Lessons on engaging the Medicare and Medicaid community from the Manova Summit

It’s well known that a small portion of Medicare and Medicaid beneficiaries drive the majority of the programs’ costs. These individuals generally suffer from expensive chronic conditions, often with comorbidities and are difficult to engage in programs meant to manage their health condition effectively.

This is the problem that Tom Wicka sought to address with his Minneapolis, Minnesota-based company NovuHealth, which works with payers to engage Medicare and Medicaid members and direct them to positive treatment outcomes.

The company, which was founded in 2011, has grown to 175 employees and around $45 million in revenue, by taking engagement techniques prevalent in retail and financial services and applying them to the healthcare industry.

At the Manova Summit in Minneapolis, Wicka shared a few strategies on how the company reaches out and connects to these elusive patient populations.

Figure out who you actually need to engage

The company has a “myopic” focus on seniors and the working poor, not the millennial health freak that is inclined to track their health analytics. 

Instead of developing their own clinical solutions, NovuHealth’s approach is centered on increasing utilization and participation and Wicka said the same techniques can be sat on any number of clinical processes.

While the ultimate goal is to engage every member, the idea of a loyalty and engagement should be centered on top-line customers and where the most expenses are going.

“We’re not in the business of helping people walk around the block and eat a banana. Our particular niche and our focus is to drive the highest value behaviors,” Wicka said.

Take into account consumerization in your engagement strategy 

Retail organizations and healthcare organizations are moving closer together. And – in the case of the CVS-Aetna acquisition – trying to combine forces. 

With that industry shift, members and patients need to be looked at with a different set of optics, according to Wicka. While buying airplane tickets is much lower stakes than getting a healthcare procedure, the approach on influencing people’s decisions are very similar.

“The industry that we’re a part of is really just replicating things that have been done five, 10, 15 years ago in other industries, which is listening to the individual and designing your solution backwards, not from the bottom-up,” Wicka said.

“It doesn’t matter how good your protocol is, if I don’t pay attention to it. It doesn’t matter all the benefits and services you’re offering me if I’m not engaged and paying attention.”

Make sure to understand the social determinants that prove to be a barrier to care

Especially in the populations targeted by NovuHealth, social determinants of health are often a key aspect on whether people get the right kind of care.

Factors like unstable housing, poverty or transportation difficulties need to be factored into the method and strategies to communicate with those patients.

“If you’re dealing with a Medicaid population like we are, you better be aware of whether people can actually get to the appointments that you’re asking them to,” Wicka said.

Segment and personalize engagement down to the single person

Wicka said the company’s strategy is based on blending consumer and healthcare data to create segments and then using behavioral science to tailor the right message for the patient.

NovuHealth uses consumer data like voter registration and driver’s license status to help determine more differentiation within patient behavior.

“The individual is the most important part of the equation that’s not being leveraged now,” Wicka said.

“What’s not normally done is overlaying the consumer data and creating scores (at the individual level) to identify what likely is going to get somebody to respond, from a frequency of message from a channel of a message to the number of touches that you’re going to invest in.”

Scaling an individualized approach to hundreds of thousands of patients requires certain automated processes which NovuHealth has developed as part of its platform. 

“We don’t wait for people to come to us,” Wicka said. “A non-compliant diabetic that demonstrated for three years that they haven’t taken their medication and haven’t showed up for their care management program … is not going to show up at your door magically. You have to drive them through outbound engagement.”

Find the right channel to engage your patients 

The preponderance of new engagement channels like smartphones has driven excitement about the possibility of reaching people through the devices that most people have in their pocket. But that idea doesn’t work for everyone.

In individualizing and segmenting the patient population, Wicka also highlighted the need to meet people on the best channel for their situation.

“If you’re an 87-year-old woman in rural Alabama, do you think the app is the way to get you?” Wicka said.

“The idea that (our patient population is) going to work their app like Candy Crush is a fallacy and therefore going to get you very poor results.”

Picture: Kevin Truong, MedCity News