Medicare Preventive Care & Screenings
Use Conversational AI to Improve Medicare Screening Utilization
Close gaps in care through proven conversations
Every Medicare plan depends on preventive care to identify rising-risk members, control costs, and improve health outcomes. Members who complete key actions like Annual Wellness Visits have been shown to have better chances of detection and management of chronic conditions as well as incur lower care costs over the long term. But despite plans’ emphasis on aligning providers and improving access, only a quarter of members complete AWVs. Plans must constantly improve screening completions to achieve high Star Rating measures.
The bottom line is that preventive care ultimately depends on member actions to visit clinics to close gaps in their care. Leading health plans understand that meaningful action begins with a conversation. They also know it’s possible to promote cost-effective utilization of Medicare screening services at scale.
The solution: mPulse Mobile Preventive Care and Screening solution.
Our powerful AI-driven solution provides necessary reminders, follow-ups, and barrier identification. We use conversations to engage your members to address health literacy gaps, gather key insights, and connect them to existing resources.
Proven Results
10pp
Improvement in colorectal cancer screening completions
21%
Engagement rate for in-home risk assessments in a hard-to-reach population
92%
Accuracy for Conversational AI response handling
How It Works
UNDERSTAND the Member
Good conversations start with context. We use data to build a dynamic profile of each member that helps guide conversations to prompt meaningful action.
- Proprietary SDOH Indexing
- Demographic information
- Screening completion history and health status
- Engagement history
- Health literacy
- Health activation
DELIVER Conversations to Close Gaps in Care
The member receives conversational reminders to drive action to complete Medicare screenings and get preventive care.
- Remind and nudge members to complete their screenings, tests, and vaccines
- Tailor conversations based on dynamic member profiles
- Use Natural Language Understanding (NLU) to gather important member-reported information, including barriers to visiting clinics
- Connect members to existing initiatives and incentives to drive awareness and better outcomes
OPTIMIZE Outcomes
We work with you to capture key insights and optimize the solution to continuously improve gap closure rates.
- Analyze all aspects of solution performance through solution dashboards
- Leverage reporting on member-identified adherence barriers and common responses for your overall preventive care strategy
- Optimize conversations and minimize friction for members to close gaps
Solution Content
Core Solution:
- Screenings, Tests, Vaccine Reminder Conversations for:
- C01 – Breast Cancer Screening (BCS)
- C02 – Colorectal Cancer Screening (COL)
- C09 – Diabetes Care – Eye Exam
- C10 – Diabetes Care – Kidney Disease Monitoring
- C11 – Diabetes Care – Blood Sugar Control
- Annual Wellness Visits
- Adult Immunizations
- Barrier Identification
- Satisfaction Surveys
Additional Modules:
- Incentives Management
- Follow-Up Survey
- Plan Initiatives (e.g. mail order, generics, 90-day supply, etc.)
- New-To-Measure Member Tailoring
- Health Literacy and Education Improvement
- Additional Channels and Languages
- CAHPS® Satisfaction Monitor
- 1:1 Messaging via mPulse Mobile’s Engagement Console
- Additional Measures: D11, D12, C16
Advanced technology. Practical solutions.
The mPulse Mobile Preventive Care and Screening solution is delivered using 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 conversations 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 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.
