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Category: Solutions & Outcomes

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.

mPulse Mobile Achieves Strong YoY Revenue Growth in Q2 2023 Driven by Outcomes-Driven Engagement Solutions

Posted on by mPulse Team

LOS ANGELES–(BUSINESS WIRE)–mPulse Mobile, a leader in conversational AI and digital engagement solutions for the healthcare industry, today announced strong momentum in Q2 2023, with 159% new revenue growth over the prior year (Q2 2022) and over 80 million unique health consumers engaged through its SMS programs in Q2 2023. The company also announced the launch of its Emergency Department Diversion solution aimed at addressing overuse of the ED to reduce costs and help members access appropriate channels of care.

Value Based Care and Emergency Department Use

Value based care (VBC) strategies require a high level of member engagement, proactive outreach, and seamless coordination of care to scale across diverse populations and drive a successful business model. mPulse is supporting the needs of VBC organizations such as Accountable Care Organizations (ACOs) and managed services providers by deploying Conversational AI solutions that integrate streaming content to educate members and drive better health behaviors.

Reducing inappropriate or overuse of the Emergency Department (ED) offers a key opportunity to improve the performance of value based care plans. Today, mPulse announced the launch of its Emergency Department Diversion solution, which targets large populations and “high utilizers” to adopt more efficient and appropriate care channels. The solution is an optimized version of in-market programs, which have already reduced improper Emergency Department use by almost 70% and directed 60% of patients to visit their primary care provider (PCP) instead of the ED.

Medicaid Continuous Enrollment

As individual states manage the resumption of Medicaid re-enrollment, mPulse is supporting 24 health plans with omnichannel digital engagement that activates members to complete the redetermination process. Recently reported data shows procedural disenrollments account for 75% of beneficiaries losing coverage. This highlights the importance of providing support to individuals to help overcome barriers and connect them to appropriate resources. mPulse has leveraged its Redetermination Solution across SMS, IVR and email channels and launched over 110 tailored Redetermination engagement programs to over 7 million Medicaid beneficiaries at risk of losing coverage. mPulse’s solution uses conversational AI to generate engagement rates in excess of 30% by automatically interpreting member’s responses, aligning with language preferences and integrating high-impact streaming content into the outreach. Historically, mPulse’s redetermination outreach solutions have driven 42% increases in redetermination rates and a 93% completion rate after engaging with the program.

mPulse Recognized by Gartner® in Multiple Categories

mPulse was recognized by Gartner in its July 2023 report, “Hype Cycle™ for U.S. Healthcare Payers, 2023” as a Sample Vendor in two categories identified as having transformational benefit rating: Consumer-Centric Health Products and Community Resource Network Management (CRNM). Both categories are forecast to have a transformational impact and mainstream market adoption within a two- to five-year time horizon.

In addition, mPulse was mentioned in a new July 2023 Hype Cycle report, “Hype Cycle for Consumer Engagement and Experience in Healthcare and Life Sciences, 2023.” We believe its mention in this report demonstrates mPulse’s growing presence in the life sciences market segment, as its engagement solution increases in adoption to help support clinical trial engagement and participant retention over time.

“Through our extensive partnerships across the healthcare ecosystem, we are closely attuned to the needs of leading healthcare organizations, which continue to seek innovative technologies to support core business strategies,” said Bob Farrell, CEO of mPulse Mobile. “The innovative health plans we work with recognize the need for technology-driven member engagement that go beyond what traditional outreach can offer, and our flexible conversational AI and digital engagement solutions move the needle for their value based care goals, even among the hardest to reach populations. We feel both our customers’ results and our recognition by Gartner in key technology categories illustrate mPulse’s ability to deliver lasting improvements in the consumer health experience and member outcomes.”

To provide a forum to discuss trends in digital engagement across the healthcare industry, mPulse Mobile is hosting the Activate2023 conference September 27-28, 2023 and today announces new speakers, including Dr. Reed Tuckson, a physician and public health research advocate, and Craig Kennedy, President & CEO of Medicaid Health Plans of America (MHPA). The full agenda and registration page can be found at https://go.mpulsemobile.com/activate2023.

Improving Maternal Health Outcomes with Digital Trends

Posted on by Andrea Amelse

The United States has the highest maternal mortality rate when compared to 10 other developed nations. Up to 60% of pregnancy-related deaths and adverse health outcomes in the U.S. can be prevented by broadening accessibility, having higher quality of care, and improving education and available resources. Proper preventive and continuity of both prenatal and postpartum care is imperative, and health organizations play a foundational role in improving maternal health outcomes for our nation.

Technology’s Role

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

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

A lot more than you may think. mPulse Mobile has harnessed innovative technology and digital trends and applied them to the healthcare landscape to educate and empower health consumers to take action. By borrowing inspiration from the world’s most innovative digital trends, we continually deliver best-in-class health outcomes. Technology’s leading trends, our in-house learning and design experts, and access to rich data and population insights enable us to create highly relevant and engaging digital experiences. Our solution to prenatal and postpartum care leverages this expertise and tackles the challenges associated with our nation’s poor maternal health outcomes, opening doors to accessibility, catering to care preferences, and building knowledge.

Broadening Access

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

The ability to send pregnant members a list of ObGyns and clinics closest to where they live, or a phone number to call and schedule removes barriers and makes it easier to set up an appointment in a manner of minutes. If the member replies they don’t have access to reliable transportation, for example, NLU can recognize that barrier, and automatically reply with resources available that provide low or no-cost transportation options.

Care Preferences and Health Equity

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

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

Building Knowledge

Information sharing and access to news today is more broadly available thanks to smart devices and the internet. With Americans spending an average of 1,300 hours each year on social networking platforms such as Facebook, Instagram and TikTok, it’s critical to derive inspiration from these platforms to maximize engagement and remove friction. More than 50% of expectant Americans download and use pregnancy-related apps for educational resources and pregnancy-related updates. Health organizations are perfectly positioned to harness these trends and provide a frictionless experience to expectant consumers to not only engage, but to deliver the right education and resources, close care gaps, and gather rich population insights.

mPulse Mobile’s prenatal and postpartum solution uses a combination of expert-led videos from Dr. Christine Noa Sterling, board-certified ObGyn, interactive modules, and short stories and animations to educate, and empower members around key milestones related to theirs and their baby’s health. Content is sent via SMS at key moments based on each consumer’s due date and encourages them to schedule routine appointments and make healthier choices. Our in-house team of behavioral scientists and instructional strategists leverage learning theory and high-quality cinematography and animation to produce content designed to drive action. See for yourself.

mPulse’s Prenatal and Postpartum Solution

mPulse Mobile’s pregnancy solution is a 12+ month interactive SMS program designed to improve quality performance and deliver better health outcomes. The solution specifically targets multiple HEDIS® measures and is proven to engage and deliver outcomes such as a 2X engagement rate with maternity care management services, a 7.1pp increase in the prenatal and postpartum care measure (PPC) owned by NCQA, and 61% engagement across 400,000 Medicaid members. By incorporating our behavior change methodology throughout all conversations and streaming content, our comprehensive approach broadens access, caters to individual preferences, and educates to improve health outcomes at scale.

How to Overcome Flu Vaccination Inequities This Flu Season

Posted on by Andrea Amelse

Flu vaccines prevent nearly 7.5 million illnesses, 3.7 million doctor visits, 105,000 hospitalizations, and 6,300 deaths annually. For the 2022-23 flu season, 173.37 million Americans received the flu vaccine, with an average savings of $13.66 per vaccine, meaning nearly $2.4 billion was saved from flu vaccinations last season. Conversely, 46% of eligible Americans weren’t vaccinated. Understanding who isn’t getting their flu vaccine and why are fundamental to improve vaccination rates for the 2023-24 season.

When taking a closer look at the 46% of Americans not getting vaccinated, Social Determinants of Health (SDoH) factors such as age, race, and income become evident. Less than 43% of Black, Hispanic, and American Indian/ Alaskan Native adults were vaccinated during the 2021-22 flu season. Flu hospitalization rates were nearly 80% higher among Black adults than White adults from 2009-2022. Adults with incomes less than $35,000 annually had 21% decreased odds of receiving the flu vaccine. Additionally, people aged 18-49 years are nearly 37% less likely to get vaccinated than those aged 65 and older. Understanding why these inequities exist is crucial when designing programs to help overcome them.

Designing Flu Outreach for All

According to a report from the CDC, some of the leading reasons for flu vaccine inequities include lack of accessibility, misinformation, and distrust of the medical system as a whole. Program design that directly targets overcoming these barriers is essential in improving vaccination rates across member populations.  

Lack of Accessibility 

The structures and solutions put in place today primarily serve those who have the upper hand. Many members face accessibility barriers including lack of reliable transportation, disabilities that inhibit access, lack of internet, inflexible work schedules, and language and translation barriers, to name a few. Through no fault of their own, the ability for members facing these challenges to receive vaccinations is nearly impossible due to systems that haven’t been designed in consideration of diverse needs and preferences.

The good news is that health plans can play a huge role in overcoming these barriers. By deploying programs designed with accessibility at the forefront, plans can identify individual barriers, and deliver tailored resources to create access. This begins with a solid understanding of the target audience.

mPulse leverages a combination of both internal and external data sets, which enables a holistic view of member insights and gives plans the ability to craft the most relevant digital touchpoints. By connecting with members through their preferred communication channel, whether it be SMS, email, or IVR, plans can quickly and efficiently identify and overcome individual barriers. With the right message, sent through the right channel, in the right language, with the right resource, plans can begin meeting members where they are to improve flu vaccination rates.

Watch our on-demand webinar to Double Flu Vaccination Rates for Your Health Population »

Misinformation and Knowledge Gaps

While the internet and social networking platforms are a great way to discover and share news and information, they aren’t always reliable. Post-pandemic, perceptions about vaccinations and flu have garnered even more skepticism. It’s more important now than ever to provide members with reliable and relevant information about vaccines.  

By borrowing inspiration from preferred methods of content consumption, i.e. popular social platforms, mPulse educates members in a frictionless, relatable format. Short-form content that is both entertaining and educational is a great way to provide relevant information. In addition to ensuring the content is frictionless and engaging, we also ensure its accessible. Relatable characters that portray diverse populations, and multilingual capabilities are essential to resonating with broader member groups and gaining credibility. Content is sent through each member’s preferred communication channel, making it easy to receive the information they need.

Like the fotonovelas? View another one included in the mPulse Mobile Flu Vaccination Solution here »

Distrust

Lack of representation in the medical field, in addition to a longstanding history of structural racism and discrimination contribute to the lack of trust many members have toward the medical system. While health plans are a small piece of this larger puzzle, gaining the trust of the members they serve is imperative. Leaning on digital trends for inspiration and support in building trust can allow plans to scale effectively.  

Several positive and meaningful touchpoints over time helps create and sustain member relationships. mPulse works with health plans to deliver empathic messaging that includes relevant and accessible information in each member’s preferred language, through the right channel. When members feel they can rely on their health plan for the care and resources they need most, they’re more likely to trust their plan and feel empowered to act. Simply informing a member they are due for a flu vaccine may come across as abrasive. Our sensitive, culturally relevant messaging incorporates behavioral science techniques, cinematic educational content, and tailored resources, letting the member know their plan understands their needs, and cares about their health. When members feel valued, they’re more likely to trust their plan, and adopt healthier behaviors.

In Conclusion 

Technology has an imperative role 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 populations 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. To learn more about how our flu vaccination solution can help overcome vaccine hesitancy for your members, contact us.

How Combining Conversational AI and Visual Stories Can Increase Colorectal Cancer Screenings

Posted on by mPulse Team

In today’s world of information overload, capturing health plan members’ attention and encouraging them to take preventive health measures isn’t easy. It’s even more challenging when members are experiencing health disparities due to race, ethnicity, socioeconomic factors, and other social determinants of health. To address this challenge, mPulse Mobile created an innovative way to encourage members to get screened for colorectal cancer.

Specifically, mPulse’s approach combines text messages powered by conversational AI with visual storytelling to address misconceptions, raise awareness, model healthy behaviors, add an element of humor, and build overall health literacy.

To evaluate the clinical value of this approach, mPulse and The AltaMed Institute for Health Equity partnered to research the impact of text messages and fotonovelas on encouraging colorectal cancer screenings with socially vulnerable groups. They conducted a study to determine whether members were more likely to get screened after receiving

  • A series of bidirectional texts that tailor responses to address individual screening barriers, and
  • Fotonovelas or illustrated comic strips that tell a story explaining the importance of early detection and encouraging screenings.

An important motivation was to use culturally relevant messaging to engage these groups and to measure whether it could yield improvements in outcomes equitably across populations.

Evaluators at the Center for Community Health and Evaluation (CCHE), part of the Kaiser Permanente Washington Health Research Institute, independently evaluated the intervention. The results, recently published in JMIR Cancer, a peer-reviewed journal focusing on innovation and technology in cancer care and research, were very positive: nearly 40 percent of patients who received texts and fotonovelas responded, and they had significantly higher screening rates than those who did not receive the texts and fotonovelas.

The program was developed by mPulse and combined interactive text messages and fotonovelas to educate and activate patients throughout the four-week outreach. When patients shared their reasons for not completing the screening, the conversational AI platform provided relevant automated responses to address these barriers and to influence their health beliefs and behavior.

A Closer Look at Colorectal Cancer

Colorectal cancer is the second-leading cause of cancer death in the US, accounting for an estimated 151,030 new cases and 52,580 deaths in 2022. With appropriate screening, however, it is mostly preventable and can be treated successfully when localized and diagnosed early. Indeed, the five-year relative survival rate for localized colorectal cancer is more than 90%.  

Several screening tests can be used to find polyps or colorectal cancer, including an at-home stool test known as the fecal immunochemical test (FIT) which uses antibodies to detect blood in the stool. Upon completing the test, the patient mails it back to the health plan.

Barriers to Screening

A key step in improving screening rates is understanding why patients don’t get screened.

Studies have identified several potential barriers, including feeling fine and not understanding the need for the test, being busy or forgetful, expressing fear about what the test may indicate, the potential risk of perforation, embarrassment about a fecal collection procedure, concerns about mailing fecal matter, mistrust of the healthcare system, and the cost of follow‐up colonoscopy. Limited health literacy is another stumbling block, particularly when combined with cultural health beliefs and linguistic barriers.

The barriers impacting different populations vary which contributes to differences in screening rates and cancer diagnoses. For example, researchers report that Hispanics have significantly lower rates of screening for colorectal cancer than non-Hispanic Whites, and are more likely to be diagnosed with advanced disease.

The Study

AltaMed, the largest federally qualified community health center (FQHC) in California, and one of the largest nonprofit FQHCs in the nation, serves approximately 300,000 patients across Southern California and routinely mails out FIT kits to patients due for colorectal screening.

As part of usual care, about 11,000 patients who were due for a screening received a text message with a link to an instructional video, a follow-up text reminder, and a call from a patient navigator within a month if they still hadn’t returned the FIT kit.

Three months after the kits were mailed, 5,241 patients, age 50-75 years, had not returned the FIT kit and they were randomized into two groups for the study: the intervention group which received additional outreach (texts and fotonovela over four weeks), and the control group (no additional outreach).

A majority of patients in the intervention group were Hispanic or Latin American. mPulse has developed an index to map social determinants of health (SDOH) impact levels (using several census variables) and over 75% of patients in the study were living in neighborhoods where SDOH might negatively impact health access and health equity, resulting in health disparities.

The texts and fotonovelas were designed and implemented by mPulse to educate, remind, and encourage patients to return their FIT kit. All text messages were in patients’ preferred language, either English or Spanish, and written at a sixth-grade reading level or lower. 

In the first week, the texts focused on building health literacy about colon cancer and screenings, and the purpose of the FIT kit. Week two texts sought to uncover barriers by asking why the patient hadn’t yet taken the test. The next week gathered feedback on the fotonovela and its impact on health beliefs and behaviors; and the last week was a final reminder to mail back the kit.

If patients replied to the texts, the conversational AI used natural language understanding (NLU) to “listen” for known barriers and other expected replies and provided automated responses to create logical conversation flows.

Conversational AI

Patients could text back in their own words, and their responses were handled using rules and conversational AI. This was also an opportunity to build health literacy and raise awareness about the need to get screened regularly. Here is a sample conversation:

Patient’s reply:

“I don’t know why I need the test; I feel fine and have no symptoms.”

Automated response:

“It turns out most people with colon cancer feel healthy and have no symptoms. And most people with colon cancer also have no family history of the disease. This is a quick and easy way to find out if there are any problems.”

Similarly, if a patient replied, “I’m worried about getting COVID-19 if I come into the clinic”, the system was listening for COVID anxiety and would respond immediately by reassuring the patient using conversational AI.

The automated response was: “You don’t need to come into the clinic right now. Just mail back the FIT colon health test kit that we sent you in the mail. If the results are abnormal, somebody from AltaMed will contact you. Don’t let your worries about coronavirus get in the way of completing the test. It’s quick and easy!”

Thus, patients received timely and relevant information as part of a meaningful back-and-forth dialogue in real time.

Fotonovelas

The fotonovelas were created to address barriers such as procrastination, lack of self-care, lack of time, embarrassment about the process, and fear of results. They were developed in Spanish and English, in collaboration with the AltaMed Institute for Health Equity, and there were separate versions for men and women.

To ensure that the fotonovelas were compelling, the storyline used characters who were 50–75-year-old Hispanic or Latino patients and who looked and talked like they could be the patient’s best friend or neighbor. And the fotonovelas reflected the central role of family in the Latino community by emphasizing that the characters were getting screened not just for their own health, but for the sake of their loved ones as well. All fotonovelas also contained a call to action for patients to use and return the kit. Sample frames are shown below for the English versions (there were 9 frames in each fotonovela). The second fotonovela can be viewed in full in the JMIR Cancer publication.

Want to learn more about how stories can change behavior? Watch the on-demand webinar, Stories That Move »

Results

Approximately 40% of the patients engaged with the text messages (1,026 patients responded to at least one text out of the 2,597 patients in the intervention group). This is considerably higher than the typical engagement rate with screening reminders. Interestingly, patients who did engage were quick to respond and 86.1% of those who engaged did so within an hour of receiving a text. Of the patients who engaged, 31% clicked on the link to view the fotonovela.

Most importantly, there was a statistically significant 7 percentage point difference in screening: 18.8% of patients in the intervention group were screened, compared with 11.6% of those in the control group.

Social Determinants of Health and Health Equity

A central consideration in the study was to understand whether culturally tailored text messages and fotonovelas could drive behavior change in patients experiencing disparities due to sociodemographic and social determinants of health factors such as race, ethnicity, income, cultural linguistic barriers, and geography.  The results suggest that layering text and visual modalities was particularly effective, with these subgroups showing higher screening rates than the group average. Spanish speakers in the intervention group had an 8.2 percentage point improvement in screening rates (compared to a 5.7 percentage point improvement among English speakers). Similarly, patients in very high need areas and high need areas based on SDOH had an 8.5 percentage point improvement and 7.2 improvement in screening rates respectively (compared to a 2 percentage point improvement in very low need areas). Finally, among those who had never been screened for colon cancer, there was a 6 percentage point improvement in screening rates.

Bringing it All Together: The Impact of Conversational AI and Fotonovelas

Most patients who engaged with the text messages, fotonovelas, and conversational AI had positive or neutral responses and there were very few negative responses. This study underscores how the combination of text, images and tailored responses can help health plans build health literacy and influence health beliefs and behavior in an innovative and culturally relevant way, while achieving positive clinical results. Looking ahead, the mobile health solution in this study provides a robust and replicable model to uncover and address barriers to screening and to improve colorectal screening rates, particularly for disparate and socially vulnerable populations. Increasing the number of screened patients typically leads to more early detection of colorectal cancer, which in turn, can save lives.

 

The author, Rena Brar Prayaga, is an Impact Tech Advocate and a Behavioral Data Scientist. She is also an Advisor at mPulse Mobile, and a co-author of the study published in JMIR Cancer.

mPulse Mobile and AltaMed Research Innovative Approach to Increasing Colorectal Cancer Screenings

Posted on by Brendan McClure

LOS ANGELES–(BUSINESS WIRE)–mPulse Mobile, a leader in conversational AI and digital engagement solutions, partnered with AltaMed Health Services, one of the largest nonprofit federally qualified health centers (FQHC) in the U.S., to publish a research study in JMIR Cancer. The study found that automated, bidirectional texting using Natural Language Understanding (NLU) and fotonovelas can increase screenings for colorectal cancer, particularly among populations facing Social Determinants of Health (SDoH) barriers.

While colorectal cancer is the second most deadly type of cancer in the United States, it is also highly preventable with regular screening, as rates of survival are high when caught early. The California member population served by AltaMed, which is majority Hispanic or Latin American, is less likely to be screened for colorectal cancer and more likely to be diagnosed with advanced disease than non-Hispanic white patients due to a variety of SDoH barriers to care. AltaMed partnered with mPulse Mobile to research ways to address these barriers by delivering culturally-tailored mobile content, in the familiar fotonovela format, aimed at overcoming lack of awareness around CRC screenings and other cultural and behavioral barriers.

Along with mailing at-home fecal immunochemical tests, or FIT kits, to members due for screenings, the randomized controlled trial used an automated texting program for two-way communication to identify barriers to getting screened and to educate members around the importance of screening. Among 5,241 members who had not completed their FIT kit after 12 weeks, an intervention group received an additional 4-week series of automated text messages monitored using a program developed by mPulse Mobile. In combination with the text messages, participants were sent a link to a fotonovela in either English or Spanish, containing a comic about someone encouraging a friend to complete their FIT kit and explaining why the screening is important.

The intervention resulted in a significant quality improvement among participating members:

  • 40% of members in the intervention group engaged with the text messages. Of those, 31% clicked on the link to view the fotonovela.
  • The intervention group had a screening rate of 18.8%, while the group that did not receive the texts and fotonovela had a screening rate of 11.7%.
  • Screening rates were higher among members who engaged with the text messages than among those who did not.

“Addressing Social Determinants of Health barriers among hard-to-reach populations is a core facet of mPulse Mobile’s mission,” said Bob Farrell, CEO of mPulse Mobile. “We’re thrilled to have partnered with an organization like AltaMed to demonstrate how innovative digital engagement approaches can address the challenges people face completing important health actions. Understanding the needs of individuals at scale and then tailoring touchpoints to address these needs is a crucial part of improving health outcomes across diverse populations.”

mPulse Mobile, the leader in Conversational AI solutions for the healthcare industry, drives improved health outcomes and business efficiencies by engaging individuals with tailored and meaningful dialogue. mPulse Mobile combines behavioral science, analytics, and industry expertise to help healthcare organizations move their consumers to adopt healthy behaviors.

“Our program used tailored conversations and personalized stories to engage different segments and drive behavior change. Conversational AI helped us to uncover the reasons why people weren’t completing their screenings and to address these barriers in real time. The results show that we were able to reach and influence some of the most vulnerable populations and this is very encouraging,” said Rena Brar Prayaga, Behavioral Data Scientist and co-author of the study.

AltaMed Health Services, serving primarily Latinx patients in Southern California, has a history of leading innovative, culturally-tailored member engagement programs that improve care outcomes and overcome social determinant barriers among their member population.

Evaluators at the Center for Community Health and Evaluation (CCHE), part of the Kaiser Permanente Washington Health Research Institute, independently evaluated the intervention. The full study, “Using Text Messages and Fotonovelas to Increase Return of Home-Mailed Colorectal Cancer Screening Tests: Mixed Methods Evaluation” was a collaboration between AltaMed, mPulse Mobile and CCHE and published in JMIR Cancer. Authors of the study are Carly E Levitz and Elena Kuo from the Center for Community Health and Evaluation, Monica Guo, Esmeralda Ruiz, Evelyn Torres-Ozadali and Anne Escaron from AltaMed, and Rena Brar Prayaga from mPulse Mobile.

About mPulse Mobile:

mPulse Mobile is transforming digital engagement for healthcare’s leading organizations through proven solutions that combine conversational AI with integrated streaming content. mPulse Mobile’s innovative technology and engagement strategy deliver business efficiencies, improve health outcomes, and inspire a more equitable, healthier world, one person at a time. mPulse Mobile has over 12 years of digital health engagement experience and partners with over 200 leading healthcare organizations to deliver over 1 billion tailored digital touch points with health consumers annually. To learn more visit mpulsemobile.com.

About AltaMed Health Services:

AltaMed understands that when people receive care that considers their individual health needs and respects their cultural preferences; they grow healthy—and help their families do the same. Since 1969, we have delivered complete medical services to communities across Southern California. Our team of qualified multicultural and bilingual professionals—from these same communities— is focused on eliminating barriers to primary care services, senior care programs, and essential community services. With nearly 50 accredited health centers and service facilities, we remain committed and ready to help you grow healthy at any age.

View the press release on Business Wire.

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

Posted on by Megan Scarlatelli

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

The Kidney Health Evaluation for Patients with Diabetes (KED) is a newer HEDIS® measure that tracks the percentage of adults with diabetes who have been screened annually for kidney disease. The measure includes two components: a urine albumin-to-creatinine ratio (uACR) and a blood test to determine the estimated glomerular filtration rate (eGFR). This measure is important because it can screen and diagnose kidney disease, and early detection and treatment can help prevent or slow down its progression.

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

While this change is intended to provide a more accurate and comprehensive assessment of a member’s kidney function, preventing downstream complications and risk, it presents a behavior change challenge for Medicare Advantage plans as improved health outcomes also support better Star Rating performance. One way members were able to satisfy the previous measure requirement was via a urine test in the comfort of their own home. Now they will likely need to visit a lab or their healthcare provider to also complete the blood test, which can be inconvenient, time-consuming, and, sometimes, intimidating, potentially impacting member compliance and overall plan performance. Routine in-clinic lab work requires behavior change that can be nearly impossible to achieve without strategic intervention.

Digital Engagement Drives Behavior Change Outcomes

Using a multichannel engagement approach that leverages tailored conversations intentionally crafted with behavioral science to activate members is proven to empower members to overcome barriers and get tested. Rooted in neuroscience and psychology, behavioral science uses cutting-edge techniques proven to empower and inspire members to act. As a matter of fact, a leading Medicare Advantage plan saw an 18% lift in members taking action when behavioral science was used in SMS messaging in mPulse programs versus when it was not. Here are a few examples of behavioral science principles that mPulse incorporates into messaging to inspire member self-efficacy:

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

Education plays a critical role in activating and empowering members to complete a desired health action. A captivating piece of streaming content or even a link to an existing resource can help educate members about why going in-clinic is a better way to monitor their diabetes, driving sustainable behavior change in combination with behavioral science-backed dialogue. That’s why Streaming Content and Instructional Strategy make up one of mPulse Mobile’s proprietary engagement strategy pillars. Our team of instructional strategists and healthcare industry experts creates compelling learning experiences inspired by trends from consumer products and aligned with key STARS measures, like Diabetes Care – Kidney Disease Monitoring. Streaming content and messaging are developed alongside thought leaders and industry experts to ensure members feel empowered, inspired, and informed to take action to improve their health and health literacy. In fact, mPulse observed a 274% increase in retinal eye exam completions when streaming content was used in SMS versus when it was not used. Powerful right? We think the data speaks for itself.

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

Delivering Equitable Health Experiences Among Medicaid Populations

Posted on by Nicole Lopez

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

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

Healthcare Experiences Powered by Technology

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

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

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

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

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

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

Three Core Capabilities for Texting Outreach

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

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

Two-way Conversations Identify and Address Barriers to Care 

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

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

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

Natural Language Understanding and Culturally Appropriate Content 

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

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

Leveraging Educational Content to Promote Health Literacy 

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

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

Equitable Healthcare for All 

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

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

mPulse Supports Over 30 Customers During the Unwinding of Continuous Enrollment

Posted on by Brendan McClure

LOS ANGELES – mPulse Mobile, a leader in conversational AI and digital engagement solutions, announces collaborations with over 30 managed healthcare organization customers to leverage digital engagement strategies to support the redetermination of Medicaid and CHIP enrollees following the end of the continuous enrollment period that was part of the Covid-19 public health emergency (PHE). These collaborations will ensure millions of low-income Americans retain the health coverage they need, and will provide digital resources to help individuals who no longer qualify for Medicaid transition to public exchange plans.

On December 29, 2022, President Biden signed a federal spending bill containing legislation decoupling continuous enrollment from the PHE effective April 1, 2023. Medicaid and CHIP enrollees will have to go through the recertification process to retain coverage. Medicaid Managed Care organizations (MCOs) have a 12-month timeframe to initiate and two additional months to complete renewals for their members in collaboration with local and state agencies. On January 23, 2023, the FCC issued a declaratory ruling reaffirming that the provision of a mobile phone number by a member to their state agency during the enrollment process constitutes prior express consent. Therefore, text outreach is an effective tool to drive the recertification process.

“Medicaid plans face a large administrative challenge to ensure their enrollees have continuous access to care,” said Bob Farrell, CEO of mPulse Mobile. “Many Medicaid beneficiaries tend to change addresses frequently, so traditional mailed recertification communications are less effective, whereas mobile phone ownership is well above 90% and text is utilized across populations. mPulse has pioneered the use of text outreach across lower income populations and individuals who face SDoH impacts, and we’ve consistently demonstrated our ability to engage and activate these hard-to-reach populations to take positive action for their own health.” 

mPulse is working with a broad set of national and regional MCOs to deploy digital outreach programs to support members through the recertification process. mPulse’s conversational AI capabilities allow health plans to send out reminders with embedded links to online sites for recertification and ask questions about barriers that may be preventing members from re-enrolling. As members respond via text, the automated program addresses the issues they identify, which provides a robust consumer experience and improves program outcomes. mPulse has deployed automated conversational programs to Medicaid populations across seven languages. Prior to the Covid-19 pandemic, mPulse’s digital outreach redetermination programs consistently delivered over 20 percentage point improvements in redetermination rates compared to traditional communication channels.

​Learn more about mPulse Mobile’s support for Medicaid and CHIP member redetermination »

“With much of the last year spent in a holding pattern with each 90-day PHE renewal, we finally have a clear path through the end of the unwinding phase,” said Reva Sheehan, Senior Director of Customer Insights at mPulse Mobile. “However, that doesn’t mean it will be easy. This is an all-hands-on-deck moment for Medicaid MCOs. We encourage all impacted health plans to take advantage​ of CMS’ call for states and MCOs to work together, and the FCC’s clarification of prior express consent to text and call individuals to provide assistance through the entire recertification process. In addition to known challenges and barriers, many of these individuals have never been through a recertification process. The robust multi-channel communication approach that mPulse Mobile provides is the best way to keep at-risk members from slipping through the cracks.”

Visit the full press release ​on business wire »

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!