Commercial Plan Experience
An Intelligent, Empowering Health Plan Member Engagement Solution
Automated conversations provide more self-service opportunities for your members.
Today’s consumers value convenience. But what constitutes convenience continues to evolve as people are increasingly connected to their devices. Conversational tools are rapidly establishing themselves as consumers’ preferred approach to engage with businesses. This “any-time, anywhere” approach makes sense for healthcare as well.
Conversational AI engagement enables consumers to engage in ways they’re already comfortable with—natural back-and-forth exchanges in clear, plain language. Interactions can be tailored to each member’s need, further improving their overall experience. Consumers can also initiate conversations on demand, enabling them to take greater control over their health. This self-service approach to health plan member engagement empowers members to navigate directly to the support and services they need. Health plans can now establish a meaningful relationship with consumers, and consumers can take more control over their own health.
mPulse Mobile’s Commercial Plan Experience solution delivers a suite of Conversational AI tools to provide an improved health plan experience using friendly check-ins and ongoing support as members onboard into their new plan and begin using services. Built-in intelligent systems tailor conversations over time to keep the consumer engaged and educate them on effective ways to continue managing their health.
Proven Results
25%
Overall engagement through a 6-week plan navigation program
24%
Members clicking through to learn more about gym and value-added benefits
95%
Members reporting their understanding of plan benefits improved
How It Works
UNDERSTAND the Member
Members have varying levels of health understanding and experience navigating the health system. We predict their knowledge and health activation levels and capture these insights on a dynamic profile. We then leverage this profile to guide health plan member engagement strategies, creating the most tailored and meaningful member experience.
- Proprietary SDOH Indexing
- Demographic Information
- Health Status and Prior Utilization of Health Services
- Engagement History
- Health Literacy
- Health Activation
DELIVER Empowering Conversations
The member receives a coordinated series of conversational touchpoints, educating them on health plan services and tools that provide more control over their healthcare experience. Conversations are aligned to the unique needs of each member and to the strategic goals of your plan.
- Ask members how confident they are navigating their plan benefits and ask what topics they need more information about
- Educate on key topics like self-service tools, important numbers, and digital health services
- Connect members to key supplemental benefits
- Keep healthy living top-of-mind with engaging check-ins, tips & tricks, and gamified health engagement challenges
OPTIMIZE Outcomes
We work with you to capture key insights about your population and their unique needs. We optimize the mPulse Mobile Commercial Plan Experience solution to deliver the best member experience possible.
- Analyze all aspects of solution performance through solution dashboards
- Leverage reporting on health activation, health literacy and other key topics to develop programs and experiences tailored to your population
- Optimize conversations and drive up satisfaction scores and sentiment captured through conversations
Solution Content
Core Solution:
- Plan Knowledge Assessment
- Health Activation Assessment
- Plan Navigation: Connecting to Key Health Benefits
- Self-Service Navigation
- Satisfaction Surveys
Additional Modules:
- Pharmacy Benefits Education
- Health Engagement Topics
- Barrier Assessment
- Health Literacy and Education Improvement
- Additional Channels and Languages
- CAHPS® Satisfaction Monitor
- 1:1 Messaging Via mPulse Mobile’s Engagement Console
Advanced technology. Practical solutions.
The mPulse Mobile Commercial Plan Experience Solution leverages our enterprise-grade communication platform and innovative technology that powers effective and scalable conversations.
- Conversational AI – Forms the core of our Natural Language Understanding and allows us to automate tailored conversations
- Engagement Console – Empowers your support staff to have 1:1 mobile conversation with members using a cloud-based desktop application
- Reporting – Provides you with the data views and analysis to understand member engagement and optimization of solution outcomes
- SDOH Index – Lets us understand populations at scale to tailor conversations, so you can provide support to all your members
- Activation Intelligence – Builds individual activation profiles for each member, so we can adapt and tailor conversations to drive solution outcomes
- Conversation Science – Enables us to measure and assess the quality of our automated conversations at scale, so we can be more meaningful and engaging
Orchestrated Engagement Across Solutions
See how our other Conversational AI solutions for commercial plans help you build stronger relationships with your members.
Start Conversations.
Build Relationships.Drive Outcomes.
It all starts with conversation. Our omnichannel solutions empower you to have conversations with your consumers through their preferred channel and with relevant content. Our behavioral data science team and Conversational AI platform give you the smarts and automation to intelligently tailor your conversations to build stronger, tighter relationships with all your members. Relationships are the key to activation and behavior change that drives positive outcomes.It’s all about relationships.
