Patient Engagement

CareMessage at NACHC FOM/IT: Practical Insights Into the Value of Texting for FQHCs

We’re exceedingly proud of the results we help our partners achieve. That’s why events like our recent session at NACHC FOM/IT are so special. 

The annual conference gathered over 700 health center executives, leaders, staff, and IT professionals from across the country. We had the opportunity to share our perspective on the value of text messaging for FQHCs and showcase one of our most successful partners, ChapCare Medical and Dental Health Center

Marywiley Pate and Sara Christenson of CareMessage along with Steven Abramson, COO of ChapCare provided an in-depth look to both in-person and an online audience into the tangible value text messaging offers FQHCs. We also explored recent use cases, closing the session out with tips for health centers who are seeking out their optimal relationship with a text messaging vendor. 

The Next Phase in Communicating with the Underserved

A quick, interactive survey revealed that the audience was using a mix of phone calls, physical mail, email, patient portals, and text messaging. These are the tools that FQHCs are using to navigate an evolving, and sometimes confusing payment system — 50% of payments to health centers are moving away from fee-for-service and toward quality. At the same time, health centers are still pressured to do more with what they have. This means optimizing decisions in driving down no-show rates, moving closer to the quadruple aim, and improving patient health and the provider experience.

The Traditional is Still Challenging

While breaking into new forms of communication like texting is uncharted territory, traditional methods of phone and mail are still challenging.

  • 52% of calls are going unanswered. 
  • Email faces persistent barriers like a lack of internet, limited laptop/computer access, and low open rates.
  • Patient portals are going unused by 63% of patients.

In this environment, FQHC leaders are continually looking for more creative ways to drive interaction. One of the most promising is 2-way, interactive texting and studies have shown this approach to be effective. We conducted the top two studies which revealed a 99% open rate, with 82% of recipients opening a text within the first five minutes. An external study found that texting usage is 2-4 times higher in lower income, less educated populations. It also found that the majority of people in underserved populations have some sort of device that receives SMS messages.

FQHCs Are Finding Their Way in the World of Texting

The session continued with a look at FQHC experiences with texting. The first presentation revealed that while many FQHCs do have texting options, many are add-ons to an existing EMR or are almost exclusively being used for appointment reminders.

FQHCs have an opportunity to do much more. By exploring the value beyond appointment reminders health centers can tap into an improved patient experience, better performance on UDS and HEDIS measures, and even additional funding — HRSA makes an annual payment of $107 million but only 62% of FQHCs are receiving Quality Awards. A mere 26% are receiving Access Enhancer Awards.

Overcoming Barriers

While text messaging does build bridges to underserved populations, challenges still exist.

Social determinants of health such as language and literacy mean that messages need to be both bilingual and culturally relevant. Text messages should be sent at an appropriate literacy level (that’s why our programs are designed at a 4th-grade reading level or below). Centers should also ask whether patients have access to transportation, food, and the networks necessary for them to achieve their healthcare goals.

The ChapCare Example

Steven heads up ChapCare’s operations and supports their mission to provide excellent comprehensive and innovative healthcare services that are accessible to all the residents of San Gabriel Valley in Los Angeles County.

ChapCare at a Glance

Time with CareMessage: 5 Years

Number of Clinics: 8 health center locations

Opportunity: Experienced significant growth as a result of the ACA

Services: Medical and dental, retail pharmacy, optometry, podiatry, behavioral health and substance use counseling

Patient Population: 16,500


Utilization of products like CareMessage has been integral to ChapCare’s progress. After the introduction of the ACA, ChapCare began navigating the shift from episodic fee-for-service to value-based payment systems. This encouraged a search for solutions that would support their growth in a changing payment and insurance landscape.

ChapCare adopted an active patient engagement strategy to become more deliberate in day-to-day patient engagement — making sure patients were coming in every year, that they were covering gaps in care, and supporting patients in their educational needs. These were critical steps in contributing to bending the healthcare cost curve as their patient population grew and they simultaneously provided more services.

ChapCare highlighted the fact that an effective patient engagement strategy is more than just communication, education and a portal. It requires:

  • Defining a vision for patient engagement that’s reflected in organizational culture
  • Emphasizing and reemphasizing that vision and culture
  • Employing the right tech, services, and vendor partners
  • Empowering patients to become collaborators in care
  • Charting progress and being ready to change as needed

ChapCare also offered the following tips for choosing the best vendor for your text messaging goals.

  • Look at a prospective vendor’s mission and track record of impact
  • Check that they’re knowledgable in both FQHC community needs and patient use of tech
  • Consider product ease of use and scalability
  • Look for broad coverage of use cases with a pre-developed content library
  • Prioritize transparent annual pricing, specifically unlimited vs. per message pricing

Learn more about ChapCare’s experiences with CareMessage

How ChapCare is Using Care Message

Because of the importance of driving insurance enrollment in a post-ACA environment, ChapCare shifted enrollment responsibilities from registration into the outreach department, opening up new opportunities for creative use of CareMessage functionality.

  • Patient Outreach: Currently using the Group Outreach function to support patient throughput through management of new member IPA lists monthly. They’ve achieved 80% visitation of assigned members in the last 12 months.
  • Health Education: Using the Texting Education program for type 2 diabetes patients.
  • Patient Retention: Leveraging the Outreach Function for clinical indicator reminders and management of patients lost to care.

ChapCare is excited to continue to use CareMessage to engage patients, assist staff, manage patient health needs, and educate at all points in the health continuum.

Tips for Success With Your Texting Vendor

As a non-profit dedicated to the health of FQHCs and the well-being of underserved patients, we want to see more health centers engaging in great partnerships with their vendors. This is why we closed this session out with a few tips from Senior Account Executive, Sara Christenson.

  • Help your patients by letting them know what’s going on and giving them the option to opt out of text campaigns.
  • Segment — the more personal the campaign, the higher the response. Consider options like demographics, quality measures, specialty, condition, and providers. 
  • Ask your patients how they’re doing. Don’t just send them information, remind them that you care.
  • Look for actionable insights that can drive impact with both clinical efficiencies and with patients. 
  • Highlight the things you’re doing right! Positivity is important to maintaining forward momentum.

Most of all, your exploration of text messaging should be a team effort that involves your staff, clinicians, local providers, and most importantly, the patients you work so hard to serve.

Presentation Highlights Video:

Full Presentation Video:

If you’d like to learn more about ChapCare’s experiences with text messaging, take some time during your next break or commute to sit down with the webinar, or consider downloading our in-depth case study here.

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