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CASE STUDY

Increasing access to care and engagement for Medicaid members with virtual care

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BACKGROUND

Bringing virtual care to Texas Medicaid families

TytoCare serves Medicaid populations nationwide. In 2022, TytoCare partnered with a leading US health plan to launch a virtual care program for around 1,000 Texas Medicaid families. Families included in the cohort were high ED utilizers and had an average family size of 4.4, with 1.7 children between the ages of 0-5.
All program KPIs set by the health plan were met or exceeded.

CHALLENGE

Engaging Medicaid members in virtual healthcare

A leading US health plan sought to launch a virtual care program for Medicaid enrollees, with the aim of improving access to quality care and improving the patient experience, while keeping costs down. Traditionally, Medicaid enrollees have been found to be less engaged in their healthcare than privately insured populations, leading to poorer health outcomes and higher cost of care. Given that patient engagement is considered a key ingredient for improving health outcomes, the health plan needed to ensure that they utilized engagement strategies to maximize successful implementation.

Launch date: July 26th, 2022
Number of families: 1,112
Cohort:

  • Avg. family size 4.4, with 1.7 children between the ages of 0-5
  • High ED utilizers

Use case:

  • Urgent care
  • Asynchronous: the patient conducts recommended exams based on symptoms, then meets with a doctor for a diagnosis and treatment plan

Cost: Free device, free visits

PROGRAM OBJECTIVES

Defining objectives for virtual care program success 

TytoCare worked with the health plan to define clear, measurable objectives for their virtual care program, to ensure that we focused on their business goals.

Advancing health equity by improving access to care

Reducing dependency on external factors, such as transportation and language.

Shift to more efficient sites of care

Shifting high-cost beneficiaries to lower-cost channels without compromising quality of care.

Improve the patient experience

Making healthcare services more accessible and easy to consume.

SOLUTION

Drawing on engagement best practices for successful program implementation

TytoCare worked closely with the health plan to design a program that fed into the health plan’s key objectives and drew on our best practices. Tyto Engagement Labs™, TytoCare’s proven framework based on behavioral science methods and years of successful nationwide deployments, formed the basis of the program design.

We followed these key steps to ensure that the program design was optimized for maximum engagement:

Identify the core elements for successful implementation

Together with the health plan, we identified the key stakeholders: Providers, the MCO, and Medicaid families. For the program to succeed, the providers and the MCO needed to be aligned and invested in the successful delivery of the virtual care program, and the Medicaid families needed to be receptive to adopting virtual care. The engagement activities would act as the bridge between the MCO, the providers, and the families.

Plan

Plan offers Home Smart Clinic to relevant cohort

Provider

Receive access to care from in network provider/doctors in the cloud

Beneficiary

TytoCare

TytoCare takes care of kit distribution and enrollee engagement journeys

Select the ideal cohort to meet program objectives

A cohort of Medicaid enrollees was identified, based on criteria that balanced between enrollees with the highest cost of care and those with the highest potential for adopting virtual care. The cohort included families with young children, who were historically high utilizers of ER and Urgent Care services for common medical complaints, and who had previously used telehealth.

Criteria
Values
Family avg. size
4.5
Children ages
2-4
Parents age
<45
Medical history condition
Ear and upper respiratory tract infections
Telehealth utilizers
1+ a year
Preventable ICD-10 codes
Acute upper respiratory infection, Rash, Unspecified fever, Acute maxillary sinusitis, etc.
ER + UC usage levels
3+ a year
Tailor the engagement plan to the cohort and program

Using our evidence-based framework, we tailored all engagement activities and messaging to the Medicaid enrollees to ensure the highest levels of adoption and utilization. This included pinpointing the specific pain points for the Medicaid community, understanding how TytoCare could help solve those challenges, and then messaging our communications accordingly.

The Medicaid population’s healthcare focus tends to be more on time-saving as opposed to cost. By focusing on this message, as well as better access to care for the whole family, we targeted all engagement more specifically to their pain points.

  • Our quiz “Is TytoCare a good fit for me?” uses brief questionnaires to ensure users are aware of TytoCare’s value and lets them know how to use it.
  • We include an informative magnet as part of the TytoCare package that directs users when to use TytoCare vs. another healthcare alternative.

With these messages, we make it easier for users to decide when to use TytoCare, because when someone is sick, making the right care decision can be an additional source of stress.

Learn more about Tyto Engagement Labs™
RESULTS

Exceeding objectives and KPIs through successful engagement

This Medicaid program in Texas exceeded the KPIs that were set to define success. The results show a strong interest in the virtual care program with high engagement among the target population. This is a clear indication of the program’s success, and of the impact it will have on advancing health equity.

Advance health equity and access to care

Shift to more efficient sites of care

Improve the patient experience

Feedback from Texas Medicaid beneficiaries

“I love the convenience of not having to make a doctor’s appointment with 6 kids in tow!”

Noah

“Everything was awesome! SO happy to have TytoCare to be able to show doctors the symptoms and get care from home!!”

Camilla

“This is the best thing since sliced bread. It is an absolute game changer and MUST!”

Jessica

KEY LEARNINGS

Ingredients for maximizing engagement in virtual care

1

Identify the right cohort with a balanced mix of families

Balancing between the highest costing and highest potential for adoption

2

Tailor the engagement plan user journey and messaging to the selected cohort

Based on literature, past experience, and interviews

3

Be agile: Continuously iterate and optimize the engagement plan

Based on ongoing program insights

NEXT STEPS

Larger cohorts, more geographies

Together with TytoCare, the partner is expanding the virtual care program to more families that match the criteria of the original cohort, as well as to families with older children and slightly different profiles. The partner also plans to roll out this program to other Medicaid cohorts across the US.

The key learnings from the initial program will be applied to the other cohorts to ensure quicker and more successful implementation. Engagement strategies tailored to the Medicaid population, built together with TytoCare through Tyto Engagement Labs™, will be replicated and adjusted where needed to maximize virtual care adoption.