Designing a mobile strategy to engage and activate high-risk populations

Healthcare organizations often struggle to adequately engage and address the health needs of high-risk populations such as Medicaid beneficiaries. Yet they don’t need to look far for the technology necessary to address this shortcoming. The solution is already in the palms of their consumers’ hands—in the form of mobile phones.

Mobile messaging is one of the most high-impact, low-cost methods of communication. With mobile phone ownership rates high across all major demographics, mobile messaging has bridged socioeconomic and generational gaps. Eighty-six percent of low income individuals own a mobile phone, according to data from Pew Research Center. What’s more, nearly 80% of Medicaid members text.

With such high levels of adoption, strategic mobile messaging programs are uniquely poised to activate and engage vulnerable populations. While many healthcare organizations already are reaching out to patients via mobile message to offer appointment reminders and prescription notifications, the true value of mobile messaging lies in its capability to foster a meaningful, two-way dialogue between consumers and organizations tasked with delivering quality care.

Proven benefits of interactive messaging

Results from a study conducted using tailored text message outreach to 17,000 Inland Empire Health Plan (IEHP) Medicaid members illustrates the benefits of an analytics-driven mobile messaging program. The study revealed that interactive text messages are highly successful at deepening member engagement, improving awareness of plan offerings, and driving increased self-activation, encouraging members to take a hands-on approach to their care. As evidence suggests, those with the skills, ability, and willingness to manage their own health tend to have better health outcomes, generating lower healthcare costs overall.

The tailored messages were found to be significantly more effective in increasing knowledge and changing member behavior than one-way texts. In the IEHP study, analytics-based, interactive texts were found to:

• Increase awareness of appropriate settings for care: The number of members reporting they would visit the emergency department for a minor condition dropped from 11 to 4% by the end of the three-month study.
• Improve response rates: IEHP’s interactive messages had a response rate of 8.2% compared to a mere 1.1% response rate for standard, one-way text messages.
• Encourage member activation: 10% of study participants engaged in a series of health challenges. Of those members who opted-in, 33% reported completing the challenges.

The findings show that members were significantly more knowledgeable about the services available to them and how to best use these services. With Medicaid members visiting the ED at twice the rate of those carrying private insurance, this increase in awareness and activation illustrates significant potential to help members seek the right level of care at the right time and place, driving the overall cost of care down.

Putting it into practice

So, how can healthcare organizations take advantage of these learnings?

To start, it’s helpful to identify a few challenges your organization wants to address, such as medication adherence, gaps in care, or new member navigation. From there, tailored message workflows can be developed to align with these priorities. In the study, IEHP first identified several specific areas where it wanted to increase member knowledge and activation. Dialog workflows were then developed to support these key priorities, with a focus on the following areas: choosing a doctor, using the nurse advice line, scheduling routine and preventive care, finding an urgent care clinic, operating the community resource center, and offering health tips and challenges.

IEHP accomplished this by leveraging a variety of message types, including:

• Informational messages such as “Call IEHP at 888-123-4567 if you need health advice and want to talk to a nurse.”
• Open-ended questions such as “Imagine that you wake up in the middle of the night with a sore throat. How would you use IEHP to get care? Please reply in your own words. Thanks!”
• On-demand resources and challenges such as “If you need urgent care, text URGENT for information about a nearby IEHP urgent care clinic” or “For new ways to take care of your health, text TRY and we’ll send you health tips and challenges.”
• Interactive polls such as “See your doctor for your annual physician exam and routine care. His or her phone number is on your IEHP card. Do you know who your doctor is? Reply YES or NO.”

These messages offered members the opportunity to answer in an open-ended fashion, using natural language processing to interpret and analyze responses, allowing IEHP to engage with members by establishing a two-way dialog. The results were overwhelmingly positive, with 91% of IEHP members reporting that the mobile messages had improved their overall knowledge of IEHP services by the end of the study period.

Implementing an interactive and tailored mobile strategy creates significant opportunities for healthcare organizations of all sizes to improve population health while simultaneously improving care quality, resulting in a reduction of overall healthcare spending and improved health outcomes.

Organizations that aren’t taking advantage of this highly effective means of communicating with their audiences will be left behind as the industry moves to embrace consumerism and value-based care, placing a greater emphasis on engaging patients in their health.