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How A Fortune 25 Payer Raised Comprehensive Medication Reviews By 20%

See how conversational outreach helped a Fortune 25 health insurer drive hard-to-reach audiences to complete CMRs.

The Importance Of MTM

Medication Therapy Management (MTM) allows health insurers to work with pharmacists to improve health outcomes for plan members. A key component of MTM is comprehensive medication reviews (CMRs). During a CMR, a pharmacist assesses a member’s medications for appropriateness and potential interactions and side effects.

A Fortune 25 payer found that certain members were difficult to contact about CMRs with its current outreach methods. In order to better serve these members, the payer needed an innovative approach.

Challenge: When Audiences Just Won’t Respond

The Fortune 25 payer approached Drips for help with a particularly hard-to-reach segment of their audience. These members had previously been called by a pharmacist upwards of 19 times with limited progress toward completing their CMR.

There can be many reasons that members don’t respond. Some may not prefer traditional channels like outbound calling and direct mail. Others may not be available during standard business hours. Drips built a customized campaign that would take a different approach to reach these members.

Solution: Conversations as a Service

Drips implemented a managed service conversational outbound strategy that used SMS, visual voicemail, and scheduled calling. This approach gave members multiple ways to engage without requiring them to answer the phone or be available at a specific time. Critically, this outreach came from Drips’ AI-powered platform, so members could receive as many touchpoints as needed without an increased headcount for the payer. Even better, Drips worked with the payer to create this campaign from start to end, making the process much easier than a do-it-yourself approach.

Results: Lift In Multiple KPIs

Drips’ conversational outreach proved to be an effective way to reach a previously non-responsive audience to complete CMRs. After investing in a solution to reach these members, the payer saw a 3% increase in its CMR completion rate. Throughout its partnership with Drips, the payer achieved an overall lift of 20% in completed reviews. Through these CMRs, pharmacists identified over 26,000 drug therapy problems for members. The payer was able to resolve nearly 50% of those problems, which could have a significant positive effect on member health outcomes. By increasing its CMR completion rates, the payer was able to increase its Star Rating under the MTM category. In fact, Drips helped the payer achieve a four-star rating in 84% of its contracts.