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Category: Social Determinants of Health

Overcoming Member Barriers to Breast Cancer Screenings 

Posted on by Andrea Amelse

Breast cancer remains a leading cause of cancer death amongst women in the United States. And while cancer rates have slowly declined, there are still barriers amongst diverse communities that prevent many of them from seeking timely and potentially life saving screenings.

Black women have a 40% higher mortality rate for breast cancer, while their five year survival rate is 81%; nearly 11% lower than white women. Women with a disability are also less likely to receive breast cancer screenings due to various barriers, including accommodations for their disabilities, and Hispanic women are 30% less likely to be screened compared to white women, yet breast cancer is the most common cause of death in Black and Hispanic women between the ages of 45 to 60 years old.

Proactively reaching out to members due for screenings and educating them on the importance of preventive care is critical to ensuring they receive the best outcomes and care. Unfortunately, when barriers such as poor experience, lack of access and respect, and costs are coupled with conflicting cultural beliefs, it becomes increasingly challenging to increase breast cancer screening rates amongst diverse communities.

However, through the power of behavioral science, technology, and health literacy tools, we can craft effective programs which remove at least some of these barriers to increase breast cancer screenings in at-risk populations.

Top 4 Challenges to Increasing Breast Cancer Screenings

Challenge 1: Influencing Members to Take Action

To influence people and drive positive behavior change, you first have to understand their individual preferences and what drives them. Behavioral science explains to us why people do the things they do. By taking and using these principles, we can engage with members and patients in ways that make it easier for them to take action—thereby ensuring they complete their breast cancer screenings.

One behavior change technique mPulse utilizes in our breast cancer screening program is social proof. Most people are heavily influenced by what others think, say, or do, especially when they see people who resonate with them. Members are motivated to schedule and attend breast cancer screenings when they hear from others similar to themselves willing to discuss culturally sensitive topics. It encourages diverse groups of women to schedule screenings because they’re learning from the experience of peers like themselves.

Below shows an example of activating social proof. When you show a member that other women like them do get breast cancer screenings and remind them that mammograms are normal and common among similar women, it’s more likely to have an impact.

Want to hear about more behavior change techniques that motivate members to complete their screenings? Watch the full on-demand webinar >>

Challenge 2: Identifying and Breaking Down Members Barriers

Getting the message to your members unfortunately doesn’t necessarily mean they will act on it. There are many barriers members face to accessing healthcare – transportation issues, lack of understanding around their health needs, the cost of healthcare, and more.

Using Natural Language Understanding (NLU) and conversational AI, you can not only understand the response of each member to identify their specific barrier, but you can also respond automatically and in real-time to address barriers at scale.

Our advanced capabilities decipher complex replies, including typos, in 7+ languages* at any point throughout the member journey to provide configurable resources and support when and where it’s needed most.

For example, if people have indicated that they’re unable to get to their breast cancer screening appointment, our technology is able to understand that and respond with rideshare resources and a phone number to request one (which reduces the perceived effort of completing this action).

By doing this, you are improving the health of your population as a whole, while continually creating personalized touchpoints that build relationships and trust with each member, enhancing retention and loyalty.

Case Study: Leading MCO Deploys Barrier Identification Program

To identify and address barriers to breast cancer screening, one leading MCO Health Plan partnered with mPulse to send tailored SMS messaging to members who hadn’t scheduled their annual mammogram. Leveraging two-way dialogue, their responses were analyzed through the use of NLU and appropriate, relevant automated replies were sent to help members overcome barriers such as fear, being “too busy”, or even not having access to transport or childcare.

For this use case, we were able to identify the largest barriers based on responses for their member population. See below for example dialogue* and most frequent barriers gathered from response data.

By analyzing member response data, plans can begin implementing the resources and education needed to further help members overcome barriers.

If people don’t see screenings as being important, or worth their time, we need to educate members by providing relevant information that explains why they’re important and empower them to take health action. Critically, we need to lower the perceived effort involved, let them know their plan is there to help them complete it and try to drive home the message that cancer treatment is more effective with early detection.

Supporting barrier identification with relevant responses and additional calls to action will continue to reinforce healthy behaviors throughout the member journey, while reinforcing self-efficacy.

Challenge 3: Improving Health Literacy to Close Gaps

​​Health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health related decisions and actions for themselves and others. When low health literacy is not addressed, it’s a problem.

So how do we create more equitable solutions?

Our team of instructional writers and designers produce high-quality content designed to build health literacy at scale. Our breast cancer streaming content in particular makes use of visuals and language that makes members feel represented in the story. So different pieces of the stories will actually change to be more reflective of the population we’re speaking to, depending on the audience and the data we receive on race and ethnicity.

Our Behavioral Science team also crafts dialogues by pulling research that studies population demographics, belief systems, health attitudes, and more. Leveraging this data allows our communication to resonate with your unique population, build health literacy and inspire behavior change through personalization.

Challenge 4: Addressing Health Inequities to Overcome Barriers

Unaddressed health disparities are going to cost almost $1 trillion by 2024. Ignoring health inequities means more people are calling out sick and means more money lost, not to mention the loss in economic productivity.

By leveraging digital strategies for member engagement, however, and focusing on key factors such as social determinants of health (SDoH), cultural competency, accessibility, and health literacy, it’s possible to tackle these challenges meaningfully and respectfully.

mPulse’s breast cancer screening program takes this all into account and tailors the content to fit the needs of each individual member. Thoughtfully incorporating streaming content at key moments serves to build trust, overcomes barriers, and educates members, while portraying characters of different races depending on member data to ensure the content resonates and feels personalized to each member.

Creating Healthier Populations, One Member at a Time

While breast cancer disproportionately affects low income, racial, and ethnic minorities populations it is possible to reduce cancer-related health disparities, with a few simple enhancements to your existing strategies.

From framing choices using social proof, to ensuring your member populations are represented in your messages, and taking the time to listen to their challenges, you can overcome physical, psychological, social, or cultural barriers, provide solutions and ultimately improve your breast cancer screenings in underserved populations.

Many of these suggestions are simple content improvements that can be added to an existing system, evaluated and adjusted with little cost but by crafting personalized member journeys, we can help build relationships that uncover barriers and facilitate healthier behavior change at scale.

To learn more about mPulse Mobile’s solutions and programs, contact us.

*Example dialogues created for the purpose of this blog.

Improving Health Outcomes// Creating Healthier Populations, One Member at a Time

Digitizing Equity: Transforming Medicaid with Technology and Empathy

Posted on by SriVani Ganti

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

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

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

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

Why Medicaid has Vast Health Disparities

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

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

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

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

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

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

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

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

3 Ways to Reduce Health Barriers

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

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

Focus on establishing trust.

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

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

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

Meet people where they are. 

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

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

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

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

Build for scalability. 

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

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

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

The Imperative for Digital Innovation

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

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

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

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

How to Overcome Flu Vaccination Inequities This Flu Season

Posted on by Andrea Amelse

The stark reality of flu vaccines is that they save millions from illness and death, yet there remains a significant inequality in vaccine distribution, particularly affecting certain demographics. During the 2022-23 flu season, while 173.37 million Americans were vaccinated, saving nearly $2.4 billion in healthcare costs, a concerning 46% of eligible Americans remained unvaccinated. 

Solving vaccine inequity requires a deeper understanding of the social determinants of health (SDoH), such as age, race, and income, which play a pivotal role in these disparities. Notably, vaccination rates are considerably lower among Black, Hispanic, and American Indian/Alaskan Native adults, with hospitalization rates significantly higher among Black adults. Furthermore, adults with lower incomes and those in the 18-49 age group are less likely to receive the flu vaccine.

Identifying and addressing the root causes of these inequities is crucial for improving vaccination rates and ensuring equitable health outcomes for all in the upcoming 2023-24 flu season.

Understanding why these inequities exist is essential when designing programs to help overcome them.

Overcoming inequality in vaccine distribution through inclusive flu outreach

Addressing vaccine inequity requires tailored strategies that specifically target the underlying causes of these disparities. The CDC highlights a lack of accessibility, misinformation, and widespread distrust in the medical system as primary reasons for flu vaccine inequities. Crafting programs that focus on overcoming these barriers is crucial to enhancing flu vaccination rates and bridging the gap in inequality in vaccine distribution.

By implementing such targeted approaches, we can work towards ensuring equitable healthcare access for all member populations.

How to address and solve vaccine inequity through enhanced accessibility

Overcoming vaccine inequity necessitates addressing accessibility challenges that disproportionately affect disadvantaged groups. Many individuals face barriers such as unreliable transportation, disabilities, limited internet access, inflexible work schedules, and language or translation issues, making vaccination access difficult. These systemic issues often fail to accommodate all members’ diverse needs and preferences, creating an unequal landscape in vaccine distribution.

Fortunately, health plans have a significant opportunity to address these challenges. By implementing programs focusing on accessibility, they can identify individual barriers and provide customized resources to facilitate access. This requires an in-depth understanding of the target audience’s specific needs.

At mPulse, we utilize internal and external data to gain comprehensive insights into member needs, allowing health plans to create highly relevant digital touchpoints. Health plans can effectively identify and address individual barriers by engaging with members through their preferred communication channels, such as SMS, email, or IVR. The right message, delivered through the right channel, in the appropriate language, and accompanied by suitable resources, is key to meeting members where they are and improving flu vaccination rates.

Learn more about how to solve vaccine inequity and enhance vaccination rates by watching our on-demand webinar, “Double Flu Vaccination Rates for Your Health Population.”

Combating vaccine inequity with effective communication strategies

In the digital age, where misinformation and knowledge gaps about vaccines are prevalent, especially post-pandemic, it’s crucial to tackle vaccine inequity by providing trustworthy and pertinent vaccine information. Misconceptions about vaccinations, particularly the flu vaccine, have increased, underscoring the need for reliable information sources.

At mPulse, we aim to solve vaccine inequity by adapting the engaging formats of popular social media platforms. Our approach involves creating short-form content that is informative, educational, entertaining, and easy to consume. We focus on making content frictionless and engaging while ensuring it’s accessible to a broader audience. This includes featuring relatable characters representing diverse populations and offering multilingual options, which are vital to resonating with broader member groups and building credibility.

By sharing health content through each member’s preferred communication channels, we ensure they efficiently receive vital vaccine information. This method is particularly effective in addressing misinformation and bridging knowledge gaps, thereby playing a significant role in how to solve vaccine inequity. To see an example of how we bring this to life, view another fotonovela included in the mPulse Mobile Flu Vaccination Solution.

Building Trust to Address Vaccine Inequity

Addressing distrust in the medical system, often rooted in a history of structural racism and discrimination, is crucial in solving vaccine inequity. While health plans represent only one component of this complex issue, establishing trust with their members is vital. Utilizing digital trends for inspiration can significantly aid health plans in scaling their efforts effectively.

Creating multiple positive and meaningful touchpoints over time is key to developing and maintaining strong member relationships. At mPulse, we collaborate with health plans to provide empathetic messaging that conveys relevant and accessible information in each member’s preferred language and through the most appropriate channel. This approach helps ensure members feel supported and can rely on their health plan for essential care and resources, fostering greater trust and empowerment.

Simply notifying members about their due flu vaccines can be perceived as intrusive. Instead, our approach incorporates sensitive, culturally relevant messaging that leverages behavioral science techniques, cinematic educational content, and tailored resources. This strategy demonstrates an understanding of the member’s unique needs and genuine concern for their health.

When members feel that their health plan values and understands them, they are more likely to trust the plan and engage in healthier behaviors, thereby contributing to solving vaccine inequity.

Leveraging technology to overcome health disparities and boost flu vaccination rates

Technology is imperative in helping overcome health disparities and barriers to flu vaccinations. By leveraging innovative digital trends designed to serve vulnerable populations, health plans can begin broadening accessibility, educating and empowering members, and building trust at scale to improve vaccination rates and inspire healthier outcomes for the people they serve.

mPulse Mobile designs solutions that identify and overcome barriers to action. Our behavior change model incorporates health equity, behavioral science, and instructional strategy to deliver best-in-class outcomes.

Contact us to learn more about how our flu vaccination solution can help overcome vaccine hesitancy for your members.

Health Equity, Part 1: How Can Digital Engagement and Conversational AI Promote Health Equity?

Posted on by Smita Bhattacharya

When COVID-19 overwhelmed our nation’s healthcare system, a stark reality emerged: health inequity. As people of color experienced a disproportionately high burden of COVID-19 cases and deaths, highlighting a gap in our system, the topic of health equity surfaced across public health agencies, policy makers, healthcare systems and providers, and employers alike, and the possibility of digital health solutions bridging these gaps and make quality healthcare more accessible came to the forefront. 

To promote health equity, it is vital to begin with a universal definition. The Centers for Disease Control and Prevention defines health equity as “the state in which everyone has a fair and just opportunity to attain the highest level of health.” Achieving this aspiration requires uplifting communities that have been minoritized and excluded and promoting affordability and accessibility to quality healthcare and other social services. First, let’s start by looking at equity and how it is different from equality.

Equality vs. Equity: The Road is Long 

While these terms may sound similar, equality and equity are not synonymous! Creating equitable solutions over equal solutions has the profound impact to uplift marginalized populations. 

Imagine that you must go five miles down the road. In an equal society, everyone who needed to travel this distance would be given the same bicycle. What determines who makes it down the road and who makes it quickest?

  • Personal conditions, such as their biking skills, what they are carrying, and whether they have the ability to pedal with their feet.
  • Circumstances of the environment such as whether the road is bumpy, inclined, or flat.

In an equal society, while everyone may have a bicycle, they are not truly equipped with the resources they need to succeed

In contrast, in an equitable society, everyone is set up to reach the end of the five miles at the same exact time, regardless of conditions. In a scenario of equity, each person has a bicycle that has been developed for their unique needs, such as a motorized vehicle for wheelchair users or a bicycle with more traction to endure the bumpy roads.

Visualizing Health Equity: One Size Does Not Fit All Infographic
Robert Wood Johnson Foundation, 2022

When it comes to healthcare, the same logic follows: a uniform approach will not work across populations. True health equity will require providing each member with the tools they need to overcome barriers and ultimately achieve their highest level of health. There are a few key digital engagement strategies that can be especially effective in addressing health inequities among member populations. 

Streaming Health Content

diabetes eye exam streaming health content in SpanishHealth illiteracy is one of the biggest barriers to equitable healthcare, and in response, streaming health content is an effective method for health literacy promotion. It borrows from the best of digital content strategy, behavioral science, and instructional design to create powerful learning experiences to address health literacy barriers in a consumer-friendly format and to encourage hard to reach members to take control of their health outcomes. Instead of telling people what they need to do, we are educating them on why it’s important, which serves to develop intrinsic motivation to get care and take healthy actions. Everyone has the knowledge needed and everyone can make health decisions with all the information available.

Interested in learning more about our approach to health literacy? Register for Activate2023: Designing Customer Journeys for Health Equity »

Conversational AI and Natural Language Understanding

With the use of artificial intelligence, conversations can be programmed to understand responses in any language and intelligently respond in that same language. It can also allow plans to respond automatically to barriers created by inequitable circumstances, such as transportation, cost, or health literacy issues. Then it can provide real time solutions to move the member forward toward the desired action. This serves to create more equitable health experiences for those members who aren’t starting on a level playing field.

Social Determinants of Health (SDoH) 

Research shows SDoH have a greater impact on health and well-being than medical care. This is because where a person lives, learns, works, and plays can affect their health in many ways. There are many non-medical factors that affect health and wellness:

  • Economic Stability: employment, income, expenses, debt, medical bills, and support 
  • Physical Environment: housing, transportation, safety, parks, playgrounds, walkability Education: literacy, language, vocational training, pre-schools, higher education 
  • Food: hunger, access to healthy, affordable options 
  • Community: social support systems, community engagement, discrimination, stress 
  • Healthcare System: health coverage, provider access, provider cultural competency, quality of care

These factors commonly overlap to affect health outcomes (health status, mortality, and morbidity).

Technology can bridge the gap created by SDoH. At mPulse mobile, we believe SDoH can be addressed directly using disaggregated data, which ensures representation of marginalized populations. We created a proprietary SDoH Index which leverages a weighting system to maximize its predictive ability. Factors such as food insecurity, transportation access, neighborhood, and environment are taken into account for each individual member to provide a more tailored, relevant, and empathetic conversation.

Bridging Gaps: Our Commitment to Equitable Health

Digital interventions can also be a powerful tool to bring communities together during a crisis (such as quick response to the COVID-19 pandemic), spread education, send interventions in multiple languages, and find different ways to get people the resources they need.

The digital platform can be used to spread health education in engaging ways (e.g. videos, courses), utilizes behavior science to break down fears and misinformation, and uses a multicultural lens to provide multiple languages and ensure cultural sensitivity. Together, this technology can bridge inequities early on, and in turn, can help mitigate preventable, deadly health consequences. 

Ultimately, we aim to close gaps in care and eliminate preventable health disparities by integrating health equity competencies across all of our work, and allow all people a fair and just opportunity for the highest level of health.

To learn more about the impact digital engagement can have on health equity, read part 2 of this blog series next.

Activating Healthcare Consumer Behavior Change: Make it Personal

Posted on by Gabe Kratzer

Key takeaways from our interview with Solome Tibebu

In the last decade, behavioral health has grown from an ancillary service offering to a critical component of health services and care delivery. According to an OPEN MINDS Market Intelligence Report, spending on mental health services totaled $225 billion in 2019, up 52% from 2009. Companies like Talkspace and BetterHelp, founded in 2012 and 2013, recognized this spike and made it their mission to increase the availability and accessibility of mental health services to those struggling to access and navigate care. Behavioral health has continued to evolve, and it is incumbent on all healthcare organizations to adopt new methods of providing care to vulnerable populations. Learning from innovative companies and forward-thinking leaders is vital to building an effective care strategy for the one in five U.S. adults living with a mental illness.  

mPulse sat down with Solome Tibebu, a pioneer in behavioral health technology and innovation, whose passion stems from the care gaps that have existed and still remain in mental healthcare. At the early age of 16 years old, Tibebu started a non-profit online resource, Anxiety in Teens, to offer education and support for teens and young adults who were struggling with anxiety and depression. After ten years, she began working in startups and consulting, continuing to advocate for the role of technology in advancing behavioral healthcare. 

This year in June, Tibebu will be putting on her third annual Going Digital: Behavioral Health Tech summit, a conference where health plans, providers, health systems, employers, investors and startups convene to discuss the evolving landscape of behavioral health. The virtual (for now) event is a great opportunity to share best practices for implementing digital resources and innovative technologies to improve access to mental health services. We are proud to be a sponsor for the second consecutive year, and we look forward to contributing to discussions around how healthcare organizations can implement solutions to tackle barriers and make mental healthcare more accessible for all.

Improving Access through Technology Innovation

COVID-19 created an array of challenges to advancing mental health access, but it also sparked a digital transformation that brought innovation to the center stage. With more consumers staying home, “tech has exploded as a response to the pandemic,” Tibebu prefaces. Technology plays an important role in understanding and addressing the social dynamics that affect each person living with mental illness. Some of the challenges that plague mental health accessibility require more than simple one-way consumer interactions, however. 

Talking about health plans, Tibebu emphasizes, “stigma is a huge barrier even after they’ve procured some kind of solution, so they need to have a strategy around how they’re gonna address stigma, and engagement of the member.” Stigma can produce feelings of worthlessness and lead to social isolation while social determinants of health (SDOH) like transportation access or income level can prevent consumers from seeking care. To tackle barriers like SDOH and stigma, it is necessary to utilize technology to understand consumer needs and preferences. 

Conversational AI and Natural Language Understanding power the capability to deploy behavioral science strategies at scale when communicating with vulnerable populations. For instance, incorporating a strategy like Affect ensures that messaging is based in empathy, increasing motivation to engage with sensitive healthcare outreach. Social Proof is an effective strategy that helps assure consumers that they are not alone and can help reduce social isolation caused by mental health stigma.  

Applying behavioral science and identifying SDOH in conversational outreach enables a deeper understanding of consumers. Once individual preferences are captured, healthcare organizations can efficiently tailor relevant content to each consumer and activate meaningful behavior change. 

Delivering Tailored Content at Scale

Incorporating clinically validated behavior change techniques helps with understanding the needs and preferences of consumers. Tibebu asks, “now all of these payers have implemented their telehealth solution but it’s the next level – how do we get something more customized, personalized to their respective populations?”  

Plans and providers can drive deeper engagement and self-efficacy by adopting tailored engagement strategies that lift utilization of the programs they’ve invested in. Conversational AI enables the orchestration of programs and resource delivery across preferred consumer channels. Natural Language Understanding helps capture important data from consumer responses to help route them to the appropriate digital resource. 

A one-size-fits-all care model fails to meet the needs of each consumer, while customization empowers healthcare organizations to intervene with meaningful content that drives behavior change. “How can you identify the consumer’s need and triage them to the right end solution?” Tibebu reiterates. Certain individuals who prefer a visual learning experience may benefit from a course like Living with Anxiety & Depression, while those who respond better to audio can be directed to a podcast like Mental Health Matters. 

Providing on-demand, curated content can motivate consumers to take control of their health and execute healthier behaviors, leading to improved outcomes and a better consumer experience.

Impacting Beyond Mental Health

We asked Tibebu why personalization in mental healthcare should be important to payers specifically. She responded, “because mental health is at the vortex of all health…for all of these other conditions, expensive conditions, that are impacted as a result of poor mental health.” Consumers who are negatively affected by mental health are more likely to develop chronic conditions, which piles up costs for both the consumer and the organization providing services. This creates an opportunity for plans and providers to adopt innovative solutions that promote well-being through tailored engagement. 

MagellanRx Management serves a complex population and recognized the need to incorporate well-being content for their members who were experiencing loneliness and anxiety from COVID-19. They partnered with mPulse to deploy digital fotonovelas, which use culturally sensitive stories in a comic-strip format to improve health education and activate diverse populations. The program drove impressive outcomes, yielding over a 38% engagement rate and a 90% member satisfaction score. 

We questioned how organizations outside of payers and providers can “step up” to make mental healthcare more accessible. Walmart Wellness is a nationally recognized brand whose goal is to “help customers raise their hand and more easily access their hubs,” Tibebu clarifies. Walmart partnered with mPulse to implement SMS solutions along with streaming health education to drive their customers to the right well-being resources. The program included custom learning plans across several wellness topics and produced significant improvements in customer engagement. 

After chatting with Tibebu, we are reassured that mental healthcare should be the focal point of an effective engagement strategy. Innovative companies can promote mental well-being and health literacy by leveraging technology that personalizes outreach. Educating consumers with tailored content through timely and convenient engagement builds self-efficacy and lasting behavior change.

Learn more about Conversational AI and streaming health education here. 

 

Leveraging Technology to Meaningfully Impact the Member Journey: Key Takeaways

Posted on by Nora Cristobal

On March 23rd, we had the opportunity to sit down with one of our Medicaid partners, Peach State Health, at Whole Person Care for Medicare, Medicaid and Duals. In this discussion, we talked through the member journey and the impact tech and data can have on the holistic approach to population health. Here are our key takeaways: 

Establishing Trust In the Member Journey

Sheakeena Lamb opened the session with Peach State Health Plan’s focus group findings that spurred the need to engage their members in a meaningful way that made sense to each unique member and their preferred channel of communication. In order to overcome health barriers, you first must be able to reach the member. From there, health plans can outreach effectively with the appropriate resources needed to inspire healthy behavior change. Connecting with the member in a way that saves both the organization, and the member time and resources helps develop a trusting relationship. Having meaningful connections is what will encourage the member to see their health plan as more than just a payer and more like a trusted partner — a valuable source to discover key information they need to take control of their health management and live a healthier life throughout their health journey.

Challenge the Unknown and learn from Past Use Cases:

Peach State learned very early on they needed to refocus their outreach efforts to meet their members in the channels they said worked best for them. For Peach State, that was text messaging over mailers and IVR. Their member population simply did not have the time to pick up the phone during workdays and did not trust unknown callers.  And as many organizations know, mailers can be costly and time consuming. After deploying SMS well-child reminders, Peach State saw 170k unique members engage with their messages. Outreach through a trusted channel like text can also overcome the unknown caller barrier – we are all hesitent to answer when receiving a call from an unknown number. If the member is not aware their health plan is calling because they do not trust “unknown callers,” then the opportunity to engage is completely missed.

Member preferences matter:

Understanding the member journey is one step of a successful engagement solution. Understanding how and when to engage members, and then using in-channel communication to reach them in the language they prefer, at the time that is right for them, is what elevates a good strategy to a successful ROI engagement solution. mPulse has seen this time and time again when deploying bi-directional communication solutions for our clients. Engagement increases when members feel like their provider or plan are able to engage with a natural language understanding. And when the organization can  scale that communication with an automated solution, it becomes cost saving too. It enables plans to get  closer to the triple-aim and deploy efficiently at scale, reduce resources and increase trust between the member-plan relationship.

Data’s impact on future member engagement strategies:

Valuable data like member preferences, SDoH information, and experiental data can and should, affect a plan’s member outreach strategy. By employing a deep understanding of the member population, you are able to build better lines of effective communication and help your members navigate their individual health journeys. Working with the correct reporting tools and solution partner, can uncover communication barriers the plan may not have known posed an immediate issue. “If we can figure out where the barriers are for our members then we can address them early instead of falling behind,” said Sheakeena Lamb. With data on measure eligibilities and having visibility of a large part of a member population, plans can catch members that could develop care gaps, and use this data to drive quality improvement strategies.

Going Beyond traditional touchpoints:

After the data is collected, and the reports have been pulled, comes the need to reimagine an outreach strategy that works for each individual member. Using the right tools to send text messages in members preferred language, or at their preferred time impacts the level of engagement and provides a meaningful facet to the holistic health journey. And the right tools can store that information for later use when tailoring downstream conversations. Not only being able to respond with the appropriate information and connect members to plan or provider resources but to be able to remember important preferences can establish health plans as more than just a payer, more than just a resource, but as a invaulable healthcare partner.

Digital Fotonovelas for Flu Engagement: A New Approach for a Unique Year

Posted on by Nora Cristobal

The 2020-21 flu season poses new challenges in addressing COVID-19 alongside traditional challenges driving flu vaccination. Flu season for most adults typically begins around November and plans push reminders to have members schedule their flu vaccination. However, with COVID-19 as an ongoing concern, healthcare experts are suggesting getting the flu shot as early as September 2020, to at least quell the brunt of one virus while trying to manage the other. In addition, members who take precautionary measures early-on will alleviate pressure on hospital systems that have been carrying the weight of COVID-19.

Organizations must enhance their flu engagement strategies to address new concerns and barriers to vaccination this year and educate members quickly on new topics. With the right tools, health plans can take a multi-angled approach to member outreach that will help address and overcome several barriers at once. mPulse has been working with our customers to roll out new content and technology to help handle the challenges of this flu season—read about our 2020-2021 Flu Engagement Solution here. The solution incorporates digital fotonovelas. These are typically a 6-frame comic-style story portrayed with lighthearted graphics, that deliver important content to across demographic segments at scale. The story-style graphic can deliver vital educational flu resources directly to members’ mobile devices, through SMS and link-to-web, using members’ preferred language. This tool has been used in key healthcare use cases in the past, (e.g., value of HPV vaccines and diabetes self-management) and has proven to be a complementary route of communication when utilized with a text messaging approach to member outreach.

mPulse Mobile first deployed fotonovelas as a bi-lingual visual tool during the onset of COVID-19 as a part of the COVID-19 Rapid Rollout Toolkit solutions. The goal was to adapt a traditional and effective style of print media into digital format delivered through SMS, to help overcome health literacy barriers during a time when the spread of healthcare information was urgent and needed to be disseminated quickly at scale. The 6-frame graphic style of communication, paired with a series of check-ins via SMS, helped our plan and provider partners build health literacy around social distancing, basic hand hygiene, and keeps multi-lingual populations informed with accessible and coordinated outreach via mobile channels. The goal of this capability was to successfully assess members’ health risk and respond through text dialogue and educational fotonovelas appropriate for each member’s situation, in their preferred language. We’ve seen that when matched with strategic member outreach, fotonovelas can be a tool that offers an access point to fill in gaps in knowledge that drive healthy behavioral change even during a time when many are hesitant to seek out healthcare in person.

Fotonovelas also present an opportunity to address individual-level barriers and inaccurate health beliefs related to COVID-19, and flu vaccines in general. They can help address education gaps surrounding available flu vaccination resources during the pandemic while promoting health literacy. Paired with text message dialogues, plans and providers are able to uncover new barriers that may have prevented members to seek flu vaccinations early and match members to follow up content, including fotonovelas, that addresses those specific challenges.

During the 2019-2020 flu season, mPulse powered over 15,000,000 flu vaccination touchpoints across Medicaid, Medicare and commercial plan populations. The solution achieved a 2x increase in recorded flu vaccination rates in a large Medicaid population*. This year, as the flu season approaches with the added layer of COVID-19, plans and providers will need to more agile and responsive than years before.

For that reason, fotonovelas have become one of the core capabilities in our Flu Vaccination Solution for 2020-21. Fotonovelas engage a range of core population groups, including key multicultural segments with configurable content and versioning that enables matching to specific personas and demographics that can be updated over time. They can be a touchpoint that alerts members of appointment reminders, vaccination site locations and educational services. But the most powerful aspect of this form of outreach is the ability to tailor content based on an understanding of members health beliefs, in members’ preferred language and through their preferred channel. By listening to member responses to automated text conversations and understanding what they need to hear in order to get vaccinated, health care organizations can gather insights and deliver tailored and engaging outreach at scale. Because the solution is available on SMS and Link-to-Web it has the ability to reach a wider population at scale, meeting members where they are, taking pressure off of the member to seek out information during the height of the pandemic and flu season.

In a year of “unprecedented situations” the 2020-21 flu season is yet another that will require healthcare to evolve its approach. The reach, engagement and rich content provided by our fotonovelas strategy is a natural fit for the unique challenges of this flu season. Healthcare organizations know they have to do more this year than a strategy of 1-way reminder outreach and reliance on employer, church, or school vaccination drives. By creating conversational touchpoints around flu vaccination and supporting members with differentiated and rich content, they can elevate their engagement strategy to support the populations they care for.

New Study Analyzes Impact of Social Determinants of Health and Conversational AI on Medicare Medication Refill Adherence

Posted on by mPulse Team

LOS ANGELES – December 2019 – mPulse Mobile, the leader in Conversational AI solutions for health activation, announces the results of a two year study that assessed the influence of social determinants of health (SDOH) on the prescription refill rates of Medicare (Part D) patients and the benefits of Conversational AI text messaging solutions. The study analyzes a large cross-sectional dataset with results from over 99,000 patients and over 270,000 refill reminders across a 2-year period.

Social determinants are linked to non-adherence. Challenges such as financial stress and limited transportation options can impact an individual’s ability to get the prescriptions they need. These influences are commonly not shared with physicians and care teams, so they can’t provide patients with help and additional support services. This study shows that patients with low SDOH impact are more likely to request a refill than those with high SDOH impact.

The study used an SDOH Index, developed by mPulse Mobile, which quantifies SDOH impacts at a census tract level as well as a predictive model that can identify patients least likely to engage with the text messaging solution. Automated text conversations in Spanish and English were initiated with patients to allow them to refill their prescriptions conveniently. Once members impacted by SDOH barriers engaged with the conversational text message, they refilled at equivalent rates to those with lower SDOH barriers.

“Understanding health needs and challenges on both the individual and community levels is crucial to understanding and appropriately addressing them,” said Chris Nicholson Co-Founder and CEO of mPulse Mobile. “Our Behavioral Data Science team identified the opportunity to model the impact of SDOH on refill adherence, and the results demonstrate how programs and services can be better targeted to deliver the greatest impact.”

The study measured refill-rates in partially adherent and nonadherent Kaiser Permanente member populations. The results confirmed previously published pilot results but addressed a much larger population and leveraged mPulse’s multicultural Conversational AI capabilities to deliver text messages to Spanish speakers.

“We continue to include more elements to address the cultural linguistic and SDOH-related impacts reported in this study, so that more patients can benefit from our solution” said the paper’s corresponding author, Rena Brar Prayaga, Director of Behavioral Data Science at mPulse Mobile.

For this program, Conversational AI was used to automate conversations in both English and Spanish that helped members review and confirm their prescriptions and asked members about barriers they were facing to direct them to appropriate support services. Over the study period, 307,484 responses were received from members, and over 92% of these messages were successfully understood and handled by Conversational AI. The ability for automation to manage replies from members significantly reduced the demand on pharmacy staff resources, enabling staff to focus on higher level tasks and more complex patient needs.

Authors of the study are Erwin Jeong and Harmony Noble from Kaiser Permanente Southern California, Rena Brar Prayaga, Andrew Paster and Ram Prayaga from mPulse Mobile, and Ridhika Agrawal and Benjamin Nguyen from mPulse Mobile and Grinnell College.