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Category: Behavioral Science

mPulse Recognizes Innovative Healthcare Organizations in the Sixth Annual Activate 2023 Awards

Posted on by mPulse Team

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! 

Avoidable & Unnecessary ER Visits: Emergency Room Diversion Strategies

Posted on by Andrea Amelse

Using the Emergency Department excessively is the fourth largest financial waste in US healthcare – it costs over $38 billion annually. Emergency departments are overwhelmed, and emergency physicians experience almost three times more burnout than other departments.

Health organizations are under increased scrutiny to lower non-emergent ER visits and implement solutions to encourage health consumers to seek the right level of care. Despite ongoing efforts and initiatives, emergency department overutilization continues to rise yearly.

Understanding and analyzing commonalities in ER utilization will enable deeper insight into how we can begin tackling this issue head-on.

Why do consumers go to the ER when it’s not an emergency?

There are many reasons why health consumers visit the ER. In more ways than not, the emergency department checks several boxes when it comes to convenience:

  • It’s open 24 hours, 7 days a week.
  • It offers patients immediate reassurance regarding their condition or ailment.
  • Patients receive a full range of services regardless of the severity of their condition or whether or not they can afford it.
  • Hospitals have financial and legal obligations to treat patients.

To deter consumers from visiting the ER, alternative care options need to become more accessible and outweigh the convenience of a visit to the ER. Shifting consumer paradigms is easier said than done, and health organizations need to adopt innovative solutions to educate and encourage patients to seek alternative care models.

Further consideration of commonalities in emergency room overutilization offers clues to designing solutions that address the why and offer insight into the how.

Commonalties in Avoidable or Unnecessary ER Visits

ER overuse is a nationwide issue with the highest prevalence among those who are uninsured or enrolled in government health programs, particularly Medicaid.

Nearly 53% of Medicaid members will have an avoidable or unnecessary ER visit this year. Those with health disparities are most likely to have an avoidable ER visit.

Risk factors include

  • being in a lower-income decile,
  • unemployed,
  • living in a single household,
  • less than high school educational attainment,
  • English speaking,
  • aged 27-54 or 65+,
  • limited internet access,
  • divorced or widowed,
  • female,
  • having a disability,
  • having one or more chronic conditions,
  • uninsured or having public health insurance, and
  • having limited or no transportation.

It is important to note that institutionalized and structural inequities cause these commonalities. Collecting data points and creating false attributions is easy; systemic racism and long-standing inequitable distribution of wealth and resources are to blame in this instance. Health organizations are taking responsibility for recreating a system in which diverse populations have greater access to the care and resources they need.

At the end of the day, health equity benefits all of us. Providing equitable opportunities for care availability and resources is foundational in lowering avoidable ER use, and understanding commonalities help address and overcome existing barriers.

The Difference Between Avoidable & Unnecessary ER Visits

There is an important distinction between the terms ‘avoidable’ and ‘unnecessary’ when it comes to the course of action and corresponding interventions needed for ED diversion.

For the purposes of this blog, avoidable ER visits are visits related to unmanaged conditions, such as diabetes or mental health/substance use disorders (MH-SUD). In fact, nearly 60% of all ER visits are from people with one or more unmanaged chronic conditions, with these individuals also having higher rates of ED recidivism.

Unnecessary ED visits are often due to a lack of accessibility and educational resources and typically account for visits that are urgent care or primary care treatable.

The top four ER diagnoses, in order, are as follows:

  1. Abdominal pain and digestive issues,
  2. Upper respiratory infections,
  3. Minor injuries, and
  4. Sprains.

Both avoidable and unnecessary ED visits require intervention; however, the methodologies and approaches vary. Healthcare isn’t one-size-fits-all, and meaningful behavior change requires personalization dependent on each consumer’s unique needs, preferences, and health status.

ER Diversion Strategies

Understanding why consumers seek care at emergency departments, coupled with commonalities in ER utilization, provides a deeper understanding of what’s needed to help support and educate consumers in seeking the right care for their health needs. The right education and support also depend on whether the ER visit is avoidable or unnecessary.

Education

Meaningful education incorporates behavioral science principles to motivate and empower behavior change. Simply telling a consumer they shouldn’t go to the ER unless they have to won’t work. Engaging with consumers in frictionless and meaningful ways requires expertise.

mPulse Mobile’s in-house instructional strategists, behavioral scientists, and health equity researchers develop cinematic streaming content experiences designed for optimal behavior change. Short-form content is designed to be relatable and educational, enabling consumers to realize the benefits of seeking alternative care.

See an example animation below.

Want to learn more about how streaming health content can drive behavior change? Download the complete guide »

Accessibility & Convenience

Providing personalized resources and support through frictionless calls to action will promote the utilization of better care options. Many health plans have resources available such as ride-share services and telehealth or nurse line providers for non-emergent cases. Despite these resources, utilization remains low, primarily due to a lack of awareness that they exist.

Engaging with members through an omnichannel approach, such as SMS, Email, and/or IVR, enables health organizations to meet their consumers where they’re at frictionlessly while providing accessible links to resources and support at their fingertips. When health organizations leverage innovative technology as a vehicle of communication with their consumers, engagement rates rise along with better health outcomes.

Avoidable ER Visits: Condition Management Solutions

Reducing avoidable ER visits begins with creating and maintaining meaningful relationships with health consumers. Because one size doesn’t fit all, understanding each consumer’s needs and preferences and their conditions and health status are crucial. mPulse Mobile creates individual member profiles in which each consumer’s protected data is leveraged to send tailored and relevant cadenced touchpoints. This becomes increasingly important for better condition management and medication nonadherence, accounting for billions in avoidable ER spending.

mPulse Mobile provides integrated and meaningful solutions for condition management, such as hypertension and diabetes, as well as MH-SUD and routine appointment reminders and scheduling.

Our solutions leverage an omnichannel engagement approach incorporating conversational AI and streaming content to educate and empower members to own their health while adopting healthier behaviors, including:

  • eating better and exercising,
  • regularly communicating with their care team, and
  • taking their medications as prescribed.

Educating consumers on where to seek the right level of care and providing resources and support are critical components of ED Diversion, but understanding individual consumer health needs and support will help health organizations reduce avoidable and unnecessary ER visits.

Visit mPulse’s condition management solutions to learn more »

mPulse Case Study

One of the nation’s leading health plans partnered with mPulse Mobile to lower unnecessary ER visits and redirect members to better, more affordable care options.

Goals & Execution: Automate and optimize digital communications to members using SMS text messages to redirect members identified as high-utilizers of the ER and provide meaningful messages and streaming content to redirect them to more appropriate levels of care.

A population analysis was performed to assess the intervention impact for members outreached. SMS messaging was deployed to engage and educate members to seek the right level of care for their health needs. A group of approximately 12,000 high-utilizers were enrolled in the program.

Results: 69.7% reduction in ER visits. Before outreach, there were nearly 19,000 total ER visits. Post outreach, that number decreased to under 5,700 visits. Assuming the average ER visit cost is $1,082, the program saved over $14 million in health plan and consumer savings during the program’s duration.

In Conclusion

Health organizations are uniquely positioned to engage meaningfully with their members and patients and have invested time, money, and resources into providing services conducive to bettering health outcomes.

mPulse Mobile is the leader in innovative digital engagement solutions and partners with 200+ leading health organizations to deploy over 1 billion conversations annually to inform, educate and tailor conversational engagement designed for health action across diverse populations.

 

To learn more about how mPulse Mobile can lower avoidable and unnecessary ER visits, lower costs, and improve health outcomes for your consumers, contact us to schedule a consultation.

Frictionless Healthcare, Part 5: The Power of Perception

Posted on by Eden Brownell

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

Understanding Behavioral Science

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

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

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

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

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

Harnessing the Power of Authority Bias

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

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

Applying Authority Bias in Healthcare

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

 – SriVani Ganti, MSHC – Director of Health Equity.

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

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

mPulse Mobile’s Approach

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

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

In Conclusion

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

Key Takeaways:

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

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

Closing Gaps in Care: What Key Strategies Should Plans Consider?

Posted on by Andrea Amelse

$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

Posted on by Eden Brownell

The public is composed of numerous groups whose cry to us writers is: 'Comfort me.' 'Amuse me.' 'Touch my sympathies.' 'Make me laugh.' 'Make me shiver.' 'Make me weep.' 'Make me think.'

Henri Rene Albert Guy de Maupassant​ Tweet

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

Posted on by Gabe Kratzer

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! 

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

Posted on by Andrea Amelse

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.

Frictionless Healthcare, Part 3: The Power of Reciprocity in Healthcare

Posted on by Eden Brownell

Don’t forget to catch up with Part 1 and Part 2 of this blog series first!

______________________

So, readers, let’s talk more about theory and research. Robert Cialdini has been studying the science of persuasion for over forty years. In 1984 he wrote Influence, which reveals 6 principles of persuasion. It was an instant success and sits on the desks of advertising executives, copywriters, and marketeers everywhere, and reciprocity is the first of Cialdini’s six universal principles of persuasion. Why? Because the evidence shows that it works. 

Free coffee and donuts help car salespeople close deals. A couple of unexpected candies in the check at a restaurant gets the server a bigger tip (particularly if they come back to the table and hand deliver the second candy to “you lovely, special people”). When the hotel donates to charity on your behalf, you reuse a towel that you’d normally throw on the floor.  

Reciprocity in Healthcare

You are probably thinking to yourself, “Cool, but what the heck does this have to do with healthcare?” Healthcare organizations have a real need for information or action from members, and it’s not always easy to get. By using a value first design to your approach (which means you provide the member with something valuable first and ask for the return favor later), you increase the likelihood of success.

We don’t just think and talk about these concepts, though. We put it into practice, and the Health Outcomes Survey (HOS) for Medicare beneficiaries is a perfect example of a healthcare initiative in which reciprocity can play a big role.  

We innovated on the standard HOS solution by applying value first design, so instead of asking members to answer a questionnaire by telling them that it’s very important (it’s important to the health plan, not the member, by the way), we first provide them with a fun, engaging digital experience designed to be valuable, personal, and unexpected. Most importantly, it includes changes members can make easily and quickly in their own lives. It’s only after we provide this experience that we ask members to provide their feedback, allowing us to identify high risk members so the plan can act.

Useful tip: Don’t only give first (it isn’t enough). Aim to also give a gift unexpectedly. In a study, customers who were given surprise discount coupons upon entering a shop spent on average 11% more than those who were given the coupons in advance. The unexpected nature of the gift amplified customer responses. Ensure that what you give is unexpected relative to the norm of what’s expected. 

Want to learn more about using reciprocity in healthcare? Watch the on-demand webinar » 

Something Unexpected 

Enter streaming health content. It’s something unexpected from healthcare but familiar to the member because it resembles media they consume every day, such as Tik Tok and Instagram stories. In this HOS example, the unexpected and helpful gifts are Fotonovelas, which are stories told through auto-advancing images (much like the snapchat or Instagram story experience). 

One of the biggest mysteries of neuroscience is how we create meaning out of the world. Stories are deep-rooted in the core of our nature and help us create this meaning.

Information presented in a story-based format is more easily remembered than plain statistics or facts. According to Stanford Graduate School of Business’ research, stories are 22 times more memorable than facts alone. This is likely because stories universally activate brain regions dealing with emotional processing and memory.

A powerful communication tool, stories can capture attention, build trust and credibility, and deliver messages and insights with impact. In the next installment in our Frictionless Healthcare blog and webinar series, we will go more in depth into storytelling effect, the psychology behind storytelling, and how to leverage it within your organization, so stay tuned and maybe sign up for our newsletter below (nudge nudge). 

Speaking of attention, dear readers, I’m probably losing yours. So, let’s wrap things up with some key takeaways about reciprocity.   

  • It’s how relationships are built ​ 
  • It’s not a trade or negotiation​ 
  • Follow the order of events: give, then ask​ 
  • Give something unexpected, personal, and valuable to increase the impact 

To learn more about using reciprocity in healthcare outreach, watch the full webinar below.

Read part four of this blog series!

How to Address Changes in Patient Engagement and Motivate Flu Vaccination Fulfillment

Posted on by mPulse Team

Flu season is coming back around, and in a post-COVID world, that means changes in how members engage when it comes to being vaccinated. Lingering perspectives related to vaccine hesitancy may influence members’ reluctance to be vaccinated for the flu despite vaccinations being even more critical to their continued health. Health plans, providers, and pharmacies will have to work harder this year to ensure their health consumers are vaccinated and protected against the flu than they have in years past.

In the 2022–23 flu season, vaccination coverage with ≥1 dose of flu vaccine was 57.4% among children 6 months through 17 years, similar to the 2021–22 flu season (57.8%), and flu vaccination coverage among adults ≥18 years was 46.9%, a decrease of 2.5 percentage points from the prior season (49.4%).

With the unpredictability of flu severity from season to season, outreach and patient engagement to provide information and identify resources for access to vaccinations is integral to a health plan’s ability to proactively communicate with diverse populations through targeted content.

Annually, unvaccinated individuals will cost the healthcare system over $10.4 billion and an additional $17.6 Billion in lost worker productivity.

Flu vaccine patient education can help to prevent:

  • 5 million flu-related illnesses
  • 7 million flu-associated medical visits
  • 105k flu-associated hospitalizations, and
  • 3k flu-associated deaths 

So, what can the healthcare industry do to combat this? With tools like behavioral science, interactive flu vaccine education, and conversational AI at their disposal, it’s possible to see significant increases in flu vaccination rates among members.

Let’s take a closer look at why.

The Foundation: Science of Human Behavior

Let’s start with the basics for any outreach program we run: behavioral science. In this mega-study conducted by The University of Pennsylvania and Walmart, 22 different behavioral science techniques were tested. These 22 varied techniques were embedded into messages delivered through SMS to over 650,000 Walmart pharmacy patients to determine which boosted vaccination rates the highest. Overall, including all these techniques increased flu vaccination rates by an average of 6.7% over a three-month follow-up period.

However, the endowment effect was the most effective technique, which encouraged patients to visit Walmart for a flu vaccine reserved specifically for them. By telling a person a particular flu shot is ‘reserved for you’ and already belongs to them, the vaccine becomes a tangible thing of value that they own. The Endowment Effect is an emotional bias to put a higher value on owned objects. This approach also uses the technique of Loss Aversion, a bias that makes us care nearly twice as much about avoiding loss than receiving an equivalent gain. In this case, if you don’t claim your flu shot, you’ll lose something you own.

We use behavioral science in every program we deploy for our clients, but this study specifically and the endowment effect itself was the basis with which we built our flu vaccination solution for the 2022-2023 flu season. What UPenn and Walmart didn’t have, though, was the following few factors that pushed our flu program beyond even this study.

Streaming flu vaccine patient education

With so much flu vaccine hesitancy in our post-COVID world, flu vaccine patient education about the safety and efficacy of vaccinations is a necessary step, and departing from the mundane pamphlets and brochures of the past by utilizing streaming health content is an extremely effective way to do this.

fotonovela to help improve flu vaccine patient education

The content we’ve produced for flu vaccine education is a series of fotonovelas, which are auto-forwarding image-based stories with a visual interface similar to the stories feature on Instagram. Fotonovelas are ultimately a health literacy tool, but at the same time, they make learning fun and easy (80% of learners on our platform report liking or loving the fotonovela content type).

In this specific flu fotonovela below, the characters featured resonate with diverse audiences, the storylines detailed transcend linguistic and cultural barriers to deliver essential information, and the tone provides empathy and support on the path toward the desired call to action. The best part is that health patients who view a Fotonovela are 72% more likely to get vaccinated.

2-Way conversations uncover barriers

Having 2-way conversations allows you to gather insights about your members that can inform future communication.

  • What is their sentiment toward the program and plan?
  • Why haven’t they been vaccinated?
  • Have they already been vaccinated, and we don’t know?

Knowing why they haven’t been vaccinated allows the plan to respond with education and resources to assist.

  • Do they need help figuring out where to go? Send them the information to their nearest pharmacy.
  • What about if they’re not sure they need a flu vaccination? Send them a Fotonovela to educate them!

Multiple channels, multiple languages

The UPenn and Walmart mega-study tested SMS messages, but why stop there? A large part of an effective engagement strategy is meeting members where they are. As such, our solution includes SMS, IVR, and email channels. Take the concept of meeting members where they are one step further, and you’ll get the ability to deploy this vaccination solution in both English and Spanish. This means reaching more of your population in the way they want to communicate.

Tackle flu early and effectively

The CDC recommends that everyone six months and older, especially people at higher risk, should get a flu vaccine annually to reduce their risk of contracting seasonal flu, alleviate the severity of symptoms, and decrease the likelihood of experiencing major health complications if infected. The importance of each individual vaccinating against the flu needs to be communicated to members through targeted, succinct, and easily understandable materials delivered through channels to reach them where they are most apt to respond and be motivated to act. Studies have found that patients who are informed and effectively motivated are also more likely to adhere to their treatment recommendations.

Our flu vaccination solution

mPulse Mobile’s flu vaccination solution uses proven behavioral science, dynamic content, and an omnichannel approach to overcome common vaccine barriers and get more members vaccinated. With over 15M Flu vaccination touchpoints sent to Medicaid, Medicare, and Commercial members by mPulse in the last two years using its 2-way Natural Language Understanding platform, we have learned from millions of past vaccine conversations in both Spanish and English. We use behavioral science in a relatable and quick experience and employ Fotonovelas to empower members to act. We can help overcome common barriers and resistance by listening for vaccine readiness.

For more information on this flu vaccination solution and a live demo on how we can improve your flu vaccine patient education, register for our webinar, Double Your Vaccination Rates for Your Health Population.

Frictionless Healthcare, Part 2: Using Reciprocity to Increase Motivation

Posted on by Eden Brownell

Behavioral science describes the study of behavior through experimentation and observation. Behavioral scientists study when and why individuals engage in specific behaviors by examining the impact of factors such as conscious thoughts, motivation, social influences, contextual effects, and habits. This week, we will look at how reciprocity can be used in healthcare design and content.

________________________

Dear reader, have you ever wondered what could make you not want to drop a hotel towel on the floor after the first use? Well, a card in a hotel bathroom might do it if it were written the right way. My good friend, Robert Cialdini, and his colleagues investigated this (okay we aren’t really good friends, but a girl can dream, right?) by testing multiple different card appeals to see which would lead to the highest rate of behavior change. They found that neither the basic environmental-protection message urging us to save some no name penguin (although, feel free to name him whichever way you like) nor the message with cooperation appeal could hold a candle to a different kind of push – our need to reciprocate. 

 The most effective way to induce the desired response was to give the donation first then ask a guest to cooperate in this effort. The message with reciprocation appeal, giving first read: 

 “WE’RE DOING OUR PART FOR THE ENVIRONMENT. CAN WE COUNT ON YOU? Because we are committed to preserving the environment, we have made a financial contribution to a nonprofit environmental protection organization on behalf of the hotel and its guests. If you would like to help us in recovering the expense, while conserving natural resources, please reuse your towels during your stay”.

 This method reported almost a 47% success rate, which was significantly greater than the cooperation condition. Why? Because the hotel donated money first on behalf of its guests and only then asked them to join in on it. You didn’t need to reuse your towel, but you felt sort of obliged to. If you didn’t recycle (help them claim the money back), well, you would probably feel a little bad, which is reciprocity in a nutshell. 

Reciprocity in Healthcare

But what does this story have to do with healthcare? The principle of reciprocity means you are more likely to comply with a request if it comes from someone who has previously done something for you, and in healthcare, obtaining compliance is a constant goal. Whether it’s urging members to get their preventive screenings or convincing patients to diet and exercise to bring down their A1C, driving healthy action is important to plans and providers, and reciprocity is a powerful tool to get this done. Let’s review one other case study before taking a deeper look at this in healthcare setting.

Want to learn more about using reciprocity in healthcare? Watch the on-demand webinar » 

 In this next example, the British Behavioral Insights Team joined forces with the NHS Blood and Transplant, the Department of Health, Government Digital Services, and DVLA to investigate a way to increase signups to the organ donor registry. It ended up being more complex than expected and was one of the biggest trials in the history of the UK public sector.

 Given the subject of this blog, you might have already figured they used reciprocity in a clever way to reach their goal. They inserted short phrases with various behavioral science techniques embedded into an existing vehicle tax webpage, and linked it to the organ donor register, which appeared after a user had finished obtaining their vehicle tax. The best-performing behavioral science technique (surprise, surprise) was the reciprocity appeal, which outperformed the existing webpage by roughly 100,000 registrants per year. Here is how it read: 

 “If you needed an organ transplant, would you have one? If so, please help others.”

 Oftentimes, healthcare organizations can approach a lot of healthcare problems with an eye towards getting members to provide them with information (even though they have a tendency not to). The trick is to flip this process by providing the member with something valuable first and encouraging them to think about these issues on their own before we ask them to share their thoughts and feelings, which is called value first design.

 In the context of digital product experiences, users are more likely to engage with your product if you first provide value to them. They’ll be more likely to trust you and reciprocate. This concept is even more important when you’re about to ask for something big from your users, such as signing up for something or closing a healthcare gap. In part 3 of this blog series, we’ll dive into the specific architecture of outreach and how to build in reciprocity by combining behavior science and streaming health education to create a value first design.