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Closing Diabetes Care Gaps

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

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

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

Background

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

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

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

How to engage the hard-to-reach diabetes patients

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

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

Using tailored health engagement to bridge gaps in diabetes care

SMS Messaging

Example:

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

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

Interactive Voice Response and email

Example:

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

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

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

The importance of health education and literacy

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

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

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

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

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

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

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

by Ranelle Kirchner, launches in 2022.

Reimagining Health Engagement

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

Case Study: A1c Test Reminders

Client: Anonymous Health Plan

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

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

Outcome:

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

Case Study: Insulin Rx Refills

Client: Anonymous Pharmaceutical and Medical Device Company

Goals: Increase conversion rate for diabetes insulin pump reorders.

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

Outcomes:

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

 

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

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

Flu Season 2021-2022: New Challenges Require New Approaches

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

COVID-19 and the Flu: Lessons from Last Year

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

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

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

Predictions and a Plan of Action 

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

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

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

 Effective flu engagement solutions for 2021-2022 should: 

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

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

MHPA & mPulse Mobile Present: Using Fotonovelas to Increase Member Engagement and Reach Wider Populations

MHPA and mPulse Mobile will partner in an exclusive webinar May 26th at 11:00 am PST / 2:00 pm ET with Rena Brar Prayaga, Behavioral Data Scientist and mPulse Mobile consultant, to discuss fotonovelas. In this session we will cover:

  • What are fotonovelas?
  • How to deploy them
  • Why they were relevant then and how to leverage fotonovelas moving forward

We’re excited to present to the Medicaid Health Plans of America audience and introduce our learnings and successes from this innovative program we have launched with multiple clients.

Learn more about one of our fotonovela use cases here, and please follow us on LinkedIn to join the discussion!

Leveraging Technology to Meaningfully Impact the Member Journey: Key Takeaways

On March 23rd, we had the opportunity to sit down with one of our Medicaid partners, Peach State Health, at Whole Person Care for Medicare, Medicaid and Duals. In this discussion, we talked through the member journey and the impact tech and data can have on the holistic approach to population health. Here are our key takeaways: 

Establishing Trust In the Member Journey

Sheakeena Lamb opened the session with Peach State Health Plan’s focus group findings that spurred the need to engage their members in a meaningful way that made sense to each unique member and their preferred channel of communication. In order to overcome health barriers, you first must be able to reach the member. From there, health plans can outreach effectively with the appropriate resources needed to inspire healthy behavior change. Connecting with the member in a way that saves both the organization, and the member time and resources helps develop a trusting relationship. Having meaningful connections is what will encourage the member to see their health plan as more than just a payer and more like a trusted partner — a valuable source to discover key information they need to take control of their health management and live a healthier life throughout their health journey.

Challenge the Unknown and learn from Past Use Cases:

Peach State learned very early on they needed to refocus their outreach efforts to meet their members in the channels they said worked best for them. For Peach State, that was text messaging over mailers and IVR. Their member population simply did not have the time to pick up the phone during workdays and did not trust unknown callers.  And as many organizations know, mailers can be costly and time consuming. After deploying SMS well-child reminders, Peach State saw 170k unique members engage with their messages. Outreach through a trusted channel like text can also overcome the unknown caller barrier – we are all hesitent to answer when receiving a call from an unknown number. If the member is not aware their health plan is calling because they do not trust “unknown callers,” then the opportunity to engage is completely missed.

Member preferences matter:

Understanding the member journey is one step of a successful engagement solution. Understanding how and when to engage members, and then using in-channel communication to reach them in the language they prefer, at the time that is right for them, is what elevates a good strategy to a successful ROI engagement solution. mPulse has seen this time and time again when deploying bi-directional communication solutions for our clients. Engagement increases when members feel like their provider or plan are able to engage with a natural language understanding. And when the organization can  scale that communication with an automated solution, it becomes cost saving too. It enables plans to get  closer to the triple-aim and deploy efficiently at scale, reduce resources and increase trust between the member-plan relationship.

Data’s impact on future member engagement strategies:

Valuable data like member preferences, SDoH information, and experiental data can and should, affect a plan’s member outreach strategy. By employing a deep understanding of the member population, you are able to build better lines of effective communication and help your members navigate their individual health journeys. Working with the correct reporting tools and solution partner, can uncover communication barriers the plan may not have known posed an immediate issue. “If we can figure out where the barriers are for our members then we can address them early instead of falling behind,” said Sheakeena Lamb. With data on measure eligibilities and having visibility of a large part of a member population, plans can catch members that could develop care gaps, and use this data to drive quality improvement strategies.

Going Beyond traditional touchpoints:

After the data is collected, and the reports have been pulled, comes the need to reimagine an outreach strategy that works for each individual member. Using the right tools to send text messages in members preferred language, or at their preferred time impacts the level of engagement and provides a meaningful facet to the holistic health journey. And the right tools can store that information for later use when tailoring downstream conversations. Not only being able to respond with the appropriate information and connect members to plan or provider resources but to be able to remember important preferences can establish health plans as more than just a payer, more than just a resource, but as a invaulable healthcare partner.

Solving Two Big COVID-19 Vaccine Challenges

The world is undertaking the largest vaccination program in history. It comes as no surprise that a number of logistical and cultural challenges have arisen. After all, there are around 8 billion people with different backgrounds, beliefs, and access to care on the planet, almost all of which should be vaccinated rapidly. Let’s look at the challenges and the solutions required to meet them.

Challenge 1: Supply Strain and Processes

There is not a uniform vaccine distribution approach. Each state and county is constrained by limited vaccine supply and faced with different populations’ needs. This lack of a broad, consistent process creates a lot of questions about who is eligible for a vaccine, how to book an appointment, and where to go for information.

What do people do when they have questions and can’t find clear answers? They reach out to the organizations and people they assume have the answers. The first issue: if people reach out to the wrong source, they may get the wrong information. The bigger issue: a huge surge of calls and other communication with their healthcare organizations, overwhelming staff and resources.

The solution is proactive outreach.

One of the biggest keys to proactive outreach is simply getting started. Establish the line of communication with members and patients to build awareness and establish trust. Then it’s all about reaching out quickly and thoughtfully. Provide updates as soon as possible, answer questions before they are asked, and share access to resources. The more reliable Covid vaccine information patients and members can easily access, the more empowered they are.

Pro Tip: Tailor Covid vaccine outreach based on eligibility. This reduces questions and improves patient and member experience as they do not try to schedule a vaccine appointment before they are eligible.

Learn more about the mPulse Mobile Ages 5-11 Covid Vaccination solution »

Challenge 2: Vaccine Education

According to Pew Research, about 40% of Americans say they do not plan to get the vaccine, though nearly half of this group cited the need for more information. At first, these stats can be a little surprising; Dr. Fauci has become something of a celebrity and the CDC is constantly sharing information. But for a range of reasons, these national campaigns aren’t convincing this segment of the population.

The solution is tailored education.

The first step in providing tailored education is understanding what personas and population segments are questioning or are doubtful of current Covid vaccines. Any healthcare organization that does not have a clear idea of who in their population falls into this category should begin with simple outreach to find out. This can be as basic as a short survey, maybe even just a single question asking whether they intend to get a Covid vaccine.

Once this population is identified, the trick is to deliver education through channels and formats they prefer. Some ideas include videos of doctors or other healthcare experts from nearby or similar communities discussing vaccine safety, digital fotonovelas featuring identifiable characters, and other streaming media like podcasts or video courses that address their specific concerns. People resonate with different messages and formats; it’s all about relating to them.

Pro Tip: Begin with basic outreach to better understand your population and their sentiments. This also opens a valuable communication channel that can be used for education.

A holistic Covid vaccine engagement solution must be able to impact both of these challenges to help your organization achieve the widest possible vaccine distribution possible this year.

mPulse Mobile Acquires The Big Know

The acquisition combines mPulse’s proven ability to reach and engage vital member populations with The Big Know’s learning expertise and rich media health education experiences, enabling health innovators to deliver personalized conversational experiences in preferred member channels and streaming content formats. Click to read the full release.

Hear from mPulse CEO, Chris Nicholson, and The Big Know President, Allison Gage

A Tale of Two Companies

mPulse Mobile

One thing we’ve learned from over a decade of experience and more than 400 million conversations annually is the power of education in self-efficacy and how that leads to activation. Our solutions excel at reaching and engaging diverse member and patient populations on their healthcare journey, helping customers to measurably improve outcomes. We are on a path to power over half a billion digital interactions in 2021, through a combination of engagement channels, behavioral science strategies, analytic insights, and industry expertise. Combining our engagement expertise with streaming health education creates a holistic member and patient engagement experience for our customers.


Chris Nicholson, CEO, mPulse Mobile

The Big Know

The Big Know creates health education for the streaming age. Through video courses and podcasts taught by inspiring health experts, the company drives health literacy and member engagement through powerful learning technology. Launched in 2015, The Big Know is recognized as an industry-leading learning experience platform and health education provider.


Allison Gage, President, The Big Know

Looking Forward

As consumer expectations and preferences continue to change, healthcare organizations must adjust to meet their needs and maintain strong relationships with their consumers. Quality member and patient engagement is a vital and unavoidable part of the healthcare journey. The acquisition of The Big Know empowers mPulse to meet consumer expectations with streaming health content, including podcasts and video courses. Additionally, this acquisition increases our ability to create new content and engagement experiences as consumer and organization needs evolve. We aim to always be up to date with consumer interest and behavior so our customers can provide best-in-class experiences to their members and patients. We are now able to do that better than ever.

Full Release

mPulse Mobile Acquires The Big Know To Add Streaming Health Education Experience

Pivotal industry partnership reimagines health engagement and sets forth path to drive greater health outcomes

LOS ANGELES, January 19, 2021 – mPulse Mobile, the leader in conversational AI solutions for the healthcare industry, today announced its acquisition of The Big Know, a prominent digital learning company transforming how healthcare educates consumers. The partnership combines mPulse’s proven ability to reach and engage vital member populations with The Big Know’s learning expertise and rich media health education experiences, enabling health innovators to deliver personalized conversational experiences in preferred member channels and streaming content formats.

“One thing we’ve learned from years of healthcare engagement is the power of education in self-efficacy and ultimately health activation,” said Chris Nicholson, CEO and Co-Founder of mPulse Mobile. “Healthcare organizations need to provide meaningful and relevant education to their consumers in a way that is both familiar and impactful. We realize that streaming health education experiences are the best way to meet that need.”

mPulse Mobile solutions excel at reaching and engaging diverse member and patient populations on their healthcare journey, helping customers to measurably improve outcomes. They are actively engaging nearly 50 million Americans and are on a path to power over half a billion digital interactions in 2021, through a combination of engagement channels, behavioral science strategies, analytic insights, and industry expertise.

The Big Know adds a superior ability to captivate, educate and activate individuals through award-winning cinematic content that is proven to sustain deeper relationships. The company’s unique approach to personalization allows for delivery of content when and where members need it most and supports their learning journey.

Both companies combine to set a new standard for health engagement and experience. The result is a holistic approach to digital health engagement with integrated conversational AI and rich content streaming, a major development for the industry that helps address gaps in how healthcare organizations educate and activate their members.

“We have a mission to improve health equity and health outcomes for the populations that we serve. Building on a foundation of knowledge through demographically appropriate learning strategies will help our clients and us achieve these goals and reduce health disparities,” Nicholson continued. “Our combination with The Big Know is a perfect synergy. Our legacy of engaging with hard-to-reach patient populations combines with their dedication to health literacy and formative learning experiences to ensure more educational engagements and greater outcomes.”

A deeper entrenchment in the streaming age and shifting consumer expectations demand a shift in the healthcare industry’s approach to care delivery and experiences. Quality patient engagement must be acknowledged as a vital and unavoidable part of the healthcare journey. Through this acquisition, mPulse and The Big Know will not only address these emerging industry demands but will pave the way by reimagining what patient engagement and experience should accomplish.

“When we think about healthcare delivery, member and patient engagement must include education,” said Allison Gage, current President of The Big Know, and mPulse’s new Chief Engagement Officer. “We must help consumers better understand and learn the skills to activate their personal health journey and give them the confidence and motivation to seek the best possible care. Only then will they take the necessary action to be healthier and happier. Our collaboration with mPulse allows us to accomplish this and so much more, and our investors, such as LFE Capital are excited about this new direction for The Big Know.  This is a most meaningful year in healthcare and a time for transformational health engagement.”

How We Tailor Healthcare Engagement Content

As consumers, most of us have grown to expect personalized and relevant messaging from the companies we interact with. Think of the pleasant surprise when you receive a coupon for a product you wanted, or by contrast, the irritation of irrelevant messages about something you were never going to buy cluttering your email inbox before you eventually flag as spam. There are two ways for organizations to provide the better experience: a lucky guess (really a broadcast message that at least a small percentage of the audience will find useful) or aligning outreach with individual-level data. In order to earn and maintain consumer attention and ultimately drive action, successful organizations understand that each touchpoint must happen as part of a coordinated, long-term relationship, not in one-time campaigns. This means each piece of content delivered in any given consumer engagement program must be timely and tailored.

Healthcare organizations must deliver this same integrated experience in order to truly engage members and patients. With multiple outreach programs in place, often across departments with competing schedules and priorities, this poses a unique challenge. Barraging members with excessive information only causes frustration and damages trust, especially if some of the messages aren’t relevant to each person. Getting members to engage with content and ultimately act upon it requires first knowing what content will be important to them, and delivering it at the right time.

mPulse Mobile built our proprietary content recommendation engine, mCare, to solve this problem a few years ago. Our customers were engaging members in dialogue via text, but were struggling to leverage the insights from their responses to inform the next touchpoint days or weeks later. Since most 3rd party recommendation engines are not focused on healthcare or conversational engagement, we built our own to fit with the kinds of activation-focused solutions that healthcare requires.

mCare not only delivers relevant content designed to drive action, but it also orchestrates each touchpoint over time, so that members are engaged rather than overwhelmed. We get a lot of questions about mCare and the Activation Intelligence process that it drives, so we put together a quick overview here.

Understanding, Tailoring, and Activating

The first step in this process is understanding the individual. We maintain persistent and dynamic profiles of members that combine a range data attributes, including demographics, health status, psychographics, engagement data, and more that can depend on the customer and solutions. Member profiles constantly evolve as we learn more about each individual, including information gathered through dialogue interactions automated by Conversational AI. This comprehensive understanding is key to determining the right topics for each member.

mCare matches members to content by comparing key profile attributes to our content libraries, and then selects the single next best content topic. Say you have a new member who we know to have a chronic condition such as diabetes. mCare will search all available content and dialogues to match this individual to topics that are relevant—a new member welcome, prompts to schedule an eye exam, or educational health tips.

While all of these subjects are pertinent, receiving several messages, or even several multi-message dialogues, at once could overwhelm and frustrate the member while dulling the impact of each. mCare uses rules configured for each customer and population that are informed by mPulse’s behavioral data science principles. It selects the best topic and prioritizes that conversation – for instance, a new member welcome over an immediate ask to schedule the eye exam. As the person engages (or doesn’t), their profile will update, along with any new data we get directly from the customer. So at the next touchpoint (e.g. a week later), mCare will make an even better informed decision.

This is also where automatically tailoring content can become very powerful. In that diabetic member example, the person may not have responded to the welcome dialogue. So when mCare runs again, it notes the lower engagement level and selects an eye exam reminder that has been written to target hard-to-reach and lower engagement populations instead of a more standard one. Whether mCare sends a follow up eye exam reminder, or changes tailoring tactics later on, would depend on whether the member engages and takes action.

Tailored and timely delivery of content is the beginning of effective engagement. mCare starts with the most important topic first and ensures that all subsequent touchpoints are delivered in a coordinated, prioritized fashion over weeks, months, or years. The ranking and importance of each topic within mCare is determined customer business goals and desired program results, as well as input from our team of behavioral data scientists to drive health outcomes. This means that a series of diet and exercise tips for a member population would be superseded by a vaccine reminder at the beginning of flu season.

Starting a conversation with the right message at the right time earns members’ trust, attention, and builds stronger relationships. To truly deliver optimal engagement, mCare handles diverse types of content and can send them across channels. Flexible and scalable, these content libraries can expand and the content recommendation engine can adjust based on shifting business needs and priorities. Rather than starting over for each campaign, mCare views each person in the context of an ongoing and evolving relationship to ensure your consumers are engaging with valuable, tailored content to activate healthy behaviors.

Key Takeaways from AHIP: Conversational Member Engagement Session

mPulse Mobile is a leader in conversational AI solutions for the healthcare industry. We work with 100+ healthcare partners and have deployed over 300 million messages to healthcare members. mPulse’s CTO, Ram Prayaga, sat down with VP of Marketing, Brendan McClure at AHIP’s Consumer Experience & Digital Health Forum 2020 last week to discuss how we execute Conversational Member Engagement: Data, Experience, and Outcomes. Here are our key takeaways:

Orchestration of AI Conversational Engagement

At any given time, plans have multiple departments that are prioritizing topics of interest for their members, so how does a plan coordinate those touchpoints and maintain a relevant member-centric strategy? The answer is data. Plans that utilize the data collected from conversations and interactions with their members and leverage tools that incorporate that data to tailor content and frequency will be more successful at reaching large populations with an approach that meets each plan and member needs. While it may be difficult to curate messaging for each member, with an omnichannel and AI-enabled system, plans are able to implement tailored content and promote a more coordinated outreach cadence for each member or population segment.

How do Plans Gather Conversational Engagement Data?

Although conversational data is a newer type of data, it has become a valuable tool when reaching out to members at scale. Brendan mentioned in the session that insights from conversational outreach can be used in a number of ways to “Give the plan an important read on experience.” A plan can analyze member responses to understand sentiment and intent, as well as see how members navigate through interactive programs to identify opportunities to optimize future outreach. Ram guided the audience through primary touchpoints that conversational engagement data impacts in the member experience. He talked through mPulse’s barriers assessment, which allows a plan to learn the why behind a member may not be meeting their health goal and the plan’s target outcome. He talked about mPulse’s analysis of sentiment and intent of member responses, which can scale from positive to neutral to negative, which gives a plan more data to tailor messaging and meet preferences. All of this information is gathered by engaging in a natural dialogue via interactive messaging – such as text messages – versus deploying a full off-cycle CAHPS survey, for example. The plan can also glean this experience data needed from conversations, rather than relying on survey questions asking the member for it directly.

How Can Plans Engage at Scale?

Utilizing artificial intelligence in text conversation allows plans to deploy messages to millions of members with  a more natural, conversational experience. In order to maintain a good connection with thousands of people at the same time, plans need to understand what people are saying, measure it and store that information for future touchpoints. Conversational AI, integrated with an omnichannel approach, is the perfect tool for that goal. Most members have access to a mobile phone and text regularly, including senior populations, but for the members who are most engaged through IVR, mailers, and other alternative routes of communication, plans will still need to consider meeting their members where they are. Adding an automated conversational solution can help support a multi-pronged communication approach to reach members in the channels they prefer with impactful dialogue.

How Do you Maintain the Human Touch?

The best engagement feels natural and easy for members. A simple act like listening to the members preference on the best time of day to initiate a conversation, or starting the conversation with content that is relevant to the individual will make a difference in the members response. How a plan manages members preferences is vital. When thinking about member-centric outreach, a plan can look at different ways to engage a member in a dialogue that listens versus putting them on a one way automated track. When we think about human conversations, we do not converse in a linear manner. Often times the conversation will jump from one topic to the other in a short period of time. A truly conversational solution should be able to listen to those pivots in the dialogue and accommodate its workflow to respond with relevant information that follows along with what the member is saying in real time. This means having a deep and well-indexed library of content for each conversational solution, as well as a thorough response-handling process – whether via Natural Language Understanding, or human support of automatically-launched programs.

Tailoring Outreach Once a Plan Has the Data to Work With

It is important to understand the challenges that members are facing, and then to target their outreach to address those barriers. Making sure to account for the hard-to-reach members in any population is vital to the approach as well. Outcome data that shows what works and what does not within certain demographics based on their SDOH impact gives the plan more insight into how to build trust within that plan-member relationship. For example, if a plan only reaches out about its benefits to their members right before they need to renew their plan, it is much less effective and meaningful than had a plan been initiating those conservations all along. But if a plan engages in those conversations about what benefits may be a good fit for that particular member based on past experiences and their demographic, then when the time comes to renew, the member is more likely to trust and value the reminder because the plan has shown to have their best interest at the core of their outreach. The member will feel more compelled to stay because they know they can rely on their current plan to address their immediate and long term needs. Maintaining the trust between plan and member is probably one of the most valuable ways conversational data can help impact the plan-member relationship.

COVID-19’s Pressure on Digital Experiences

Plans were forced to evaluate and evolve their digital outreach approach quickly with the onset of COVID-19. For a lot of plans, they had to adopt strategies to pivot into virtual care as quickly as possible. They also had to provide additional resources to help their members navigate through virtual platforms that they themselves may have been adjusting to. When a plan is able to curate a digital journey, they have an opportunity to build awareness around solutions that are relevant to members specific needs. Curating the journey helps hold their hand, helps them navigate a new digital landscape in addition to sustaining the relationship. During the pandemic, mPulse positioned the need for digital therapy to our client’s members suffering from social isolation. Before initiating an ask to the member to engage in the program, we communicated the value. This strategy was effective because we were able to educate around the need for digital therapy and gauge the members interest, which gave the member the opportunity to come to the plan on their own instead of pushing them to sign up for a new virtual care program.

As we look ahead to 2021, what we have learned in the past year and throughout our most successful programs, is that trust between member, provider, and plan is crucial, especially as we transition through one of the most pivotal moments in healthcare. But the better prepared a plan is to respond to members and their immediate needs that also doesn’t burn a lot of resources on the plan’s end, the better relationship between member and plan will be. Focusing on approach, collecting all data from those use cases, and keeping the member at the center of all strategic communication is key.

How to Maximize Health Plan Member Experience Through Communication

When members think of their health plan, they don’t typically think of a bunch of separate departments with different goals and initiatives. They think of a single entity. To maintain a positive relationship and strong member experience, it is important for plans to act as much like a single entity as possible.

For example, a call or message about the importance of blood testing for a diabetic member on the same day as a claims update, vaccination reminder, and a customer service survey provide a confusing, often frustrating experience for members. Making matters worse is when this cross-communication also comes from a variety of channels. When multiple departments use multiple tools that allow for easy email, IVR, or mobile outreach, the convenience of self-service can mean haphazard outreach for the member, causing abrasion and confusion.

The move toward mobile and digital outreach requires intelligent coordination to fully deliver on its potential and avoid dangerous pitfalls around member experience and compliance. The first step is to fully audit the member communication experience from both the entire organization’s and a member’s perspective. Understanding the topics and needs that different departments have, as well as how often a member is getting letters, emails, calls, texts or portal messages in a period of time, helps frame the member/plan relationship more accurately.

Learn more about mPulse Mobile’s omnichannel solutions

To address this challenge, it is important that departments and communication strategies are aligned. This requires either incredible communication throughout the organization, or more simply a single platform that coordinates and orchestrates outreach. This platform must consolidate engagement efforts into a single hub that gives you a clear idea of performance, engagement, and volume for each channel at the population, segment, or individual member level. From the member’s side, it means that their engagement on one channel doesn’t occur in a vacuum – responding to a text that you received a flu vaccine means you will not have to receive a phone call reminding you to get one two days later. For the plan, channel selection is no longer a limiting factor in launching programs – letting your team and ours focus on maximizing outcomes through the most effective mix. The platform also centralized preferences for channel, frequency, and language while also maintaining key compliance functions for opt-outs.

If your mission is to provide a positive member experience that builds trust, consolidating your engagement outreach in a single source is likely your best option.

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Key Takeaways: RISE 10th Annual HEDIS and Quality Improvement Summit

mPulse Mobile’s Government Programs Strategic Market Executive, Reva Sheehan, sat down with John Hopkin’s Director of Medicare STARS at Advantage MD, Tejaswita Karve, and Molina’s Regional Manager of Risk Adjustment, Ryan Dodson, to discuss New HEDIS Patient Experience Measures and Weights at the RISE HEDIS and Quality Improvement Summit. While the summit focused primarily on HEDIS and Star Ratings changes affecting the 2021-23 years, there were a few key insights we thought stood out during the panel. Here are our Key Takeaways:

Get to Know Your Members and Their Experience with Their Plans

The Annual Open Enrollment period is an important time of the year for both health plan and members. Health plans have the opportunity to re-engage members with new and important information and hopefully retain membership while welcoming new acquisitions. Members also have the opportunity during this time to reevaluate their current plan and benefits and voice what is important to them and what they felt was lacking throughout their interactions with their plan. It is a crucial time for member outreach.

Because CMS requires some materials are delivered to members before the beginning of the Annual Enrollment Period (AEP), if plans experience returned mail or unopened digital messages it can be a good indicator of who is or is not  receiving the plan’s communications because the bulk of members will get some form of touchpoint from the plan during AEP. This presents an added opportunity to engage members the plan may not have known they were missing all while strengthening continued outreach to members who voiced their pain points with the plan.

Discover the Differences Between High Utilizers and the Mildly Engaged

Understanding engagement differences from in-between members, those who the plan does not hear from often enough, from high utilizers will help guide what touchpoints are most effective for that mildly engaged population. Perhaps one method of communication results in a high feedback but is less successful for an entire smaller core demographic. What does the plan do with that data? Using encounter data or claims compared to communications with the plan can uncover communication barriers that will help the plan hone in on the right outreach for each member. For example, when mPulse deployed our Fotonovela Solution with one of our managed care partners, our data reflected that our partnered plan had a 37% engagement rate from the Spanish speaking population vs. 17% from the English-speaking population. Fotonovelas proved to work more effectively with one population over the other. Without that response data with specific language points and outcomes, mPulse may have seen a successful use case but would not have had the valuable data that prompts the plan to segment their outreach appropriately. Being able to capture those data points and incorporate them into future outreach strategies alleviates some of the unknown factors that affect the overall member experience from outreach to appointment.

Measures with Increased Weights – Moving forward with CAHPS

CAHPS carries much more weight in the coming years and with that plans will need to rethink how they deploy off cycle surveys and related communications, while trying to sift through the stagnant data they have now. During the RISE panel, John Hopkins’, Tejaswita Karve, touched on the efficacy of NPS scores and how to collect that feedback and utilize those data sets. Plans can use that data to keep their members in the loop while waiting for the 2021 survey results. Educating members and empowering them with the knowledge that their feedback matters and why it matters and how the plan makes changes based on the data collected from these surveys will have a positive impact on member perception. Being proactive helps engage the member in future communications because the member is more aware of what to expect and how their input directly impacts their care management.

Combat Survey Fatigue

Deploying short surveys throughout the year to collect information on what resonates with the members shows that the health plan is listening to members’ feedback and are taking action. One of the panelists mentioned that her past organization deployed a “We Heard You” campaign that worked well by engaging members of new changes all throughout the year, keeping them informed of new programs and benefits that in some cases were a direct response from the members. Advisory boards and focus groups can be a good tactic when gathering data for outreach, but it also makes the member the centerpiece of the conversation. It is an opportunity to ask if they have everything they need, all while building a relationship and ambassadorship. The data collected right from the source is a valuable tool when engaging in future outreach.

Sometimes Perception is More Important than Experience. Go Above and Beyond Ahead of the Visit.

Taking action to inform and engage members on what to expect from their doctor visits, providing information that is important to them, like billing and what is covered and what is not, will help build a more trusting relationship between provider and member, but it will also eliminate any future mistrust due to lack of information. Utilizing automated touchpoints to prevent minor backend mistakes and miscommunication with the member can go beyond the annual survey. For example, the provider and plan have the opportunity to explain the terms of Annual Well Visits within the defined value sets ahead of the member booking their “free AWV” that could prevent any mistakes about co-payments and billing. Explaining the terms ahead of the visit and providing a list of what falls under annual well visits, not only informs the member and prevents coding errors on the provider side, but it creates a relationship and line of communicative trust.

Including members in the conversation ahead of outreach goes above and beyond the standard level of communication between plan and member. It is important to keep the data collected from past surveys and NPS scores close to engagement strategy, and above all, prioritize the ongoing relationship between member and provider and plan as member experience will make up over one-third of the overall Star Rating for 2023.