How Welltok is personalizing the member experience and generating ROI for health plans

Welltok

08/20/2018

Transformation has been brewing within the healthcare industry. Gone are the days when healthcare was just about annual checkups and treating illnesses. Thanks to the rise of digital retailers, like Amazon, members are now demanding that they be treated as savvy consumers. They want more options, easy access and an overall positive experience when it comes to their health.

At the same time, health plans, regardless of their size and market are juggling their fair share of challenges. Not only do they need to keep up with the growing demands of their members, but they also need to impact gaps in care, generate ROI on care management programs and improve the overall health of their population – all while keeping their members continuously engaged and happy.

But, the truth is, members aren’t happy

A whopping 81% of consumers are unsatisfied with their healthcare experience, according to a report by Prophet and GE Healthcare Camden Group. And, let’s face it – most health plans aren’t equipped to understand what makes each individual member satisfied and engaged. Data shows that there is a significant gap between what health plans are offering and what members are wanting and needing.

 So, how can health plans keep up?

Simply put - to motivate members to act and take charge of their own health, health plans need to create wellbeing programs that are highly personalized and meaningful to each individual member.

To keep up, they need to implement the right capabilities that target the right member, with the right message, at the right time and through the right communication channel. However, health plans can’t do it alone. They need a partner with the right tools and resources.

The solution is Welltok, a data-driven enterprise SaaS company

Seeing personalization as the solution for improving the consumer experience in healthcare, Welltok spearheaded and brought together essential digital tools and capabilities, such as:

1. Big data to target the right people at the right time with the right message
2. Multi-channel communications to achieve the highest level of engagement while reducing noise and waste
3. Digital platform to engage individual consumers with a highly personalized and rewarding user experience

 

Welltok in Action: 3 health plans achieve impressive results

With more than 1.5 billion communication touches, 15 years of multi-channel communication experience, 80,000 programs executed and 100+ leading clients, Welltok has demonstrated its ongoing value with clients. By partnering with Welltok, three different health plans were able to increase their Star Ratings, improve engagement rates and impact health outcomes:

Personalized Outreach Increased Medication Adherence and Improved Star Ratings

The Challenge: As an end-of-year push within a tight timeframe, a large national health plan sought to identify and target Medicare beneficiaries with diabetes, hypertension, and/or high cholesterol for a medication adherence program.

The Solution: By working with Welltok’s engagement team, the plan identified over 78,000 Medicare beneficiaries taking multiple medications daily with a proportion of day covered (PDC) rate between 65% and 80%. Welltok targeted these members to encourage participation in a medication adherence program via tailored automated calls. 

The Results: The outreach strategy proved to be effective in increasing medication adherence. 

• 18% to 23% improvements in fill rates for those contacted vs those not reached
• 1 and 2 Star improvements across medication categories

Health Plan Generates 10:1 ROI for Targeted Care Management Outreach

The Challenge: A national managed care organization wanted to better utilize its care management resources to mitigate hospital readmission for their Medicare Advantage population by:

• Identifying individuals likely to be readmitted within 30 days following discharge over the next 6 months
• Improving health outcomes

The Solution: The plan partnered with Welltok’s analytics team to analyze their 140,000 members to identify the right individuals for tailored care management outreach.

The Results: By combining consumer and client data, Welltok identified individuals at risk of 30-day readmission within 6 months as well as those who would likely be impacted by the care management program and receptive to outreach.

• 10:1 ROI
• 10% improvement in program engagement
• 16% increase in medical cost savings

Multi-Channel Outreach Closed Gap in Care and Increased Star Ratings

The Challenge: A large national health plan struggling with closing gaps in care sought to increase its Star Ratings for its Medicare Advantage program, which included seven plans and 10 contracts. They sought to target members with custom messaging via a multi-channel communications strategy, including phone and mail outreach, to increase health screenings for colorectal cancer, diabetes, mammography, spirometry and more.

The Solution: The health plan partnered with Welltok’s engagement team to design an end-of-year outreach program that enabled the plan to take control of their Star Ratings through a customized, multi-channel communications campaign.

The Results: The campaign delivered positive health actions, improved member satisfaction, and increased Star Ratings. Screening rates for those engaged were greater than the control group.

• 5-point increase in colorectal screenings
• 1 Star increase in 10 of the screening measures

 

Want to learn more about Welltok and how they’re transforming healthcare? Get a demo of their products or contact optimizedhealth@welltok.com for more information.