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CareSource Activates Hard-to-Reach Members with Conversational Outreach and Streaming Content

COVID-19 Accelerating Digital Engagement

It is no secret that COVID-19 has changed the way healthcare communication is delivered to consumers. The uncertain nature of the pandemic has forced healthcare organizations to incorporate digital strategies to continuously update their members on important COVID-19 information. Just this year, health plans have had to respond to the new mandate requiring reimbursements for at-home COVID-19 tests.  

Gaps remain in other facets of COVID-19 communication, like driving behavior change to increase vaccinations. Across the country, states are seeing lower vaccination rates among Medicaid beneficiaries. In California, the Department of Health Care Services (DHCS) released a January 2022 report indicating that 81% of the general population had received one dose of a COVID vaccine compared to only 54% of Medi-Cal (California’s Medicaid program) beneficiaries. Significant disparities in vaccination completion such has this have developed in states beyond California as well. 

CareSource, an Ohio-based managed care plan offering insurance coverage to vulnerable populations across five states, recognized a similar disparity in their diverse member population and sought a solution. Traditional methods of engaging members had failed to produce desired results, creating an opportunity to incorporate a new approach in their outreach efforts. The plan partnered with us to implement conversational outreach and streaming health education into their COVID-19 vaccine program strategy.  

Here’s some key takeaways from the program along with strategies that health plans can adopt to drive vaccine engagement.  

Strategies That Personalize Outreach

Delivering vital information about vaccines becomes more difficult when using a one-size-fits-all approach to communicating with vulnerable members. A successful COVID-19 outreach program requires personalized interactions with members to inspire healthier actions. CareSource identified a need to activate hard-to-reach consumers and sought a tool to tailor engagement based of range of factors including health beliefs. 

The plan leveraged our robust technology platform and Natural Language Understanding capabilities, which enabled tailored engagement through 25 SMS workflows, 1 Secure Survey, and 1 streaming video.  

We helped deploy SMS surveys to assess individual vaccine readiness levels, and members were assigned one of three personas based on their responses: Ready, Unsure, and Nonbeliever. Developing personas enables plans to tailor messaging according to personalized interactions with members to inspire healthier actions each member’s preferences and self-reported barriers. Messaging must be intentional and sensitive to inspire paradigm shifts for unvaccinated members or members who have no plans to get vaccinated.

Behavior science informs every communication we send, and this program was no different. An effective behavioral science strategy in the CareSource program was giving members Social Proof, which comes from the Social Determination Theory and suggests that people are motivated by feelings of competence and relatedness. Through the texting channel, members were sent a streaming video, “My Why,” which highlights a diverse range of people explaining their personal reasons for getting vaccinated. Plans can inspire confidence and healthier actions just by making members feel as though they are not alone.

Another behavior science strategy employed in the program was Authority, which is using trusted health experts to improve education, drive health literacy and reduce barriers like misinformation. Using sources like the CDC can ease doubt and motivate members to reconsider personal health beliefs that may contribute to vaccine hesitancy.   

CareSource provided zip code data, which we used to further tailor conversations based on socioeconomic factors. Providing members with personalized, familiar interactions gives the member a voice and drives self-efficacy. 

By incorporating behavioral science and SDOH into their COVID-19 engagement strategy, CareSource was able to tailor conversations and streaming educational content at scale. Social determinants of health (SDOH) can play an integral role in tailoring messaging to each individual inspiring vaccine readiness. 

Innovation That Drives Outcomes

We sent a total of 4 million SMS messages and delivered over 3 million automated dialogues to 664,000 members. The program yielded nearly a 15% engagement rate, an increase from traditional rates of 8-10%. Of the members who received a first dose, 81% reported they would follow through to get a second dose. By the end of the program, 57,000 of the 107,000 “Unsure” members moved into the “Ready” persona. 

Each member response led to additional tailoring, with automated responses covering topics like variants, availability, cost, fear/anxiety, effectiveness, and side effects. Upon conducting 30-day and 90-day reviews of the program, common themes were uncovered within each member persona. Gathering insights from member interactions can help influence future vaccine engagement programs and ensure that each conversation is tailored to drive the best results. 

As companies focus on highly tailored engagement, scalable intelligent capabilities are required.  CareSource has demonstrated the potential for Conversational AI outreach and streaming health education to drive healthier actions and meaningful outcomes.

Member Communication for the Home COVID-19 Test Coverage Mandate and Other Rapid Response Programs

Beginning January 15th, the Biden Administration required health insurers to cover the costs of up to 8 at-home COVID-19 tests per month for their privately insured members. This not only helps reduce or eliminate up-front costs of Americans seeking an at-home solution to COVID-19 testing, but it also helps dull the pain points of finding testing facilities when needed.

The mandate, which quickly became breaking news, was a welcome announcement for health care consumers, but it threatened to strain insurers who were given official notice just days prior to its effective date. In the last two weeks, we’ve heard from many of our healthcare partners about the challenges this presents during an already busy season. Plans found themselves in a difficult position needing to communicate as quickly and accurately as possible while maintaining their current programs and managing their open enrollment period (OEP).

Easy Rapid Roll-out Practices for Your Members and Organization

Between call-center re-routes, at-home test kit availabilities, and managing the member experience, staying agile after this announcement can become both overwhelming and costly. This is not the time to trial and error communication with your populations.

Relying on the methods you have already been using for member communication is your best bet in yet another unpredictable turn during the pandemic, and there are several distinct best practices plans can follow to handle unexpected situations like this as they arise.

To start, use the quickest and most impactful means of communication with your members first. 3.8 billion people own a smart phone and SMS is a reliable source of fast communication. If that line of communication is already set up with your population, connecting them with resources after any sudden event will be much simpler. The minimum data requirements we recommend for our at-home testing mandate outreach or similar programs are the member’s first and last name, date of birth, mobile phone number, and address.

Channels like SMS are ideal for reaching consumers quickly but implementing a multi-channel approach by including email and even IVR channels is an option, too. For example, using a consumer’s preferred method of outreach, like IVR, to authenticate mobile numbers and direct them to two-way automated workflows can be an effective tool, allowing your organization to provide cost saving information within hours while still utilizing all lines of preferred communication.

Whatever the channels you choose, we recommend providing comprehensive education and resources by redirecting consumers to trusted information sources, such as an interactive FAQs page or links to valuable sites like USPS How to find a test site. This reduces the chance of them calling their plan for information that is thorough and easily accessible elsewhere. In the case of this at-home test mandate, providing them information on their pharmacy or a link to all in-network pharmacies near them can also help the plan save money on reimbursement costs.

Orchestrating this outreach early and getting in front of the member with the correct messaging before they reach out to your call centers can help mitigate costs in any situation, but it can be especially helpful after the at-home mandate announcement. It will not only help ease the influx of calls to a costly call center, but it will also lead your membership to the resources they need to secure their at-home tests at a more reasonable cost to the plan.

Another rapid roll-out best practice we recommend is partnering with a solution provider which has the technology in place to quickly deploy two-way messaging at scale. The ability to have bi-directional conversations to address the specific questions of each member individually (ideally through natural language understanding technology) will significantly improve the efficacy of your program. And with this partnership in place, you won’t need to focus on setting up member communications in the middle of figuring out execution. You can lean on your solution provider to build and deploy the program for you.

Interested in learning more? Watch our on-demand webinar on at-home covid-19 mandate best practices and rapid response solutions »

The most important factor, however, is acting quickly. If your outreach provider has contingencies in place for last-minute events like this, they will most likely be able to stand up a solution that has all our best practice elements included in a timeframe of two to three weeks or less.

How Does This Fit Into the Member Journey?

Though communication surrounding this mandate is trickier than other rapid responses, swift messaging to member populations is still essential. When a health plan reacts quickly to market changes and provides helpful information to ease members and patients through a complicated and cumbersome process, they become trusted partners throughout that member’s journey. The right communications from a trusted authority, reduce the complexity this new mandate has presented, and others to come, and will prevent misinformation that members face. If your organization has a communications partner with experience standing up programs quickly, then it can feel easier on the member to get common questions answered, find vaccine sites, and submit claims, etc. – further reducing barriers to crucial and accurate information.

And with CAHPS right around the corner, what better timing to solidify that spot as your member’s trusted source of information that is preventative and timely? Further strengthening trusted relationship between plan and member.

Understanding your membership and leaning on the information you have, such as their preferred language, the channels your healthcare consumers use, and the right contact information will go far when your organization needs to pivot and deploy information timely and most efficiently.

COVID-19 Home Test Coverage Takeaways

If your organization is currently using SMS to outreach to your populations, you are in the perfect position to outreach quickly and at scale, and you only have to switch out standard messaging with the right messaging for the moment. An easy framework for rapid rollout solutions your organization has at the ready, is a sure-fire way to communicate all new breaking information.

Then working with your solution provider to craft the perfect messaging or leaning on your solution provider’s behavior science technology will impact how swiftly your organization can easily respond in moments when messaging is not able to take the priority–like we saw just a few weeks ago many other times throughout the pandemic. The focus can remain on execution while your automated solution provides your membership with what they need to feel like they can come to you for the most reliable trusted resources at any time.