Medicaid Health Plan Leverages Text Messaging to Improve HEDIS Measures Across Arizona Membership

The Client

Name: Arizona-based health plan with Medicare and Medicaid lines of business

The Goal

Scale customizable member outreach.

The Result

Improved HEDIS measures and member response rates.

The Challenge

For nearly two decades, an Arizona-based health plan has provided progressive, government-sponsored managed care services to families, children, and senior citizens. Today, the health plan serves nearly 200,000 individuals across Arizona living with complex medical needs.

As a health plan invested in the wellness of the families receiving Medicaid and Medicare services, the organization prioritizes member outreach to help their populations stay healthy. A team of dedicated individuals is committed to engaging with members throughout their care journey, including helping members:

  • Find a provider
  • Learn about preventive care services
  • Schedule appointments
  • Arrange transportation

…and more.

Having grown remarkably in size since its inception, the health plan struggled to effectively connect with and engage members at scale. Campaigns relying on telephonic and direct mail outreach required significant manual efforts, costing the health plan time and money with limited success. The organization knew they needed to augment their outreach campaigns with another method for connecting with members.

The health plan was familiar with Providertech and interested in their innovative text messaging solution, which was one of the first of its kind at the time. They were also impressed with Providertech’s proactive approach to addressing state and regulatory guidelines that ensured compliance with national security and privacy standards, such as HIPAA and TCPA.

Solution Implemented

Population Health

Outreach Via Text

Messaging

The Solution

In 2016, the Arizona-based health plan engaged Providertech to implement a comprehensive and customizable text messaging solution to conduct targeted outreach.

Together, the health plan and Providertech developed over 15 text messaging campaigns designed to address gaps in member care, as measured by the Healthcare Effectiveness Data and Information Set (HEDIS). Through this partnership, Providertech’s expertise helped the health plan build, filter, and segment member data based on criteria spanning demographics and health history. This ensured each campaign targeted the unique needs of a specific segment of members, leading to increased response and action. For example, chronic disease outreach for patients with uncontrolled diabetes was sent to only eligible members, resulting in improved engagement rates and related measures. Likewise, members with children who were due for their annual well visit received messaging reminding them it was time for their child’s visit and highlighting the importance of the visit.

The population health campaigns combined educational information with navigational content so members clearly understood both why and how to take action. For example, one campaign targeted women who recently gave birth. Text messages delivered relevant information regarding developmental milestones for the newborn stage through 15 months of age while also prompting members to schedule appointments, vaccinations, and other visits, as appropriate. Brief texts directed recipients to visit a short landing page where they could learn more, access contact information, and take the next step as directed.

Other customized campaigns focused on:

  • Pregnancy and postpartum care
  • School-aged wellness visits
  • Cancer screenings
  • Mental health screenings
  • Flu reminders
  • Diabetes care
  • COVID-19 support

 …and more.

They were also able to leverage on-demand messaging to distribute urgent messages at scale to members in areas affected by natural disasters or other unexpected scenarios, such as the COVID-19 pandemic. One of the plan’s quality leaders noted that Providertech’s communication templates enabled them to quickly create or edit messaging based on specific scenarios and distribute urgent communications via text within minutes.

The health plan was pleased with the implementation process, noting that Providertech had already thought through potential obstacles and developed solutions for mitigating any possible issue. They especially appreciated Providertech’s knowledge and expertise related to the Telephone Consumer Protection Act (TCPA). Their experience ensured that outreach efforts remained compliant with current standards, such as frequency, opt-out messaging, and more.

Increase in shared decision making visits

Increase in lung cancer screening rates for eligible patients

Increase in early detection, resulting in better patient outcomes

The Result

Five years later, the health plan continues to collaborate with Providertech on customized population health campaigns that leverage text messaging to engage members and improve HEDIS measures. The outreach campaigns leverage multiple channels to reach members and have had a variety of positive results, including significant increases in member responses and outcomes measures.

After the first year of using text messaging in tandem with mailers and phone calls, the plan observed a remarkable increase in the HEDIS measure for well-child visits in the first 15 months of life. And, anecdotally, the health plan experiences an influx of calls to the dedicated response phone line immediately following campaigns.

The health plan’s quality improvement director notes,

“Providertech’s text messaging solution enabled us to contact thousands of members at once without compromising our ability to tailor messaging based on specific populations… As a result, we’ve saved a tremendous amount of time while increasing HEDIS measures, in combination with other communication channels.”

While other texting platforms have since reached out to the health plan, the organization is pleased to continue working with Providertech to reach their member populations via text messaging. The director adds, “Aside from Providertech’s cutting edge technology, we remain impressed by their responsive and proactive customer service which demonstrates a true partnership that has our best interest at heart.”

As COVID-19 continues to affect communities around the world, future outreach may leverage texting to ensure the health plan’s members safely receive the support and care they need through reminders for vaccination, preventative and acute visits, and more.

75%

decrease in time spent confirming appointments

With Providertech’s help, we achieved a 75% decrease in time spent manually confirming appointments, helping us to more efficiently engage our patients using the resources we already had.

Amy Bastianelli |

Director of Population Health, La Communidad Hiispana

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