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How Text Messages Boost Member Engagement, COVID-19 Outreach

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Colorado Access utilized Virgin Pulse’s text message technology to push out member engagement and outreach messages pertaining to COVID-19 and, more recently, reopening. Krista Beckwith, the senior director of Population Health and Quality at Colorado Access, recently sat down with Patient EngagementHIT to discuss how they did it. See below for the full article. 


For health plans, member engagement has always been critical. But during the novel coronavirus outbreak, you can double that. 

Member engagement and communication has long been defined by the gentle nudges from a healthcare payer. “Remember to take your medications.” “Have you gone in for your annual physical?” “Here is a new wellness app — try using it to track your fitness and nutrition levels to drive holistic health.”

But the COVID-19 pandemic changed much of that. Health plans across the country were confronted with the imperative to keep their beneficiaries healthy and virus-free, which meant not only screening and connecting them with care access but also driving member education and public health messaging.

“At Colorado Access, we follow a philosophy for member engagement that really focuses on reaching the right members with the right intervention at the right time using the right channel,” Krista Beckwith, the senior director of Population Health and Quality at Colorado Access, told PatientEngagementHIT. “In the case of COVID-19 back in March, we needed to reach everybody in our membership. And to provide information to let them know we were here for them.”

And that information ran quite the gamut: everything from what could prevent infection spread to how to continue care even during stay-at-home orders to what kind of benefits Colorado Access could offer to support patients during the pandemic.

“Our initial goals were to focus on getting information resources and tools out to the population in a timely manner, using channels that would most likely be read by the membership,” Beckwith added.

After all, this is a lot of information needed during a high-stakes time period. It would be essential for Colorado Access to meet members where they are.

And by and large, where they are is on their phones.

“We know that about 80 to 90 percent of our population has a cell phone,” Beckwith said, citing internal data. “So from that standpoint, we knew that for the most part, the majority of our population had a digital platform on which we could get out of quick communication.”

Colorado Access leaned on its text message outreach technology from Welltok to push public health guidelines and information about care access and wellness to its members. In doing so, the public payer was able create a high-touch education and information ecosystem to support patients throughout the height of the pandemic.

This approach built off one that Colorado Access had been previously using. In early 2017, the organization adopted text message outreach as part of its wraparound communication and member engagement strategies, which also include direct mail, email, and interactive voice recognition (IVR), which supports phone call outreach.

While the payer organization still utilized those other modalities, text message certainly seemed the most beneficial for getting the message out about COVID-19. Again, most Colorado Access members have a cell phone that can receive text messages, and email or direct mail can reinforce that for those who may not use cell phones as often.

In the case of IVR, Colorado Access mostly strayed away, out of fear their message may be conflated with scam phone calls seeping into the market at the height of the pandemic.

Ultimately, the text message outreach approach allowed Colorado Access to develop a high-touch engagement strategy that would not drum up alert fatigue in members.

“We can develop a program that has multiple texts related to COVID-19 that a member can receive over a scheduled period of time,” Beckwith explained.

“All programs that we initiate in general, but through COVID especially, has a call to action,” she added. “That means that with each text, we’re giving the members something they could act upon. That could be a phone number to call us, that could be a tool or a resource for them to get more information about something, or that could be encouraging them to talk to their provider or to engage with their provider about something that might be going on with them.”

Over time, the text message content has evolved, Beckwith explained. Earlier on during the pandemic, much of the messaging was focused on public health best practices, so how to manage social distancing, how to contact the payer quickly, or how to get necessary medications when many businesses and provider offices are closed.

Colorado Access also concentrated on checking about social isolation, how to engage in routine behaviors, and dispelling myths that were spreading about COVID-19.

Starting in June, that message shifted.

“Now, getting out of the first wave of the pandemic, our process and goals are shifting now in the summer versus March during that immediate response,” Beckwith said.

“Much more, we are dealing with the focus on the fall out of the first waves of pandemic. The impacts of social isolation on many populations, the impact of what it’s meant for an economic downturn. A lot of new folks coming onto Medicaid that maybe have never been on Medicaid before, or it’s been quite a while since they were a member previously.”

Colorado Access is also turning a keen eye to getting its populations back to their routine care. Like many health plans and providers across the country, Colorado Access saw a notable decrease in members actively engaging in routine care for their chronic conditions and general wellness. This can largely be explained by the fear patients and members may have about engaging with the healthcare system and what risk that may pose.

“As with many health plans, we are learning and adapting and re-engaging all at the same time with everything that’s coming out of the woodwork. There’s still a level of education we’re focused on,” Beckwith stated.

For example, the public payer has seen an influx of new members who are now enrolling on Medicaid because they have lost their jobs as part of the economic downturn. This adds to the laundry list of things Colorado Access needs to touch on in member engagement.

“Some of that education becomes focused on navigating your Medicaid benefits, how you can continue to receive care, questions you may have, and how we could be here to support that,” Beckwith said. “Being a peer and a support and a partner with the new members coming on around how we support them, given the life circumstances we’ve all been put into.”

None of the member engagement success that Colorado Access has seen would have been possible without its community health partners, Beckwith pointed out. Despite the organization’s strong wraparound approach to member engagement, it is always possible for someone to fall through the cracks. These tend to be high-risk and traditionally underserved individuals who face language, technology, or lifestyle barriers to care access and communication.

“We have a fairly robust community engagement department that is really working closely with some of the community-based organizations in our region,” Beckwith explained. “Some of those partners become, quite frankly, the lifeline for some of the populations that we see who are non-English speakers, who might be immigrating from another country. So we are working closely with those partners to provide support to members because we know that they are directly supporting our membership.”

This could be the member engagement strategy for a long time moving forward. Like the rest of the medical industry, Beckwith and her team at Colorado Access are hunkering down for a new normal defined by high-touch and effective engagement and outreach. With health and wellness top-of-mind for individuals across the country, payers and providers alike are looking for ways to best serve their populations and make those populations feel comfortable and safe.

While a positive experience and feelings of safety have always been important, this is going to look differently than it did before, Beckwith acknowledged.

“Prior to this pandemic, our focus was much more on inappropriate utilization,” she said. “How can we drive that cost down? How can we prevent those high cost services like an emergency department visit or an in-patient? We can prevent that from happening, if we can get them the right care prior to that cost.”

“Well, now we’re in a phase with having a population who isn’t engaging, but should,” Beckwith concluded. “So when we’re working with our membership and we’re talking about stay-at-home guidelines or ways to prevent contracting the virus, we really look for that leadership, for that guidance. If we can support our population to work towards functioning in a new normal, you will have a much greater focus on success over time.”

Original article appeared on Patient EngagementHIT – July, 15 2020