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mPulse Drives Strong Q4 2023 Results with Organic and Strategic Growth

LOS ANGELES–(BUSINESS WIRE)–mPulse, a leader in conversational AI and digital engagement solutions for the healthcare industry, today announced strong momentum with revenue growth of 94% and 106% year over year in Q4 2023 and full year 2023, respectively. This progress was driven by both organic expansion and the acquisitions of HealthTrio and Decision Point Health Solutions.

The offerings created by the combination of mPulse, HealthTrio, and Decision Point have greatly expanded the company’s scale across the healthcare landscape. Through partnerships with 19 of the top 20 largest health plans in the country and over 300 healthcare organizations, health consumers engaged in more than 4 billion digital interactions across mPulse’s suite of digital solutions in the last 12 months.

“Healthcare organizations are continuing to invest in digital strategies that personalize the consumer experience and lead to improved health outcomes,” said Bob Farrell, CEO of mPulse. “The companies we partner with are leveraging analytics-powered digital engagement to empower the consumer throughout their health journeys, from online health plan shopping experiences to managing complex health conditions and renewing coverage. We’re gathering a broad array of new insights about consumers, which is transforming how we target and personalize the digital experience.”

mPulse’s digital programs are valued by leading organizations, with over 50% of the 5-star Medicare Advantage plans leveraging mPulse’s digital tools. mPulse’s tools enable collaboration across care stakeholders with over 2 million providers and care managers accessing shared care plans and key health plan member insights.

“We’re building a powerful set of digital engagement capabilities that are unique within the market and address fundamental challenges healthcare organizations have related to fragmented data and underpowered digital engagement capabilities,” said Sanjeev Sawai, CTO of mPulse. “Our expertise in ingesting the full range of clinical and administrative data sets and performing analytics allows us to build programs and collaboration tools that transform how health plans engage their member populations. It enables our customers to see key insights at the individual member level.”

Gartner® included mPulse as a Representative Provider in its January 2024 research note, titled Innovation Insight: A Rising Risk Strategy Delivers Care Management Gains. mPulse continues to invest in advanced analytics-based programs that allow its healthcare partners to be proactive in addressing the needs of consumers with complex health profiles.

mPulse also announced the dates for its Activate2024 industry conference, which it will host in Dallas, Texas from September 24-25. The conference convenes leaders across the healthcare landscape to explore innovation in digital health and the consumer experience. The focus of this year’s conference is “From Insights to Intervention: Creating Consumer-Centric Digital Experiences.”

Click here to learn more about how mPulse transforms patient engagement.

Pictured left to right: Dominic Wallen, Bob Farrell, Saeed Aminzadeh

GARTNER and HYPE CYCLE are registered trademarks of Gartner, Inc. and/or its affiliates in the U.S. and internationally and are used herein with permission. All rights reserved. Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

Top 10 Trends in Digital Health Engagement

As we roll into 2024, new technologies are creating optimism around healthcare delivery. Intelligent technologies create opportunities for workforce efficiency, while data is powering much more sophisticated consumer experiences. We have the potential to deliver better more equitable health outcomes, but it will require the right focus. Here’s my breakdown of Top 10 trends impacting digital health engagement.

  1. Generative AI: Health systems are piloting generative AI solutions across clinical touchpoints, with the documentation of clinical encounters and first draft messaging some of the initial use cases. As these programs evolve (and if they produce impactful outcomes) we will see similar use cases deployed in the payor space supporting care management and support staff interactions.
  2. Measuring consumer experience: With intense focus on CAHPS performance ratings, health plans will invest in programs to capture real-time insights across consumer digital touchpoints. The mix of engagement data, sentiment and conversational insights will provide actionable data for advanced consumer satisfaction strategies.
  3. Analytics driven engagement: Payors are building out broad data sets that leverage AI to identify individuals who need engagement programs and predicting their likelihood to engage and complete actions. As these capabilities evolve, we will see tighter integration between the analytics and the outreach, leading us towards more automated ‘next-best-action’ capabilities. 
  4. TCPA: We will see more healthcare organizations realizing that overly conservative interpretation of the Telephone Communication Protection Act (TCPA) is bad for health outcomes and healthcare costs overall.  This impacts hard to reach populations the most, where outreach and awareness programs are critical for ensuring individuals know about and can access the care that they need.
  5. Addressing health equity performance: As healthcare organizations advance their health equity strategies, one of their main areas of focus is improving access to care.Measuring performance across race and ethnicity stratifications and correlating this back to their digital solutions will help optimize their digital engagement strategies.
  6. Connecting to community health resources: Enabling individuals to access local social health resources is a critical way for organizations to address localized health needs, but has been hard to operationalize at scale. Organizations who are investing in data systems and building out tailored digital programs to connect people to these resources will see significant improvements in engagement and corresponding health outcomes.
  7. Integrating behavioral health and other clinical programs into enterprise digital engagement strategies: The prevalence of behavioral health challenges across populations coupled with the diversity of the issues that individuals face has meant is hard for healthcare organizations to address at scale. By creating self-service digital tools for individuals to engage with and identify the areas of support they need will enable innovative organizations to make meaningful inroads against this key national health challenge
  8. Understanding consumer health journeys: As organizations develop connected ecosystems of consumer-centric health products, they can capture data on how consumers navigate through these experiences. Analytics will provide insights on how to optimize these journeys, to increase engagement and build out the best touchpoints for different personas.
  9. Integrating self-service and proactive touchpoints: Healthcare organizations deliver a blend of proactive outreach experiences as well as capabilities for consumers to self-service through portals and other tools. Invariably, these are highly disconnected experiences for consumers. Healthcare organizations who invest in the data and capabilities to deliver more seamless journeys across these ecosystems will drive increased utilization and optimize their technology investments.
  10. Focusing on content: Simply having the communication channels in place to deliver digital engagement is not sufficient to improve outcomes. Healthcare organizations will increasingly realize the design of programs delivered through these channels is critical to achieving outcomes. People have diverse needs at different stages along their health journeys, and being able to deliver meaningful content and captivating experiences is key to successful engagement programs.

Navigating the Changing Landscape of Medicare Advantage Star Ratings in Healthcare

In the ever-evolving world of healthcare, the importance of Star Ratings cannot be overstated. These ratings, issued by the Centers for Medicare & Medicaid Services (CMS), have a significant impact on a health plan’s reputation, member enrollment, and financial performance. However, the landscape of Star Ratings is undergoing a transformation that requires health plans to adapt and implement new strategies to maintain their competitive edge. 

 Now that the 2024 Medicare Star Ratings have been released and AEP is underway, let’s delve into the recent and upcoming changes in the Star Ratings program and explore strategies and best practices to mitigate risk, overcome challenges, and improve member engagement and experience.

Want more information upcoming changes? Watch the webinar to get the full download »

Understanding the Changing Star Ratings

The 2023 Star Ratings saw a fundamental shift, with an increased emphasis on patient experience and access. The CMS introduced a weight adjustment, elevating the patient experience component from a weighting value of two to four. Even though the weighting value will move back down to 2 for 2026 stars, health plans still need to focus on delivering exceptional member experiences.

Quality ratings, particularly those related to Consumer Assessment of Healthcare Providers and Systems (CAHPS®), member experience and access, are now more critical than ever. Health plans must focus on providing positive experiences to their members to maintain high scores in this domain.

One of the most significant changes on the horizon is the introduction of the Health Equity Index (HEI), along with the removal of the Reward Factor, which was previously a vital component in Star Ratings. It’s no longer enough to provide high quality care to the general population. The HEI will require health plans to pay closer attention to the healthcare experiences of vulnerable populations, including dual eligible, low-income subsidy, and disabled individuals.

There are also some new Part D measures on the horizon around concurrent use of Opioids and Benzodiazepines, polypharmacy use of multiple anticholinergic medications in older adults, as well as polypharmacy use of multiple central nervous system active medications in older adults too. So it’s important to work with your pharmacy and clinical teams to help make sure you’re getting messaging out to providers and support to members to help manage these drug classifications. 

While the final rule changes will impact plans very differently, knowing how you will be impacted will determine your path forward. Why not apply each proposed change to your overall Stars 2023 and see the effect they have on your final results, assuming no performance change whatsoever. We’re sure you’ll find the results surprising, but more than that, it’ll arm you with the information you need to mitigate risk and adapt your strategies to ensure your continued success.

So, how can you impact and influence these measures across the Stars landscape moving forward? 

Member Experience is Paramount 

The recent changes and the introduction of the HEI emphasize the importance of member experience across the board. Now, Quality Ratings and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) ratings gauge the member’s experience and satisfaction with their healthcare providers and health plan.

Health plans should therefore view every interaction with their members as an opportunity to enhance the member experience, from appointment scheduling to care coordination. Take the time to understand not just where there’s room for improvement, but also what’s working well through the use of event-based check-ins, surveys and benefits. Implementing a three-pronged approach to behavior change that includes behavioral science, learning strategy, and a focus on health equity can help health plans drive better outcomes.

With the HEI coming into play, health plans must pay special attention to vulnerable populations. Member populations are anything but homogenous and represent a wide array of ethnic, racial and linguistic backgrounds, as well as being impacted by a variety of SDoH factors. 

NCQA started adding socioeconomic stratifications to a number measures some years ago, and this trend is expected to continue. Strategies to manage these populations should include addressing barriers to care, providing transportation options, and offering culturally sensitive content and language options to improve engagement and outcomes.

The Role of Digital Engagement 

Contrary to popular belief, Seniors, who make up a significant portion of Medicare beneficiaries, are increasingly receptive to digital channels, such as SMS messaging. While they might struggle with new digital technologies, 98% own a mobile phone (81% own a smartphone) and 94% use text messaging regularly. This shows that they are very comfortable with the simplicity and consistency of the text channel interface.

Interestingly, Seniors have some of the highest levels of engagement across population segments within programs. In fact, they have the highest levels of “conversational turns”. This means that when a plan sends a message, Seniors engage in the conversation and send responses back. Health plans should leverage these channels to connect and engage with senior members effectively. 

The Art of Conversation

There are a number of proven strategies health plans can employ to address these changes in Star ratings measures, such as leveraging best practices across behavioral science, instructional strategy and culturally sensitive and relevant content when it comes to the streaming content.

Members should feel heard, valued and informed throughout their healthcare journey. Two-way conversations are a powerful tool in this regard. These interactions, often facilitated through SMS messaging, allow health plans to engage with members effectively.

While standard two-way interactions are unable to provide tailored responses to potential barriers members might reply with, personalized two-way conversations can identify potential barriers to care or even members who may need specific screenings. Making use of Natural Language Understanding (NLU) and AI, they’re able to respond appropriately, provide real-time assistance, and enhance the member experience. In this way, health plans are able to close the intention gap and increase motivation to take action.

Furthermore, delivering culturally sensitive streaming health content that addresses health literacy gaps in a member’s preferred language can significantly impact the outcomes of outreach campaigns, improving preventive screenings and member engagement. By offering compelling, culturally relevant content, health plans can resonate more deeply with diverse populations.

The consumer experience should be at the heart of every health plan’s strategy. By leveraging best practices, like two-way conversations, personalized messaging and streaming health content, health plans can connect and resonate with their diverse member populations, and so differentiate themselves in a crowded market.

Charting a Way Forward

The changing landscape of Star Ratings requires health plans to adapt and embrace new strategies. As the industry places more emphasis on member experience, health equity, and quality ratings, health plans must prioritize these aspects to thrive in the competitive healthcare market.

By implementing behavior change methodologies, and leveraging digital engagement, health plans can not only maintain their Star Ratings but also improve the overall health and satisfaction of your members.

mPulse Creates Ongoing Momentum and Revenue Growth in Q3 2023

mPulse continues to address growing market demand for innovative healthcare engagement solutions tailored to hard-to-reach populations.

LOS ANGELES–(BUSINESS WIRE)–mPulse, a leader in conversational AI and digital engagement solutions for the healthcare industry, today announced strong momentum and growth year over year in Q3 2023 with 34% new and upsell revenue growth. This progress is driven by the company’s new platform licenses for omnichannel engagement and programs that drive outcomes for hard-to-reach populations across more than 220 leading healthcare organizations.

This past quarter, mPulse hosted its annual Activate2023 conference with over 200 participants across the healthcare ecosystem. The theme of this year’s programming was focused on the need to combine innovative technology, novel data, and creative digital content that create consumer journeys that demonstratively improve health equity.

At the conference, mPulse presented the company’s new generative AI capabilities that deploy large language models (LLMs) to interpret consumer messages and stage responses for health plan support staff to utilize in member communication. mPulse technology leaders led discussions on the utilization of generative AI models and the role they play alongside determinist language models for a range of digital engagement applications.

“Generative AI is poised to disrupt the healthcare space,” said Sanjeev Sawai, mPulse’s Chief Product and Technology Officer. “With the rapid adoption of this technology, we need to consider how it may impact the way individuals seek out or follow through on their care to leverage it safely and responsibly. We are glad to help spearhead these important conversations at events like Activate. Honest, transparent discussion is an important step toward developing this technology in ways that ensure patient privacy and equitable health outcomes. mPulse is on the forefront of using Generative AI in healthcare digital engagement solutions.”

Healthcare organizations are highly focused on applying generative AI capabilities across the ecosystem as they also weigh the value of these solutions against the complexity of deploying them. In a research report, U.S. Payer and Provider CIOs: Apply AI in Care Management Programs, Gartner ® outlines the role AI solutions can play in supporting AI strategies and lists mPulse as a Representative Vendor.

mPulse Mobile recently completed a survey of healthcare executives assessing the focus of their health equity strategies and the challenges they are facing. The survey report highlights the most common areas of focus for health equity strategies: improving access, leveraging digital outreach and capturing data, and managing data completeness around race, ethnicity, and language. The results indicate that healthcare executives face common barriers when implementing health equity initiatives, including connecting members to resources, the availability of actionable data and access to funds overall.

“We are at a crossroads, as emerging AI technologies are showing very real potential to drive progress in health equity initiatives,” said Bob Farrell, CEO of mPulse Mobile. “We are constantly collaborating with innovative healthcare leaders who recognize the importance of technology-driven engagement programs that best serve hard-to-reach populations. There is an urgent need to deliver innovative solutions that address health equity barriers at scale. Our partnerships with leading healthcare systems continue to drive our growth and support our mission of improving individual healthcare outcomes.”

Read the full press release on Business Wire »

Gartner, U.S. Payer and Provider CIOs: Apply AI in Care Management Programs 13 October 2023, Amanda Dall’Occhio

GARTNER is a registered trademark and service mark of Gartner, Inc. and/or its affiliates in the U.S. and internationally and is used herein with permission. All rights reserved.

Gartner does not endorse any vendor, product or service depicted in its research publications and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Garnter’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

Frictionless Healthcare, Part 5: The Power of Perception

Welcome, dear readers! Today, we will delve again into the captivating world of behavioral science and some of its applications in healthcare. By gaining insights into human behavior, we can effectively drive behavior change and create a seamless healthcare experience. Let’s delve into this fascinating subject!

Understanding Behavioral Science

Behavioral science is a discipline that investigates human behavior through observation and experimentation. It delves into various factors that influence our actions, including conscious thoughts, motivation, social influences, contextual effects, and habits. By comprehending these aspects, we gain a better understanding of why people behave the way they do.

To simplify the concept, behavioral change can be likened to launching a rocket. Just as a rocket requires increased fuel and reduced friction to propel forward, behavior change necessitates increased motivation and decreased barriers. By employing principles from behavioral science, we can identify the driving factors of behavior change and apply them effectively in healthcare settings.

mPulse Mobile has developed the Behavior Change Wheel, a comprehensive framework that combines best practices from behavioral science, user experience design, and instructional strategy. By utilizing behavior change techniques, mPulse Mobile engages diverse populations, promotes behavior change, and achieves positive health and business outcomes.

In today’s blog, we will focus on two significant concepts from the behavior change wheel: authority bias and reactance. Authority bias refers to the tendency of individuals to place more importance on the opinions of respected experts. Reactance, on the other hand, suggests that people are less likely to adopt a behavior when they feel coerced. Balancing these concepts is vital in effective healthcare communication.

Interested in learning more? Watch the on-demand webinar, Frictionless Healthcare: The Power of Perception »

Harnessing the Power of Authority Bias

Making decisions can be challenging, leading our minds to seek guidance from authority figures. This phenomenon is known as authority bias. Observational research demonstrates our strong inclination to comply with those in charge, as we place our trust in their expertise. The infamous Milgram Study, for example, showcased how individuals followed instructions from researchers despite witnessing distress in others.

Moreover, authority figures can influence our behavior through a simple change in attire. An experiment with New York pedestrians revealed a significant increase in the likelihood of offering financial assistance to a stranger when the requester wore a police officer’s uniform*. These examples emphasize the impact of authority bias on decision-making.

Applying Authority Bias in Healthcare

“When it comes to applying authority bias, we cannot ignore historical and structural inequities that have shifted the definition of authority in some communities. This means expanding the definition beyond healthcare providers and entities to include other leaders including community organizers, faith leaders, and other trusted leaders”

 – SriVani Ganti, MSHC – Director of Health Equity.

In the healthcare domain, where uncertainty often prevails, authority bias plays a crucial role. Patients frequently encounter various uncertainties, ranging from scheduling appointments to managing their conditions. We can provide clarity and build trust with patients by alleviating uncertainty during these critical moments. Authority bias works effectively in situations where individuals are undecided, guiding them towards preferred options and fostering trust.

However, dear readers, it is essential to approach authority bias through the lens of health equity. Different types of authority figures, including medical institutions, community leaders, and faith leaders, can influence behavior change. It is key to understand the target audience and tailor messaging to resonate with their values and beliefs. Engaging with the community, gaining their trust, and upgrading messages to establish meaningful connections are vital steps.

mPulse Mobile’s Approach

mPulse Mobile recognizes the importance of authority bias and health equity in healthcare. In developing programs such as the maternal health program, mPulse actively involves pregnant people from diverse backgrounds to share their personal journeys. By creating meaningful connections between program members and relatable individuals, behavior change becomes more achievable.

Representation holds great significance in healthcare communication. When developing solutions, it is crucial to ensure that individuals can see themselves reflected in the stories and visuals. By featuring diverse perspectives and experiences, we foster a sense of connection and enhance engagement.

In Conclusion

The power of authority bias in healthcare communication should never be underestimated. By comprehending the intricacies of human behavior, leveraging appropriate authority figures, and tailoring messaging to diverse populations, we can drive behavior change, enhance patient experiences, and ultimately improve health outcomes. Let us embrace the potential of behavioral science and work towards creating a frictionless healthcare system that genuinely meets the needs of individuals.

Key Takeaways:

  • Behavioral science is an essential tool for understanding and driving behavior change in healthcare.
  • Authority bias, when utilized effectively, can provide clarity and build trust.
  • Health equity must be considered when leveraging authority bias, tailoring messaging to diverse audiences and engaging with various authority figures.
  • Representation plays a vital role in healthcare communication, necessitating the inclusion of diverse perspectives and stories.
  • By combining behavioral science principles with a focus on health equity, we can foster positive health outcomes.

*Bickman, L. (1974). The social power of a uniform. Journal of Applied Social Psychology 4, 47-61.