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Digitizing Equity: Transforming Medicaid with Technology and Empathy

Medicaid is a vital safety net for millions of low-income and vulnerable individuals across the U.S. However, glaring health disparities persist within the program.

The pandemic underscored the stark health inequities among marginalized communities, including BIPOC (Black, Indigenous and People of Color), LGBTQIA+, people who are neurodivergent, and people with differing physical abilities. These challenges are especially pertinent to Medicaid, since more than half of Medicaid enrollees are people of color, and an estimated 20 percent are considered disabled.

Although tackling health inequities is a massive, multi-stakeholder undertaking, innovative solutions and strategic changes can have a significant impact, especially in the realm of digital health technology.

Digital health tools play a crucial role in eliminating health inequities and improving care for all. But technology alone isn’t the answer. Investing in technology without a clear strategy to advance equity can actually exacerbate existing inequities. Instead, health organizations need to address health equity by combining data-driven practices with a whole-person approach that grounds services in humanity and ensures all people receive the care they deserve.

Why Medicaid has Vast Health Disparities

Health organizations are undergoing a reckoning about the ways the insurers, providers and the greater healthcare community have failed marginalized communities. Tangible steps must be taken to fix systemic problems.

That includes viewing health from the whole-person perspective. It’s estimated that about 80 percent to 90 percent of health outcomes can be attributed to social determinants of health (SDOH) – non-medical factors such as socioeconomic conditions, environmental factors, race, ethnicity, language, sexual orientation and gender identification (SoGI).

It can be all too easy for providers to make assumptions. For example, some providers may write off a Latino patient as non-compliant when they don’t take prescribed medicines without further investigation or may ignore a female patient’s pain because it was seen as common period symptoms. However, a Latino patient may not take medication because it’s cost-prohibitive or they don’t have a pharmacy near them, while the other patient’s pain could be a symptom of a more serious illness that requires medical intervention.

If a provider has more time to connect with patients, listen to their perspectives and treat them as individuals, they can better identify their needs and identify solutions, such as prescribing a lower-cost formulary or scheduling a follow-up appointment with a specialist.

While these SDOH-related health disparities exist for all individuals, Medicaid members face another unique hurdle that affects their healthcare experiences – stigma and negative stereotypes about their use of government services. Although individuals must meet stringent criteria to qualify for Medicaid, organizations and even providers themselves may perpetuate stereotypes about people who need government services — increasing barriers to care rather than eliminating them.

It doesn’t help that there are significant data gaps among Medicaid populations that hinder organizations from understanding and addressing the myriad factors impacting people’s health outcomes and access. Approximately one in five Medicaid beneficiaries are missing information related to their race and ethnicity. These gaps make it even more challenging to pinpoint and prioritize areas for health equity initiatives.  

So, with all of this in mind, what can health organizations do to address these complex challenges and bridge the health equity gap?  Advancements and innovations in digital technology create new opportunities for health organizations to identify and track health disparities, and target services and medical interventions for vulnerable populations.

But to make progress on health equity goals, organizations need strategies and structures that put people at the center of the health care experience.

3 Ways to Reduce Health Barriers

While digital tools and data-driven strategies can streamline processes, reduce friction and enhance consumer experience and engagement, effectively using these tools to serve and support vulnerable populations poses a unique challenge.

The following considerations can help organizations focus their technology strategy to better support those who are most in need.

Focus on establishing trust.

Trust is often the determining factor when it comes to a patient refilling their prescription, showing up to a follow-up appointment or making a healthy change in their behavior. But establishing trust among Medicaid beneficiaries can be even more challenging in light of the historical medical discrimination and mistreatment of marginalized populations, as well as government recipients’ current experiences with medical bias.

Building trust requires empathy, transparency, and an in-depth understanding of individuals and their unique needs. Robust data analytics can help with this. By collecting and analyzing data on race, ethnicity, language, sexual orientation and gender identity, healthcare organizations gain actionable insights that can help identify disparities and tailor interventions to meet the unique needs of diverse populations.

With a better understanding of these needs, organizations can treat Medicaid beneficiaries as individuals and begin to rebuild the critical link of trust with their beneficiaries.

Meet people where they are. 

Another way health organizations can increase access to care is by providing beneficiaries with meaningful interactions and tailored personalized engagement. In fact, nearly two-thirds of consumers would access additional care if their healthcare experiences were more personalized.

In particular, health plans should focus on improving accessibility to healthcare information and communicating with Medicaid members on channels they already know and use. For 85 percent of Americans, that’s on their smartphones. Digital health programs that use text messaging and other mobile channels can deliver personalized health information, reminders and resources to individuals in a convenient setting.

Programs like the national Affordable Connectivity Program (ACP) are helping close the digital divide (the inequitable access to computing devices and stable high-speed Internet) that can alienate Medicaid recipients, especially in rural communities.

Texting and other mobile technologies can not only provide timely updates and appointment reminders; they can also offer valuable educational materials. For example, health plans and providers can inform members of the importance of mammograms while removing common fears or provide members with limited literacy skills with high-quality videos that utilize best practices in learning strategy. By meeting beneficiaries on their terms (without condescension or stigmatization), health organizations can remove points of friction and make services more accessible.

Build for scalability. 

It’s not enough to build digital experiences that only work in a single scenario or specific moment. Health organizations need to build processes that scale across operations and alongside organizations as they continue to grow. Artificial intelligence and automation are valuable tools to help organizations achieve these goals.

Administrative costs comprise a majority of health system waste, with at least half of administrative spending deemed wasteful. Automating manual tasks and supercharging data-driven decisions enables organizations to streamline burdensome administrative processes and enhance the overall efficiency of healthcare delivery at scale, ultimately improving care for patients.

While artificial intelligence technologies have vast potential to improve healthcare delivery, it’s crucial to ensure AI tools are used responsibly and avoid perpetuating existing disparities or biases in data sources. To minimize the potential negative effects of AI, set rigorous safeguards and standards that adhere to best practices established by trusted entities, like the Coalition for Health AI.

The Imperative for Digital Innovation

“Healthcare as usual” isn’t optimal for Medicaid enrollees, health organizations or anyone for that matter.

Programs that fail to address underlying disparities lead to greater inefficiencies and higher costs for organizations. In fact, treatment of chronic conditions such as asthma, cancer, diabetes and heart disease costs the U.S. $320 billion a year resulting from health inequities — and unaddressed health disparities costs could balloon to $1 trillion by 2040.

Technology adopted in a vacuum won’t solve deep-seated health disparities. But by pairing digital investments with meaningful conversations and support for Medicaid beneficiaries, we can begin to break down barriers and accelerate progress toward a more equitable healthcare system for all.

This article was originally published on healthdatamanagement.com on December 20, 2023.

Navigating New TCPA Regulations: A Guide for Healthcare Communications

In the ever-evolving landscape of healthcare communications, staying compliant with regulatory changes is paramount. One such significant transformation occurred on July 20, 2023, when new requirements under the Telephone Consumer Protection Act (TCPA) came into effect. These changes directly impact how healthcare organizations engage with their patients and members, including significant implications for HIPAA-related calls. Understanding the intricacies of these regulations is essential to avoid hefty fines and legal complications.

At mPulse, we recognize the challenges and complexities that healthcare organizations face, which were previously mostly exempted. With our expertise and innovative solutions, we are well-positioned to help healthcare organizations navigate these changes seamlessly and ensure they remain compliant, safeguarding both their reputation and financial well-being. 

In this blog post, we’ll explore the key aspects of the TCPA changes that took effect on July 20, 2023, and shed light on how mPulse can assist healthcare organizations meet these regulatory demands through our digital health solutions, especially as they relate to HIPAA-related communications.

Three notable impacts of the Telephone Consumer Protection Act on healthcare pre-recorded voice calls

  1. The TCPA now sets a call limitation on healthcare-related calls without prior express consent, allowing for one artificial or pre-recorded call per day and up to three artificial or pre-recorded calls per week. This is a significant change, as there was previously no limit on calls without prior consent. However, even with these TCPA changes in effect, if recipients have willingly provided their prior express consent—often obtained through providing a telephone number or completing a registration process—there is still no limit to the number of calls that can be made.

mPulse solutions are thoughtfully designed to make an impact with the fewest touch points possible, well within the call limits, to comply with the TCPA changes when there is no prior express consent. With consent, we can also offer configurations involving multiple solutions that may need more touchpoints, enabling healthcare organizations to achieve their communication goals. 

2. The callers* must provide the following to help recipients opt out of the artificial or pre-recorded healthcare-related call:

  • State the identity of the entity*
  • State the entity’s phone number* that allows the recipient to make a do-not-call request during regular business hours. 
  • The message must include an automated, interactive voice and/or key press-activated opt-out mechanism within two seconds of the identification message. 
  • Brief instructions on how to use the mechanism.
  • If the recipient elects to opt-out, the mechanism must record the recipient’s number to the do-not-call list and immediately terminate the call. 
  • If the call is left on an answering machine or a voice mail service, the automated message must leave a toll-free number that leads the recipient to the opt-out mechanism above. 

mPulse diligently adheres to these requirements in our IVR scripting, ensuring that all information is provided, including contact information and instructions for opting out using our key-press-activated mechanism. Moreover, our technology enables the management of do-not-call information at an account level for do-not-call requests made directly to mPulse.**

3. Ensure that the entity* making the healthcare-related calls has a do-not-call policy. The do-not-call policy must be in writing, and the personnel must be trained on do-not-call practices. As for the specifics, consumer do-not-call requests must be honored within 30 days of receipt. The party seeking to be placed on the do-not-call list must provide their name (or their entity’s name) and number(s) for inclusion on the do-not-call list. Furthermore, companies must maintain records of do-not-call requests for five years.

It’s important to note that while mPulse offers a robust platform for managing these communications, the responsibility for creating a written policy and training personnel on the do-not-call list primarily lies with the healthcare organization. We understand our partners’ needs and procedures may vary, and we aim to provide the necessary tools and support to facilitate compliance. With mPulse software, we ensure that do-not-call requests are promptly recorded and retained for five years, which is vital to regulatory adherence. However, it remains our partners’ duty to maintain a holistic list that captures all do-not-call requests – especially ones made directly to their call center.

Navigating the complexities of TCPA regulations can be daunting, but with mPulse, healthcare organizations can find a reliable partner to help them navigate these intricacies seamlessly. We understand the nuances of TCPA and are well-equipped to guide healthcare organizations toward compliance while ensuring that their digital engagement remains robust and effective. Moreover, mPulse offers diverse health communication solutions, including text messaging, email, and mobile web, providing healthcare organizations with a comprehensive toolkit to engage consumers and achieve the best possible outcomes. With our expertise and multifaceted approach, we are here to support healthcare organizations in delivering top-notch services while adhering to regulatory standards.

Please visit the Code of Federal Regulations website to learn more about TCPA changes.

*Refers to healthcare organizations mPulse partners with

**mPulse is not liable for a complete do-not-call list as the healthcare organizations we partner with may have multiple lists from historical vendors, direct requests from members, or other various do-not-call requests in the healthcare organization’s database. To comply with TCPA, it’s imperative that the healthcare organization manages and owns the holistic do-not-call list with or without mPulse technology and that the correct list is sent to mPulse prior to the launch of the solution.

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
 
 

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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! 

Medicaid Redetermination: 180 Days After the Return to Regular Operations

Three years after the start of the COVID-19 pandemic and after over two years of continuous Medicaid enrollment, we finally saw the return to normal operations in April 2023 as the national public health emergency (PHE) was officially decoupled from Redetermination.

Now, almost 180 days out from the start of the unwinding process, it’s time to look back at how states have handled this massive undertaking, how Medicaid beneficiaries have fared, and the strategies of those plans who have been successful with the redetermination process these last six months.

The 2023 Medicaid Redetermination Process So Far

Having been in Phase 1 of the unwinding process (outreaching to members for updated contact information) for the majority of 2022 and into 2023, the market finally saw a shift into phase 2 in April 2023 when states officially began the process of redetermining eligibility for millions of members

Sourced from KFF.org. Of all people who were disenrolled, 73% were terminated for procedural reasons, as of October 2, 2023.

While it’s true that it was expected many people would lose their coverage, we are unfortunately seeing large numbers of people losing coverage for procedural reasons rather than due to a lack of eligibility. Recent data from the KFF Medicaid Enrollment and Unwinding Tracker shows that of the over 7 million people who have lost their Medicaid coverage since the start of the unwinding, 73% of those fall into this bucket of people losing coverage not as a result of merit or financial requirements but rather on a lack of replies, incomplete information, and the like. 

In light of this, Congress has paused the redetermination efforts of 30 states due to their exceedingly high numbers of procedural disenrollments. Nearly half a million individuals will be reinstated after CMS found some states processing eligibility checks at the family level thus leaving out children who have lower or fewer requirements for coverage.

These 30 states have had to return to Phase 1 and 2 efforts to reach out to individuals to update their contact information and process their eligibility. Some are taking action to re-enroll everyone they presume might no longer be eligible, while others are asking their members to re-enroll based on their initial enrollment month. 

An All Hands On Deck Approach 

There’s been no shortage of assistance from state and federal organizations providing guidance and resources on approaches to drive the redetermination process and encourage people to re-enroll and maintain as much coverage as possible.

Furthermore, to reduce some of those procedural issues, health plans are now also allowed to help individuals fill out enrollment forms, which we hope will drastically reduce the amount of procedural disenrollments.

Another game-changing move was a declaratory ruling by the FCC earlier this year that health plans can now leverage SMS texting and IVR calls to conduct outreach and support continuation of coverage efforts.

This brings us to a discussion around digital strategies and asking the question, will doing the same thing deliver different results? If states are encountering issues around procedural disenrollment, what other approaches can they adopt? 

Digital Strategies to Tackle Medicaid Redetermination 

If traditional outreach methods haven’t been as effective as we hope in some states, it only makes sense to consider alternate strategies when it comes to member outreach. One channel we have seen work very successfully in redetermination efforts is SMS texting. A widely adopted channel, it can produce engagement rates of up to 60% for the most valuable and tailored programs sent to engaged populations.

To employ the SMS channel in your redetermination efforts, there are four best practices to consider.

Deliver Outreach Aligned to Language Preferences

Be sure the messages you are sending are personalized and relevant to the member. Reaching your Limited English Proficient (LEP) members can be difficult, especially when you don’t know who they are or what their preferred language is. Even if you are using pre-approved language for your redetermination outreach, an easy action to implement when leveraging a text channel is to ensure you align your messaging to the language preferences of your members. For example, mPulse technology allows for you to go beyond typical language challenges or compliance required taglines by automatically transitioning between English and Spanish in our two-way SMS conversations.

Include Educational Content to Address Health Literacy Gaps

Streaming health empowers behavior change and overcomes member barriers in 60 seconds or less.

Use captivating and engaging content in these outreach programs that educate individuals on why they should reapply. While creating awareness is the first step, educating members on why it’s important to reapply in an effort to maintain their coverage is vital. Think about it: if you don’t understand the benefits of Medicaid and how it contributes to your long-term health, why would you spend the time and energy filling in forms to prove your eligibility? Providing members with educational tools designed to build knowledge and confidence will increase the likelihood that they’ll take action.

Incorporate Behavioral Science Strategies into Messaging

Behavioral science has become a crucial component of health engagement programs and has been proven to directly impact health outcomes. Loss aversion, a cognitive bias that describes why the pain of losing is psychologically twice as powerful as the pleasure of gaining, or social proof, the phenomenon where we look around us for clues on how to behave, are examples of behavioral science strategies you can incorporate into messaging to foster greater trust, dispel concerns and increase the likelihood that your hard-to-reach members will engage and respond to outreach materials. This will help create a need for members to act.

Use Conversation AI Outreach to Identify Barriers

Leverage conversational AI and two-way texting to uncover barriers and encourage action. These AI powered, bidirectional texts allow automated, tailored responses to address individual barriers. If members reply to the texts, conversational AI uses natural language understanding (NLU) to “listen” for known barriers and other expected replies and provide relevant, automated responses to create logical conversation flows to address these barriers. This is also an opportunity to build health literacy and raise awareness about the need to maintain coverage. You can imagine how helpful these kind of capabilitiies are when trying to determine barriers to reapplying for coverage and encouraging action among your members. 

An Activation Solution 

While organizations may feel hampered by the requirement to use pre-approved state language, there’s no reason you can’t use it as an interim solution or in tandem with additional, tailored outreach. 

This is exactly the approach that one health plan adopted in preparation for the unwinding. Their goal was to activate Medicaid members with high-impact messaging and content to educate, set intent, and reduce the perceived effort of completing the redetermination process.

They achieved this by utilizing automated two-way programming to uncover and address member barriers, integrating fotonovelas, in multiple languages, into the outreach messaging. They delivered relatable stories to members that leveraged the endowment effect and loss aversion to build intent to keep coverage, and they used natural language understanding (NLU) to uncover and address common barriers and address members’ issues at scale. 

As a result, 33% of targeted members engaged with the program and by leveraging NLU, 18% of targeted members responded to the program which uncovered and addressed common barriers.

So, what does this prove? SMS is an effective channel for member outreach. It allows for delivering messages via a high-reach, high-touch channel and gives people something they can either act on in the moment or return to after the fact.

In the example above, the outreach was delivered in both English and Spanish, and made all the difference in overcoming barriers to action. Considering the best practices for member outreach that we mentioned earlier, it’s clear that addressing people in their own language, at the right time, on the right channel is key. 

Looking Ahead to Better Health Coverage 

While procedural disenrollment is a concern, several systemic issues have been identified, and the administration is taking steps to address them to keep people connected to care. Better processes and partnerships are expected to come into play, enabling easier approvals and ways to share data between states and health plans.

This includes partnering with managed care organizations, community health workers, walk-in centers, and more to raise awareness and assist enrollees in completing and submitting their renewal forms, even over the phone.

And while state-based content and language is a great starting point for communication, if you’re looking for ways to enhance your outreach efforts, start by considering what’s worked, what hasn’t worked, and where you can integrate these best practices to produce better outcomes.

How can you improve the content, add more languages, or add additional outreach modalities such as phone, email or SMS? Most importantly, how can you include streaming content and facilitate two-way conversations to overcome barriers and inspire your member populations to take action?

Not sure where to start? Reach out to learn more about the power of SMS and how you can establish a robust redetermination solution to reduce coverage loss and create high-value member touchpoints. 

Improving Maternal Health Outcomes with Digital Trends

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

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

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

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

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

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

The role of healthcare communication technology

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

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

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

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

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

Maximizing mobile outreach with conversational AI to enhance maternal healthcare accessibility

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

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

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

Addressing maternal health disparities with culturally competent and personalized solutions

conversational ai example relevant and relatable

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

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

How we leverage digital trends for enhanced maternal health education

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

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

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

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

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

Overview of mPulse Mobile’s prenatal and postpartum solution

mPulse’s prenatal and postpartum solution

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

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

Delivering Equitable Health Experiences Among Medicaid Populations

Earlier this month, four of mPulse Mobile’s best and brightest subject matter experts packed up and headed to sunny Florida to attend The Strategic Solution Network’s (SSN) 14th Annual Medicaid Innovations Forum. A huge topic of conversation was, not surprisingly, the FCC’s Declaratory Ruling on phone outreach for redetermination. Released in late January, this ruling opened the door for plans to utilize texting in their efforts to maintain coverage for millions of Medicaid members. 

Texting, however, has always been a big topic of conversation for us. 97% of US adults own a cell phone, and it seems everywhere you go people are glued to their devices. That is what makes SMS texting such an incredibly effective tool to add into your mix of channels. We spoke about just that during our session at the conference. 

Healthcare Experiences Powered by Technology

For that session, Reva Sheehan, mPulse Mobile’s Senior Director of Customer Insights, had the opportunity to present onstage with Sammie Turner, Quality HEDIS Manager for Maryland Physician’s Care. Maryland Physicians Care, a customer of mPulse Mobile and the third largest Managed Care Organization in the state of Maryland, administers healthcare services to Maryland’s HealthChoice enrollees. 

Maryland Physicians Care and mPulse partnered together to deploy a two-way SMS text campaign targeting multiple preventative care screenings, including Breast Cancer Screenings, Well-Child Visits, SSI, and Lead Screening in Children, and we delivered the results of that program to the audience.  

With reach rates ranging from 83% to 95%, we were able to target and communicate with thousands of their customers. The main metric we wanted to observe, however, was the success of texting compared to outbound calls. Is texting a more effective method of outreach to obtain scheduled appointments?

We focused on breast cancer screenings and found strong evidence that it was. After 30 days of outbound calls, 123 breast cancer screenings were scheduled. But with the texting program, we found that we were able to schedule 94 screenings in just four days.  

The texting program was able to get 76% of the screenings scheduled that outbound calling did in just a fraction of the amount of time and did so without the manual work of call center representatives. 

But why is this so? How is texting, which may seem less personal, able to have so much success so quickly?

Three Core Capabilities for Texting Outreach

Texting allows us to reach a large population in a single event and assists in reducing the volume of outbound calls and or letters. If you have the right technology powering your texting program, however, it turns into more than just a text but into a dynamic two-way conversation that can be used to connect with a member, break down barriers to healthcare, and deliver better outcomes.  

There are three core components that enabled this experience for Maryland Physicians Care’s members: two-way text capabilities, natural language understanding, and educational content. 

Two-way Conversations Identify and Address Barriers to Care 

When you have dynamic, interactive conversations with your members, you truly address the barriers they face when trying to get care. Lack of transportation, inability to get time off work, cost, and other factors all play a role in creating an inequitable health experience.

When a plan has the technology to have a real conversation with its members at scale, it can not only identify the reasons members aren’t scheduling screenings, but it can take it a step further to provide solutions and education for the member, such as helping them find a doctor like you see in the example below from Maryland Physicians Care’s program. When the door for care is opened a bit wider for one person, it makes the healthcare system a little bit more equitable for all.

Interested in these capabilities? Learn how these same concepts can be applied to outreach around the end of continuous enrollment » 

Natural Language Understanding and Culturally Appropriate Content 

Natural Language Understanding (NLU), a type of artificial intelligence, is the ability for our system to interpret the responses from the member (even if they are non-standard responses or slang) and respond back in an intelligent manner. mPule Mobile’s NLU is available in 7 languages with translation services for 13.  

One example of NLU in Maryland Physicians Care’s program focuses on creating a more culturally sensitive experience. For this program, the two-way SMS content automatically converted from English to Spanish if the member responded in Spanish. Their language preferences were then reported back to the plan for future interactions. The ability to communicate with your health plan in the language that you are most comfortable with makes it much more likely that they’ll keep communicating and take the desired action.

Leveraging Educational Content to Promote Health Literacy 

One thing we all know is how vital health literacy is to the concept of health equity. The ability to understand not only the care system, but your own body and healthcare needs is critical.  

Videos can leverage educational content to help overcome barriers and inspire action by delivering bite-sized stories and entertainment straight to the member’s phone during a text exchange. The below example was used for a diabetes eye exam program run with a large national health plan. There was a 274% increase in link clicks to scheduling when this video was used in the text outreach vs when it wasn’t.

Equitable Healthcare for All 

The dynamic conversational engagement used by Maryland Physicians Care enabled them to reach more members and deliver tailored resources and calls-to-action to empower members to act and deliver better outcomes at scale. When each member has the opportunity for a personalized and relevant conversation about their health with their plan, they’re receiving a more equitable experience.  

Interested in these capabilities for a redetermination program? Learn how these same concepts can be applied to outreach around the end of continuous enrollment!

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

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! 

The State of Health Disengagement

How do we unlock digital to get more people enrolled, lower costs to serve, and improve health outcomes at scale?

That question sums up a major challenge and business imperative to lift programs and people. To frame up that challenge, three key gaps must be considered for meaningful innovation:

The Health Programs Gap

There’s no shortage of solutions or investment focused on the problem. By 2027, the global corporate health and wellness market is expected to exceed $100 billion.

From health coaches to wellness programs, EAPs to DPPs, 401k to HSA, there’s a lot of shorthand around programs that are too often short on utilization.

By the Numbers

At a time when nearly half of U.S. adults report struggles with mental health or substance abuse, only 5% of employees reach out to their EAP. Plus, 6 in 10 are unaware of wellness programs that offer incentives just to engage.

Meanwhile, better convenience and reduced risk of illness are driving more health consumers to telemedicine for mental health and routine care than ever before.

Bottom Line

You likely have many programs in place to support the rising need for total-person care. The opportunity is now to connect your offerings and streamline the digital path to serving the right ones based on need.

By aligning your human services alongside your digital experience journey, you can start shifting from push-based efforts across disconnected programs to a pull-based model that assesses and adapts to the individual’s needs.

The Health Literacy Gap

Patty Starr at Health Action Council sums it up: “Health literacy is the key to lowering healthcare costs and better education is the key to health literacy.”

By the Numbers

As just a sample of an increasingly global problem, 88% of U.S. adults lack health literacy skills needed to manage their health and prevent disease or other illness. 70% of healthcare costs come from lifestyle choices, and people with lower health literacy report worse outcomes.

Bottom Line

Back up. Nearly 9 in 10 adults lack health literacy? That’s a huge number. And part of the problem is that people don’t know their numbers, from reading nutrition labels and measuring medications to understanding lifestyle factors and personal health history.

So if education drives lifestyle choices and choices drive costs, shouldn’t we invest in better education? Yes. But that’s not the problem. From Dr. Google to a WebMD article (designed to sell ads) to a pamphlet to take home, most health “education” is built to inform not to teach.

We know from adult learning theory that simply telling someone to read, watch or listen is not enough. These are inherently passive ways to impart information. If we want real learning and change to occur, we need to design learning experiences that give us ways to reflect, process and apply what we’re learning.

Across need state or wellbeing dimension, a properly designed digital learning experience can personalize to the individual’s needs and guide them to the right programs. In doing so, it can help us solve the health program gap and the health literacy gap at the same time.

The Latent Health Gap

When we look at health programs and services offered today, we see a spectrum from prevention to intervention.

On one side, wellness and benefits offerings are trying to expand beyond hand raisers to help more people quit smoking, move more, or talk to a health expert to start us down a healthier path.

On the intervention side, disease management, care coordination and a host of point solutions are trying to reach people before major issues occur.

That movement to the middle is by no mistake. The vast majority of people show up in the middle. Except, they don’t show up. That’s the problem.

So now that we’ve covered key gaps behind health disengagement, how can we align with evolving consumer behaviors to lift engagement at scale?

Keep Reading: The Future of Health Literacy