to connect hard-to-reach populations with tools and information to access and maintain their healthcare. Overall cellphone adoption rates in the US have converged across demographics, with Black, Hispanic, and white Americans equally likely to own a cellphone (over 96% of all adults do). So while internet and broadband-reliant technology may create new barriers hat must be overcome if telehealth is to become a long-term solution for improving access, engagement solutions that focus on cellphones have the potential to reach oft-neglected populations just as effectively as any other 

The role technology can plan to help address health disparities will be a key area covered by our keynote speaker – Dr. Gail Christopher- at our Activate 2020 virtual conference. Dr Christopher is the Chair of the Trust for America’s Health. 

Language Barriers: A New Version of Old Challenges

Telehealth and virtual care in general must be able to support multicultural and multilingual populations effectively. According to a poll from the Associated Press-NORC Center for Public Affairs Research, “half of these Hispanic adults age 18 and older rely on family or another health care provider to help resolve language or cultural difficulties in the health care system, while more than a quarter have relied on a translator, public resources in their community, or online sources for assistance. Understanding that language barriers in traditional care delivery may have been managed more than successfully bridged will be vital as systems and plans roll out new models. Beyond language, there can be significant cultural differences in attitudes and use of the healthcare system across populations.  mPulse has seen in cases with several multi-cultural populations that tailoring content to account for language as well as culture can be just as important as tailoring based off of health status or age. In cases like the COVID-19 pandemic, where organizations need their entire populations to understand important prevention and system navigation information, closing gaps between language and cultural groups becomes critical. Configurable and engaging content that can be fully adapted to different languages or populations, such as the fotonovelas we’ve used with some of our customers are just one example of the effort required to get key information to people in these diverse populations equitably.    

Preconceived Notions of Telehealth 

Studies have shown Black and Hispanic communities may feel more uncomfortable interacting with health professionals via camera and having facial pictures taken – practices that are common in telehealth appointments. This discomfort could be a factor for low engagement, or appointment no-shows. So while these two communities are likely to be among the most at risk for negative health outcomes, if they do not feel comfortable engaging with their plan in the new virtual or telehealth environment, they may be a lot less likely to move forward or seek out careBuilding trust becomes crucial. One of the advantages to the kinds of asynchronous and automated conversations that the mPulse platform supports is that the patient or member can engage on their own time and terms. Whether through solutions like ours, or other types of outreach, organizations should find opportunities to create meaningful touchpoints with the people they care for that do not initially require new technology navigation, app downloads, or unfamiliar forms of interaction. In fact, some of our leading plan partners have used mPulse as the primary means of driving awareness and adoption of their telehealth platforms. The key has been that members who are used to getting important and relevant engagement from our solutions about their benefits, medications, and preventive care, are being directed to telehealth by an established and trusted line of communication with their plan. Helping to meet members at their comfort level and introduce new technology with compassion and understanding will be vital to ensuring the widest access.  

How can healthcare achieve the triple aim of managing cost, access and quality of care when it comes to virtual care and other new technologies? How can we embrace connected health and the power of the Internet of Things when smart device use is not embraced or even feasible across all populations? And how can technology create opportunities to solve disparities and inequities in healthcare? These questions will take a central role as we move toward an end of the pandemic and the healthcare system reckons with its long-term impact on how we deliver healthcare in the US. And while we can’t always expect definitive answers, being aware of challenges and watching for opportunities is the first step to making that impact as positive as humanly possible.