Meeting Members Where They Are
Aligning the Wellth member experience journey with health plan goals all year long.
November 17, 2022

The end of the year is an intimidating beast for everyone. There are appointments to wrap up, deadlines, and not to mention the stress and exhilaration of the holiday season. But there’s also a general buzz around new beginnings.

People all over see the approaching year as an opportunity to start fresh, including adopting healthy habits and creating a runway for health and wellness. It’s a fresh start for health plans as well ​​– as they look to not only support members with their individual health journeys ​​– but also focus on important quality and experience initiatives set forth in the new year.

The beginning of the year is a crucial time for health plans to bring awareness of plan benefits to their new and existing members. It’s also a chance to make a lasting good impression, to form connections, and to understand how to best support members’ needs. And importantly, it’s a time where health plans are focused on improving member experience and health outcomes to get a head start on achieving plan goals for the year. 

At Wellth, we help our partners achieve their goals by creating individually tailored member experiences at scale that prompt daily engagement and build trusting relationships. Members benefit from improved health outcomes and quality of life, which translates into reduced costs, care gap closure, health equity investment, and improved quality measures for our partner health plans. 

A core part of the Wellth model is the focus on the member journey. Below we take you through “Maria’s” experience, a member who at 67 is recently retired and living with type 2 diabetes. She’s struggling to keep up with her health amongst being a mother, a grandmother, and living on a fixed income. As we take you through her member journey, we share how the Wellth member experience influences outcomes to help health plans achieve their goals.

Getting Started with Wellth

Maria is giving hugs and saying goodbyes at the front door of her home after ringing in the new year with her family. She kisses her son on the cheek and she does her best to kneel down to give her granddaughter a hug. Her granddaughter leaps up and wraps her arms around her grandmother’s neck in excitement. 

“Be careful with Memaw,” the son warns, “she’s not quite as strong as she used to be.” Her granddaughter leans in and gives her a very gentle kiss on the cheek. 

Once they’ve gone, Maria shuffles into the kitchen. Her body is aching and she’s feeling a bit dizzy so she sits down, grabs one more cookie (it is the holidays after all), and decides to flip through her mail that she let pile up over the holiday weekend. Mostly bills (cable, phone, utilities), but an envelope from her new Medicare Advantage plan catches her eye. 

Upon opening, a green postcard flutters out. 'Claim your spot with Wellth today, and you can earn rewards each month just for staying on top of your health!'

The First 90 Days on Wellth

It’s the first full day of the new year. Maria wakes up, fixes herself a cup of coffee and turns on the TV. As she flips through the channel she gets bombarded with advertisements “New year new you, start your gym membership today!” “The new weight loss program to hit your 2023 goals!”. Then the alarm in her head goes off. ‘I haven’t taken my pills today!’ She gets up, goes to the kitchen, and gets her pill box from the cabinet. SMTWThFSa. She takes her Tuesday pills but notices that her Sa and Th from the week before are still in there. 

She grabs her glucometer and sits at the kitchen table to take her reading: 202 HbA1C. Oof. The green postcard catches her eye again. 'You can earn rewards each month just for staying on top of your health!' She decides to pick up her phone and give it a try, and it didn’t take long to get Maria up and running on her Wellth program.

Wellth enrollment is designed to be a streamlined yet personal experience. Members can either enroll themselves or talk directly with a member enrollment specialist to walk them through the program and enrollment process in just a few minutes. The Wellth app, built on the foundation of behavioral economics, encourages daily engagement in individual health regimens. Members can see their daily check-in streak, incentivized rewards, and receive extra motivational messaging within the app. 

Day 31 on the Wellth program. Maria snaps a picture of her glucometer in the Wellth app and is congratulated on completing 95% of her check-ins for her first month! Maria smiles at her phone and another screen pops up. ‘Help your Medicare Advantage plan to get to know you better!’ She’s a little surprised, but she puts on her reading glasses to take a look at the screen. A few simple questions pop up; Do you feel like you have enough money to fill your pantry? Do you have reliable transportation for your appointments? And just like that she’s done. ‘Huh, that was easy,' she thinks to herself, ‘If they’re asking these questions maybe they’ll be able to help.’

Day 90. After successfully hitting a streak of 100% check-ins every day during her third month on the Wellth program, Maria wants to celebrate by hosting a family dinner. Not just any family dinner, but her mother’s legendary recipe – slow-cooked pork pozole. This was a staple of big occasions throughout her life but was something she hadn’t been able to afford for a while. As she gets up to the register at her local grocery store, she proudly presents her Wellth rewards card with the rewards she’s been saving from her first three months with Wellth.

Daily engagement in the Wellth app provides key insights for our partners on how to better connect with their members and understand where they are at in their health journey from the very beginning. 

The Wellth program also brings a unique opportunity for health plans to address social determinants of health and health equity related care gaps that members may be facing. When health plans partner with platforms that bridge communication with members, it demonstrates that health plans are invested in their care and wellbeing in good times and in times of need. This brings trust and enables open and honest communication from both sides. 

Persistence Equals Progress

The hardest part of creating a new habit is maintaining the new habit. Once the exhilaration of a new year, new program, new initiative begins to wear off, the goals we had in mind for ourselves tend to fall by the wayside. However, Wellth members (like Maria) are able to achieve long-term results. This is because the foundation of the Wellth program is built from the understanding of human behavior and knowing what gets and keeps people motivated. 

Once members have mastered their daily check-ins, additional engagement-oriented tasks like member experience surveys, appointment reminders, and additional tasks can be incorporated along the way to continue to build on the momentum. This helps health plans gain clearer insight to a member’s responsiveness and identifies any potential gaps in care. 

Day 120. Maria is preparing for her morning neighborhood walk. Her phone pings and she has a Wellth reminder that it’s time to refill her medication. ‘Oh, I’d almost forgotten. That was a close one.’

She clicks 'learn more' and another screen pops up, 'Would you like to switch to mail delivery for your prescription?' Since she doesn’t drive herself anymore, it’s hard to get out to pick up prescriptions, and she clicks 'yes'. 

If a member’s engagement behaviors have a sudden change, Wellth’s member support team proactively reaches out to check in with the member and address any concerns. These intervention systems help members follow their care plans, even as they face the tests of everyday life. In addition, Wellth can connect with our health plan partners to help recognize and take action when needed, to support a member closer to real time.

Day 150. With Maria’s increasing energy levels, she’s decided to take a roadtrip with some of her old girlfriends. The “glam grannies” they call themselves. They’ve chosen a remote cabin retreat in Colorado, but when she goes to complete her Wellth check-in, the picture doesn’t seem to load. Maria sees that she has some phone bars but no wifi available. ‘Shoot.’

The next day when she and her friends go into town, Maria gets a notification about her missed check-in. She calls the member support number and gets a hold of a Wellth member support specialist. After explaining the issue, Maria is credited for her check-in, and she is back to her 100% streak (and back to enjoying the rest of her trip). 

Mid-Year: Maintaining Momentum

Summer months can be a balancing act for members and health plans alike. For health plans, the third quarter means CAHPS surveys, budget crunching, and the looming care gap rush. Their employees are also juggling personal time off to enjoy with family and friends. Members like Maria face a similar dilemma – balancing taking care of themselves and their personal health with joys like grandkids and family vacations. 

Day 181 on the Wellth program. Maria’s check-ins feel almost second nature at this point. Get up, make a coffee, complete her Wellth check-in. Once she completes her task, her phone pings. She has a Facebook notification. 'On this day 1 year ago…' One year ago today, Maria’s son posted an update for friends and family on how she was doing in the hospital. She had Hypoglycemia and ended up with a little over a week in the hospital (and a hefty emergency room bill). Looking at the picture felt like she was looking into an alternate reality with a different version of herself. 

This year, she not only has her blood sugar under control, but she’s anticipating a week with her grandkids. “Camp Memaw” they’ve been calling it. A ring at the doorbell carries through the house, and she greets her son and her little campers with a big hug. 

Program results from one of Wellth’s Medicare Advantage partners shows prolonged member engagement with Wellth has led to a 64% reduction in readmissions and a 56.4% improvement in inpatient visits compared to non-Wellth members. These outcomes demonstrate significant cost-savings for health plans AND their members.

Day 210. Maria sits at the kitchen table to a nice meal she’s made for herself. Roasted red pepper soup and a side salad. Next to her, she has her pill box, glucometer, and her phone ready to do her evening check-in. This time upon completion she gets a request for a survey: 'Help your health plan improve by taking this member experience survey.' She’s never been one too keen to give feedback unless she really believes that the services deserve commending; “If you don’t have anything nice to say, don’t say it at all” she was taught. So, excitedly, Maria accepts, and works through the survey while she works through her soup. 

Wellth has over 90% of its members check in on the app every single day. This level of engagement can serve as a catalyst to help plans connect with their members around mock-CAHPS and experience surveys to gauge what their results will be toward the end of the year. 

The Home Stretch: Closing Care Gaps 

End of the year for Medicare Advantage plans means 3 key things: closing care gaps, CMS Star Ratings, and member enrollment. 

It’s a busy time for plans, but it’s a busy time for members too. Keeping care gap closure top of mind for members is not always easy. For Medicare Advantage members enrolled in the Wellth program, there is an established track record of member engagement through daily check-ins which can indicate that they will be receptive to nudges surrounding care gap closures

Day 271 on the Wellth program. Maria is shopping with her granddaughter for a Halloween costume when she gets an alert on her phone from the Wellth app. Her health plan is offering a bonus reward for completing her flu shot! “Huh, that could cover a nice lunch for the two of us wouldn’t it?”, she says. Her granddaughter bounces in agreement. 

They walk over to the pharmacy, and Maria is able to get her flu shot. Even her granddaughter got hers (with permission from her parents of course). While Maria takes a picture of her receipt for the Wellth app, her granddaughter looks at the phone and looks at her grandma. “We need to take pictures of our band-aids too!”

Maria smiles, completes the check in and turns the camera around for their picture. “Now flex big because we’re super healthy now!” They flex their band-aid arms to the camera and say “cheeeeeese!”

The end of year can also be a time to reflect and appreciate how far we’ve come. When health plans work with member-centric partners such as Wellth, it contributes to improving the bottom line. A Wellth partner plan has seen fewer hospitalization readmissions (reductions of 64%), less cost per member and ultimately, better quality scores (+72 NPS score). Other partner plans have seen similarly compelling results across disease states. 

Day 330. Maria completes her morning Wellth check in, as is her routine. Halloween and Thanksgiving have come and gone, and she’s getting everything ready for the holiday season’s festivities. After she completes her check-in – taking time to enjoy that 100% streak she’s been able to maintain – she reflects on how far she’s come with everything she’s been able to do since she’s been feeling better and staying on top of her care regimen. 

Maria gets to reflect positively on the year. Instead of feeling discontent with where she is and what she needs to do next year, there’s a sense of calm and gratefulness she hasn’t felt in a while. She set out to better her health for herself and for her family. With the help of her Medicare Advantage plan and Wellth, she was able to improve her health and enjoy more quality time with her family. 

Ultimately, health plans want to keep their members coming back and maximize future enrollment. If a member can see and feel their improvement by working alongside their health plan, they are likely to stay enrolled and spread the word to their friends and family. Wellth is able to bridge the gaps between health plans and their members in order to improve quality measures, reduce costs, and ultimately help members live longer and healthier lives. Members like Maria are Wellth’s mission.