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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.

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 Recognizes Innovative Healthcare Organizations in the Sixth Annual Activate 2023 Awards

mPulse Mobile recently wrapped up its fifth annual Activate conference with the Activate Awards, which provided yet another celebration of healthcare leadership, innovative program design, and improved health outcomes amidst various health engagement challenges.

The theme of Activate2022, The Power of Behavioral Science to Drive Health Action, was reflected throughout the conference with captivating speaker sessions and expert panel discussions. Networking inspired exciting conversation around innovative technology, behavior change design, and consumer experience, and the Activate Awards surely brought those conversations full circle.

The awards help illuminate health plans, health systems, health service providers, PBMs and other types of healthcare organizations that utilized new strategies or unique tools to activate their consumer populations. The companies highlighted each year typically face barriers with engaging a certain population or driving specific health actions, so they search for innovative solutions to tackle those challenges. 

For example, in 2019, CountyCare saw drastic rates of members losing Medicaid coverage, so the managed care organization (MCO) implemented automated text dialogues and saw their Redetermination rates improve by 3.3 percentage points in just one month, subsequently running away with the Most Improved Consumer Experience award. Last year, CareSource incorporated secure surveys, SMS, and streaming video to significantly impact their hard-to-reach members – they won 2021’s Best Use of Conversational A.I.  

The same story is true for this year’s winners.   

The remaining 3 award categories are Achieving Health Equity, Most Innovative Solution and Most Significant Outcome. Like the teamwork and critical thinking generated from breakout workshops and Q&A during the conference, the awards are a celebration of two companies that partnered together to overcome consumer barriers or gaps in care by building uniquely tailored engagement programs. 

Here are the winners of the 2022 Activate Awards: 

Achieving Health Equity

 
Program Goal
Increase Colorectal Cancer Screenings

AltaMed Health Services is one of the largest Federally Qualified Health Centers (FQHC) in the United States and provides a range of health services to Latino, multi-ethnic and underserved communities in Southern California. After seeing a steep drop in colorectal cancer screenings during the COVID-19 pandemic, the health center sought a solution that could help patients overcome barriers like language and lack of awareness of services. 

AltaMed partnered with mPulse to deliver multi-lingual, educational health content to patients using mobile fotonovelas tailored to both males and females who had not completed a screening. Patients received and digested vital communication about getting screened, where to find the nearest screening site, and more through culturally sensitive stories delivered in a familiar format.  

A randomized control study found that 63% of patients who responded to the fotonovelas either liked or loved it, and 39% reported it positively impacted their willingness to act. By educating patients with curated content, AltaMed closed a key screening gap, lifted health literacy and perhaps most importantly – made significant progress toward health equity.

Notable Outcome
Patients that viewed the fotonovelas (19%) were more likely to submit a sample for cancer screening than patients in a control group (11%)

Best Use of Conversational A.I.

 
A Technology-Enabled Health Services Company
 
 
Program Goal 
Promote smoking cessation among teen vapers 

This leading health services organization employs over 210,000 employees globally and utilizes technology-enabled solutions to promote consumer wellness and population health. A major public health problem facing young adults, particularly teens, across the U.S. is the use of e-cigarettes, or vaping. The company sought to promote smoking cessation among teen vapers, a cohort still widely understudied, by implementing intelligent conversational solutions and educational content.

They collaborated with mPulse to build a personalized SMS program, lasting 4-6 months, that leveraged Natural Language Understanding (NLU) to deliver automated, interactive text dialogues to a targeted teen population. Individuals were also provided custom-built streaming health videos that offered tips on quitting and even an option to connect with an SMS coach. 

The use of NLU enabled the delivery of automated messaging based on text responses, which helped the organization direct each individual to the appropriate resource. The program yielded an 85% engagement rate, and ultimately 69% of participating teens completed the program. The key result, that 73% of teens in the program set a date to quit vaping, demonstrates the value in utilizing automated text conversations and on-demand content to promote smoking cessation in vulnerable teens.

Notable Outcome 
73% of participating teens set a quit date
 
 

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

 

Most Improved Consumer Experience

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

CalOptima Health is a County Organized Health System that provides health insurance coverage for low-income children, adults, seniors and people with disabilities. As Orange County’s largest health plan, the organization includes a network of over 10,000 primary care doctors and serves over 900,000 Medi-Cal beneficiaries. The health system looked to address a gap they had identified with low-income families enrolling in the state’s food assistance program, CalFresh, federally known as SNAP.

CalOptima and mPulse partnered to launch a two-way texting campaign, which utilized interactive SMS powered by NLU and tailored to 7 different languages. The health plan addressed language barriers by delivering vital information about CalFresh’s food security benefits to underserved families and Medi-Cal members in their preferred language.  

Through automated text workflows, members could respond in their native language with answers like: “I already have CalFresh” or “I want to apply.” The program has continued to expand, having delivered over 5 million messages in 2022 already. Communicating with members according to their preferences about important CalFresh benefits helped CalOptima both improve consumer experience and reduce food insecurity for an at-risk population.  

 
Notable Outcome 
Over 5 million messages delivered to members in 2022 about CalFresh benefits

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

Most Innovative Solution

 
 
Program Goal 
Drive members to schedule a diabetic eye exam

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

The plan worked with mPulse to launch an SMS texting campaign to increase awareness around the importance of the eye exam and to drive members to schedule an exam. The program featured A/B testing, in which one half of members was provided a 30-second streaming health video in the initial message while the other half received only text.  

The educational video enabled a learning experience that was easily accessible and familiar, concluding with a URL for members to learn more about scheduling the eye exam. Humana saw a remarkable 270% increase in clicks to schedule an exam when outreach included the streaming video. The test demonstrates that using streaming health content alongside two-way conversational solutions can significantly help activate hard-to-reach members with diabetes.

Notable Outcome 
270% increase in clicks to schedule a diabetic eye exam when outreach included 30-second streaming video

Most Significant Outcome (tie)

 
A Technology-Enabled Pharmacy Services Company
 
 
Program Goal 
Improve member experience and pharmacy engagement

The leading PBM and pharmacy services company is nationally recognized and fills over 1 billion prescriptions annually for millions of healthcare consumers across the country. With a rapidly growing population, the healthcare leader sought a solution to improve pharmacy patient engagement by utilizing a new communication channel for its home delivery pharmacy and prior authorization programs. 

The pharmacy leader partnered with mPulse to roll out more than 50 outbound-dialer Interactive Voice Response (IVR) campaigns. The IVR messages notified members about prior authorization approvals/denials, refill reminders, shipping details and doctor responses.  

Ultimately, over 5.8 million IVR records were exchanged and the outbound dialer launched over 5.1 million total calls. By offering a new avenue for members to complete a healthy action like ordering medications, the pharmacy enterprise initiated meaningful conversations to help enhance member experience, improve self-service capabilities, and close pharmacy engagement gaps.

Notable Outcome 
Reached over 2.2 million members with 55,000+ members giving SMS consent

Most Significant Outcome (tie)

 
 
Program Goal 
Improve refill adherence for HIV patients 

MetroPlus Health Plan is a subsidiary of NYC Health & Hospitals, the largest municipal health system in the country. The insurance organization serves a diverse group of over 600,000 New York residents across Medicaid Managed Care, Medicare, D-SNP, MLTC and more plan types. A big challenge for the plan was getting HIV patients to refill medications that are pivotal to managing their condition and avoiding complications.

MetroPlus partnered with mPulse to educate the vulnerable population through interactive text messaging about the importance of medication adherence and reducing their  unmedicated days. Texts were delivered one week apart and provided members with vital resources like phone numbers of a pharmacy or a member of the HIV care team.

The plan measured results based on whether or not a patient completed a refill within 7 days of initial outreach. The program yielded a 69% improvement in medication refills when SMS text reminders were deployed, indicating that text nudges inspire self-efficacy and action within this vulnerable population. Through targeted, mobile intervention, MetroPlus helped positively impact medication adherence for over 1,000 patients living with HIV.

Notable Outcome 
69% improvement in medication refills with mPulse text reminders

Health Challenges in 2023

The 6 winners of this year’s Activate Awards showed that even when a new barrier is identified with engaging a population, healthcare organizations must adapt to adhere to their consumers’ needs. Whether utilizing a new communication channel, adding streaming video or incorporating multiple languages, the awards demonstrate that providing healthcare consumers with tailored, learning experiences can significantly impact how they engage with a program. 

As the needs and preferences of healthcare consumers continue to evolve, so too should the capabilities of the healthcare organizations that serve them. Next year’s awards ceremony will surely exhibit a new string of engagement challenges with complex populations and niche use cases – let’s see what type of healthcare innovation surfaces in 2023! 

2023 Star Ratings Update: Digital Engagement’s Role in Closing Diabetic Care Gaps

38% of all eligible Medicare Advantage plans saw a decrease in the Diabetes Care – Kidney Disease Monitoring measure performance from 2022 to 2023 Star Ratings. The year 2022 marks the final measurement year for this measure, with Kidney Health Evaluation for Patients with Diabetes (KED) being the proposed replacement. Acknowledging this, plans are uniquely positioned to raise performance scores and improve kidney health for diabetic members using digital health engagement solutions for condition management as they prompt their member populations and provider groups to manage a new measure.

Kidney health evaluation for patients with diabetes

The Kidney Health Evaluation for Patients with Diabetes (KED) is a newer HEDIS® measure that tracks the percentage of adults with diabetes who have been screened annually for kidney disease.

The measure includes two components:

  1. A urine albumin-to-creatinine ratio (uACR)
  2. A blood test to determine the estimated glomerular filtration rate (eGFR).

This measure is important because it can screen and diagnose kidney disease, and early detection and treatment can help prevent or slow down its progression.

Interested in closing this gap? Learn more about our Diabetic Screening Solution.

While this change intends to provide a more accurate and comprehensive assessment of a member’s kidney function, preventing downstream complications and risk, it presents a behavior change challenge for Medicare Advantage plans as improved health outcomes also support better Star Rating performance.

One way members could satisfy the previous measure requirement was via a urine test in the comfort of their own homes. Now, they will likely need to visit a lab or their healthcare provider to also complete the blood test, which can be inconvenient, time-consuming, and, sometimes, intimidating, potentially impacting member compliance and overall plan performance. Routine in-clinic lab work requires behavior change that can be nearly impossible to achieve without strategic intervention.

A multichannel engagement solution to activate diabetes patients

Using a multichannel digital engagement solution that leverages tailored conversations intentionally crafted with behavioral science to activate members is proven to empower members to overcome barriers and get tested.

Rooted in neuroscience and psychology, behavioral science uses cutting-edge techniques proven to empower and inspire members to act. As a matter of fact, a leading Medicare Advantage plan saw an 18% lift in members taking action when behavioral science was used in SMS messaging in mPulse programs versus when it was not.

Here are a few examples of behavioral science principles that mPulse incorporates into messaging to inspire member self-efficacy:

  • Social Proof: Highlighting that a member’s peers are undergoing the exam can increase the likelihood that they will schedule their appointment.
  • Loss Aversion: Highlighting the potential negative consequences of not undergoing the exam can motivate members to take action.
  • Default Bias: Making the in-person exam the default option for members can reduce the effort required to schedule the appointment and increase compliance.

Education is critical in activating and empowering members to complete a desired health action. Streaming a captivating piece of healthcare content or even a link to an existing resource can help educate members about why going in-clinic is a better way to monitor their diabetes, driving sustainable behavior change in combination with behavioral science-backed dialogue. That’s why Streaming Content and Instructional Strategy make up one of mPulse Mobile’s proprietary engagement strategy pillars.

Our team of instructional strategists and healthcare industry experts creates compelling learning experiences to close gaps in healthcare inspired by trends from consumer products and aligned with key STARS measures, like Diabetes Care – Kidney Disease Monitoring. Streaming educational health content and messaging are developed alongside thought leaders and industry experts to ensure members feel empowered, inspired, and informed to take action to improve their health and health literacy.

In fact, mPulse observed a 274% increase in retinal eye exam completions when streaming content was used in SMS versus when it was not. Powerful right? The data speaks for itself.

While the addition of a blood test to the Kidney Disease Monitoring measure presents a challenge for plans, an omnichannel digital health engagement solution utilizing behavioral science strategies and streaming content can successfully drive members to receive the necessary care, improve the overall member experience, and improve measure performance. At the end of the day, everybody wins!

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

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

In part 1 of this blog series, we looked at the power of Fotonovelas, Interactive Content, and Animations to drive action in health consumers. All this content does the same thing: it goes beyond just telling a member or patient that taking an action is important. It teaches someone why it’s important and what can be gained or lost by action or inaction.

There are more types of content that can be used to solve some pervasive health challenges, though. In this post, we’ll tackle four of the top performing content types that can be used to do this: Courses, Expert Led Lessons, Stories, and Self-Assessments.

Courses to Manage Anxiety and Depression

The World Health Organization estimates lost production as the result of anxiety and depression costs the global economy over $1 trillion every year.  And, of course, it isn’t just a productivity issue. Mood disorders make it harder for people to stick with treatment plans, manage chronic conditions, and keep doctor appointments, which can have an overall impact on health and cost of healthcare treatment in the long term.

This makes it an important topic for plans and providers to discuss with their health consumers. Our 5-part course, Living with Anxiety and Depression, taught by author and mindfulness guru, Elisha Goldstein, PhD, teaches self-care strategies for navigating the negativity loop that can serve to keep many of us stuck in negative patterns and behaviors making it a truly powerful learning experience. Healthcare organizations can license the content to provide it any number of ways, including in their own branded content portal.

And anxiety doesn’t just affect adults. According to the CDC, approximately one out of every 10 kids (ages 3-17) have a confirmed anxiety diagnosis. The Parenting Kids with Anxiety course led taught by child psychologist and author, Renee Jain, contains five lessons focused on helping parents help their children transform their feelings of anxiety so they can all find calm, courage, and resilience.

Expert Led Lessons to Empower Consumers

Patients can often feel powerless when they engage in the healthcare system. They leave appointments confused. They have care plans they don’t want or know how to follow. They might not know how to advocate for themselves.

To address this and help them take charge of their care, healthcare organizations can provide expert-led video lessons from trusted experts to educate their members and patients on how to take control of their health. For example, Preparing for a Diagnostic Conversation features Dr. Archelle Georgiou who teaches members how to ensure every health decision is their decision, they leave every interaction feeling heard, and that the decisions made reflect their values and priorities.

These lessons can be embedded online, delivered via SMS messaging, or available on a streaming platform. Giving access to content led by reputable and trusted professionals is the first step to ensuring your members and patients take ownership of their healthcare.

Interactive Stories Encourage Diabetes Eye Exams

Started by Snapchat and copied by Facebook and Instagram, stories are now everywhere. Optimized for mobile delivery, they are auto-advancing snips of videos and images which healthcare plans and providers can take and use on social media as another channel to communicate with their populations or repurpose them for SMS delivered solutions. Our diabetes eye exam story below was promoted to at risk populations and is a great example of how the use of stories can educate.

A quick eye exam can detect early signs of diabetes or pre-diabetes. Because of that, getting members to their eye doctor every year is a priority. To help members really understand why doing so matters to them, we could simply send a text or an email telling them it’s that time, and that might work.

We want to help members really connect to the reality of life with eye disease, though, so to take it a step further and ensure the member or patient really understands the reason behind these exams, you can embedd this video you’re your communication program, and it includes a powerful, easy to follow call-to-action.

Self-Assessment to Determine a Need for Preventive Care Screenings

Increasing regular health screenings is an important goal for every health plan. We have an entire library of assets to help members understand when, why, and how to get the most common health screenings (like mammograms, colonoscopies, eye exams, and more).

Below is an example of a simple interactive self-assessment we provide to help members identify which health screenings are most appropriate for them based on what they tell us. Plans may already know what screenings the member is due for, but by providing this activity, it helps the member connect how their personal characteristics connect to their screening recommendations. Once the member receives their recommendations, we then connect them to additional content to help them better understand how the screening works and what their options may be.

The Bottom Line

Health content in the past has largely been underwhelming where pamphlets, brochures, and information documents were the norm. In today’s environment of social media, streaming content, and digital-first experiences, that won’t work. Healthcare organizations have a wide-open world of rich media experiences they can take and adapt for health education, and it’s imperative they do so! Consumers are not impressed with static (and oftentimes boring) content when the rest of their life is starkly different from that.

These are the top 7 content experiences we’ve seen work, but there are more than just these at healthcare’s disposal. Reach out to us to see what else is available for health outreach!

D-SNP Spotlight, Part 2: Engagement Opportunities within the 2023 Ruling

The CY 2023 Medicare Advantage and Part D Final Rule places a magnifying glass on vulnerable D-SNP members with additional regulations that will require plans to integrate services, adopt new products designed to deepen engagement, drive growth and retention, and inspire meaningful behavior change. Plans must consider these new guidelines when designing their D-SNP engagement programs. Visit Part 1, D-SNP Spotlight: Engagement Opportunities within the 2023 Ruling, to read a summary of the ruling and related changes to D-SNP regulations.

Why D-SNP? 

D-SNP members offer plans a unique engagement challenge, particularly due to their hard-to-reach reputation and growth potential. There are roughly 4 million D-SNP members nationwide, with 7 million additional individuals remaining eligible. This rapidly expanding population saw a growth increase of 52% since 2018, with an increase of 16.4% in 2021 alone. 

This fast-growing member population qualifies for both Medicaid and Medicare due to their complex needs and requirements. D-SNP members often have a disabling condition, suffer from mental health disorders, receive care from multiple doctors for a variety of health conditions, and/or receive in-home care or other specialized health and social service care. D-SNP members also have access to additional benefits which often include dental care, discounted over-the-counter pharmaceuticals, hearing exams, annual eye exams, and no-cost transportation to health care visits.  

Despite their complex needs, D-SNP members open the door to several opportunities due to the requirements in place that enforce plan coordination and whole person care engagement models. Here are a few opportunities to consider.

Opportunities to Engage and Drive Outcomes  

Cut Through the Competition 

Creating meaningful relationships is the key to retaining members, and the stakes are high when it comes to D-SNP. To retain members, each individual needs to feel seen and addressed. Scaling communications across an entire population is no small feat, particularly when each member has their own unique needs and challenges. 

Personalized omnichannel messaging is essential to creating a valuable experience and allows for resources and services to be delivered on a case-by-case basis through each member’s preferred channel of communication. Conversational AI allows messaging to remain dynamic, while Natural Language Understanding (NLU) analyzes each response. mPulse Mobile uses a combination of industry, public and private data sets combined with plan data to create highly accurate predictions, and continually optimizes dialogs using conversational insights. By sending the right message at key moments, and providing resources and information each member needs most, we can begin building meaningful relationships that reduce churn. 

Break Down the Barriers 

Reaching and getting D-SNP members to engage is a great start, but instilling behavior change and self-efficacy to create action? Definitely a challenge – particularly when we consider the unique needs D-SNP members face. Members face a combination of mental health and physical health challenges, which can include ailments such as substance abuse and comorbidities. They often receive in-home care, reside in long-term care facilities, or have designated caregivers. These situations can create even more barriers to engaging and activating D-SNP members. Despite obstacles, providing relevant and critical care information and resources, particularly benefits they may not be aware they have access to, through their preferred communication channel is a great first step. But how do we create meaningful behavior change? 

We can begin building health literacy by providing powerful media experiences that include interactive and educational modalities. mPulse Mobile offers streaming health education across a variety of health topics. All content is designed by our team of production designers and learning strategists, with the goal to build skills that empower members to own their health and adopt healthier behaviors over time. Not only do we design for health literacy, we design for entertainment and boast a 71% member self-reported likelihood to take action after engaging with our streaming content.  

Drive Value Again and Again 

D-SNP members offer plans tons of flexibility. Because Medicare and Medicaid benefits are tied into a single member, premium dollars increase and open the door to curating much-needed exceptional member experiences. Allowing plan resources and benefits to reach, engage and educate this rapidly growing and vulnerable population is crucial. To attain and retain the market share, developing partnerships with organizations designed to drive repeated value is key. Understanding your member’s needs, using behavioral and learning science to engage and educate them, and driving action at key moments increases member retention, and delivers better health outcomes. 

How mPulse drove a 58% D-SNP Engagement Rate 

mPulse partnered with a national payer who serves over 17 million members nationwide, with D-SNP member eligibility available in 28 states.  

Goals 

The program focuses on welcoming new D-SNP members to the plan, with an emphasis on increasing awareness and utilization of available benefits and services. By providing a white glove experience, the plan aimed to increase retention of D-SNP members and create meaningful relationships with these members at scale. Additional goals included HRA completion. 

Execution 

Over the course of three weeks, more than 45,000 D-SNP members were enrolled into a 3-week SMS program. Each week promoted a different service offering, including healthy food card and over-the-counter pharmaceutical discounts, as well as assistance in finding a provider and ensuring members received their ID cards.  

Results 

SMS text messages saw a 99% delivery rate with 58% engagement. More than 30% of engagement included link clicks to related plan benefit offerings, which included over-the-counter pharmaceutical discount cards, healthy food cards, and provide finder links.

What’s next?  

By understanding how to reach members with complex needs, plans can cut through the competition and provide unrivaled experiences for D-SNP members. mPulse Mobile is the leader in Conversational AI solutions for the healthcare industry and operates to continually drive outcomes using tailored and engaging digital experiences. Our rich understanding of diverse populations enables our team of behavioral and learning scientists to curate highly tailored programs designed to impact the lives served by our 180+ client roster.