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HTN and CareOps

HTN CareOps Mastermind: Engaging Medicaid Beneficiaries

April 27, 2023
Community Wisdom

Mastermind note disclaimer: This is not intended to be a polished article by any means, but rather a way to share quick insights, ideas, and tactics around the topic. We hope these takeaways might spark an idea or two for other HTNers working through similar problems.

Setting the stage

For our most recent HTN CareOps Mastermind session, Sina Haeri, Ouma Health’s CEO, took the hot seat to talk about Ouma and its push to improve patient engagement, particularly for individuals in the Medicaid market.

Ouma Health is a startup building a virtual care platform for pregnant women offering 24/7 telemedicine access. Currently, the company’s primary focus is on high risk pregnancies - a key part of that segment is the Medicaid population. Like many other digital health startups, Ouma distributes its offering through payors and employers in a B2B2C model. Similar to every other solution leveraging this strategy, engagement is hard, particularly when addressing the Medicaid population. The reasons are common in that the health plans and employers:

  • Have a lot of priorities that constrain resources to focus on one particular solution
  • Are nervous about giving up touch point control as any backlash on bad member experiences will likely come back on them
  • Don’t actually have good data themselves
  • Lack true financial incentives to open up the spigot and are actually incentivized to go slow to see how programs like this work

In short, from a cost-benefit tradeoff perspective for these payors, the risks far outweigh the rewards for allowing companies like Ouma to use any means at their disposal to engage the payor’s beneficiaries - even if from a patient perspective, it could be the right thing to do.

So, the HTN CareOps crew came together to help brainstorm and solution around this problem. Below is a summary of ideas from the brainstorming/solutioning session that we hope spark ideas for folks.

Please note, we are skipping the Q&A portion of the session that digs into how Ouma's model works. So, if you want to engage in these going forward be on the lookout for more announcements on Mastermind sessions. If you have other ideas or suggestions to add to this document on the topic of Medicaid beneficiary engagement, feel free to DM us on Slack (Ryan and Amanda) or email us at - we’ll try to periodically update them in the article takeaways.

Last thing - Before diving in, a brief but big thanks to Sina Haeri for taking the hot seat and these HTNers for sharing experiences and ideas: Norma Bostarr, Julie Kopp, Sara Gallo, Nate Brown, Kevin Stephens, Eric Patzelt, Raul Estrada, Beau Palin, Rob Calvey, Nicole Warshauer, Sarah Tilton, Sara Greenbaum, Stella Berke, Kate Schlag

Overall takeaways

These summary notes are lightly organized from top of funnel through end of the funnel + enablement of funnel.

From our perspective, there were two overarching themes from the session:

  • First, that engaging in this market segment does not come with a one-size fits all approach. It takes localized, personalized approaches that aim to build trust, and not just with the patient, but also the payors you are working with.
  • Secondly, framing engagement around an interaction funnel (similar to the sales funnel) is a useful exercise in evaluating performance and intervening.

Augment and segment your data

  • Payor and MCO data is only so accurate, so be sure to find ways to augment your data sources. Then, segment that data finding pockets of high density.
  • Related to density, it is important to create as many (positive) awareness touchpoints as possible before the first interaction. You'll need to understand where your segments are to do this, whether physical or digital.

Build trust with your B2B partner over time

  • Demonstrating real ROI in pilots or in short periods of time is realistically not feasible. So, share testimonials and stories with your payor partners - this often drops restrictions about marketing / sharing with other members.
  • Be honest and transparent about what needs improvement though - no one believes things are rosey all the time. Not presenting areas for improvement can make partners skeptical.

Understand the users at the beginning of the engagement

  • Often times, training the person on using telemedicine, particularly your type of telemedicine, should help inform different interactions.
  • Ask questions upfront to understand where there is concern, lack of understanding or knowledge. You can do this via quick dial surveys or over the phone.

Engage more than just the patient with more than just the clinical provider

  • Engagement metrics don’t need to be tied just to one individual, but could be tied to engaging other members of the family.
  • Expand touch points to people who truly understand the segment as people, not just as patients.
  • Docs may actually not be the most trusted person or know how to best build trust. 
  • Nurses don’t always have the level of influence or message of value to someone who is skeptical.
  • Community health workers can be a great engagement resources.

Local community is key

  • Community advocates - finding people and organizations to share services with locally.
  • Local canvassing and physical mailers work well.
  • Reach out to churches, local areas, barbers, etc.
  • Look at LiveChair and Fabric Health for examples.
  • Partner with the hospitals / health systems in the community.

Work with other existing relationships your beneficiaries have

  • Leverage CareSource - they engage Medicaid patients, educate patients and providers, and can help make the connection for you.
  • Community aspect is really important.

Continued engagement can be driven at the end of the interaction

  • Conduct quick surveys (verbal or written) and make it easy with options.
  • Suggested questions:
    1) How was your visit? 
    2) How was your doctor? 
    3) Where would you have gone if not here?
    4) Text field for any issues, comments, or questions (built in testimonials).
  • Building in with a lightweight app can be helpful to see the details and the history.

Leverage your “CRM” to assess engagement throughout the funnel

  • There are different conversion/engagement points throughout the funnel. 
  • What are the friction points and who is the right individual to be speaking? 
  • Do you have different segments of scripts based on the situation or context?
  • We are often so excited to talk about our care services that we take 4 minutes to talk about us and don't cater to what the individual needs or connect on a level of trust.
  • With direct mail, make sure the URL ties back into Salesforce to make sure ties back to leads.
  • If someone is already a customer, move them off marketing distribution lists.
  • has worked great.