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Join the RISE team as we chat with industry leaders and explore ever-changing policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health. Produced by RISE, the number one source for information on all things Medicare Advantage.
RISE Radio
Episode 29: Agile Engagement: A Cost-Effective Path to Better Member Behavior
Join RISE Radio Editorial Director Ilene MacDonald for this 15-minute episode that explores how agile engagement replaces slow, campaign-centric outreach with rapid testing, hyper-personalization, and real-time learning that lower cost of care and raise member trust.
Our guest is Kathleen Ellmore, cofounder and managing partner of Engagys, a health care consumer engagement consulting and advisory services firm, who shares proof points, practical steps, and why 2026 is the moment to act.
About Kathleen Ellmore
Kathleen Ellmore, cofounder and managing partner of Engagys, is one of the earliest pioneers in bringing the best of consumer marketing and data-driven methodologies to health care. Instead of getting you to eat when you are not hungry and buy things you don’t need, Ellmore uses the same strategies to instead change the health equation in America.
Ellmore previously led the consumer engagement consulting practice for Welltok (formerly Silverlink) for 12 years, leveraging its data repository of over a billion consumer health interactions, the best of behavioral economics, and the latest in clinical research, to create evidenced-based communications on what works to drive consumer health care behavior yielding better outcomes and lower costs. She is often quoted in the trade and national press and is a regular speaker on the national stage, having spent the first 20 years of her career in brand marketing at leading consumer marketing organizations, including General Mills and P&G.
She also was a vice president at Digitas, a leading direct marketing firm. Recently she was selected as consultant member of the first ever FDA’s Patient Engagement Advisory Committee.
About Engagys
Founded in 2017, Engagys is a leading health care consumer engagement consulting and advisory services firm. With decades of combined experience in health care and having deployed hundreds of engagement and marketing projects, Engagys has driven significant value in revenue generation, consumer behavior change, and more.
Hello, and welcome to the latest episode of RISE Radio. I'm your host, Ilene MacDonald, the editorial director at RISE. Today we'll be discussing agile engagement, an approach to member engagement that aims to change patient behavior as well as lower the cost of care. Helping me to understand this approach is Kathleen Ellmore, co-founder and managing partner of Engagys, a health care consumer engagement consulting and advisory services firm. Kathleen, thank you for joining me. It's always a pleasure to talk with you. I always learn so much. Welcome. I thought we could start by talking about the current state of health care engagement. What have you found that works and what is no longer working?
Kathleen Ellmore:Sure. So, you know, we're right now, we're kind of at this tipping point where we have to change the way we're doing things, or some of these health plans won't survive. And then the biggest area that we impact is consumer behavior change to drive down cost of care. And we do that by helping them instantiate agile practices that have been used, you know, industries, across industries for three, four, or five decades , starting with the American Expresses of the world. Every single interaction a consumer has with an organization, they learn from, and they learn from to get better and better of how to, you know, help you along the journey, of how to drive your behavior in ways that are win-wins for the organization and for the consumer. And so that's the discipline and methodologies that we're bringing to health care. And we're already seeing radically transformative results.
Ilene MacDonald:You know, you do you talked about those results, I think, in a recent blog post that I read, and you talked about how it's lowered the cost of care, this agile engagement. And I wondered if you could talk a little bit more about what does that actually mean? I had never heard of it and how does it work?
Kathleen Ellmore:I'm so glad you asked because I think there's some kind of misperceptions around agile engagement. And so, you know, kind of the word agile means just that, agile. The current state of health care communications across health plans is very campaign-centric. And a lot of times, because of the compliance and the brand and the lead times and the kind of challenges around getting data, it can sometimes take up to six months to actually from kind of beginning idea to getting the campaign out the door. And the problem with that is this if you are going to do an A-B test within a campaign, what you want to do is have it be agile so that immediately as you start to get statistical significance on choice A, you know, A is winning and B's not, you can then change what you're doing to kind of put more people into the A bucket or add test C. And the reason that works is that we are in this kind of world of health care diversity. So we have 500 things we need consumers to do, and we have all kinds of different people we need to get to do them, need these, you know, to get to do these actions. And so I always joke when I was at Cheerios, I had a very narrow target, affluent moms with brand new babies. And I needed them to do one thing, buy Cheerios. I didn't even need them to eat Cheerios, frankly, as long as they kept buying them. So when we come to health care, there's no way to one human can possibly know all of the different messages, hundreds of different messages across all of the hundreds of different interactions. Instead, we've got to build these agile systems because Ilene, what you need to motivate a mammogram or a colorectal screening is different than what Lindsay needs, right? And so we've got to continue to learn and peel back that onion to get better and better. When we apply these practices, they work in spades. So I'll give an example. We just launched a program where in a six, we took a campaign production from six months to six weeks. And in that six weeks, we 10x'd what they were doing. And it doesn't stop there. Like they're all excited about the 10x. We're like, well, no, that was just the first round. Now we're gonna take all those insights we learned from the A through G testing, and we're gonna put them back into that next round to get better, smarter, drive better results until we really build up this bolus of know-how around who needs what intervention to drive what action to drive better experience.
Ilene MacDonald:You talked about that example of that 10 times, but can you elaborate on what that involved and what you were trying to achieve and how much it saved and what do you got people to do?
Kathleen Ellmore:Sure. So we um so hyperpersonalization is a buzzword, but for the most part, most plans are using like maybe three, maybe four data attributes. Sometimes we're looking for 17 different data attributes on use case A, maybe it's ER diversion. There's a different set of attributes, maybe it's like 22 for use case B, get your well visit, right? And knowing which data attributes to bring to which use cases makes all the difference. So let me give you an example. Hyperpersonalization and ER diversion. The way ER diversion runs these days is somewhere around June, a health plan will say, oh, you know what? It's time for an ER diversion campaign to remind people why they should start with their urgent care clinic for things that are avoidable asthma, headaches, things like that. But instead, imagine this world, Ilene, where you are hooked up to the ADT feeds or your health plan communication group is. All of a sudden you go for a headache to an ER in January. As you're walking out the door, you get a text that says, Hey, Ilene, sorry about your headache. Do you know that you could have saved $700 from your out-of-pocket deductible cost instead by going to these three urgent care clinics that are both near you and in your network for benefits, right? That's a whole different world. By the time you get that diversion campaign in June, you almost forgot you went. And then by the time you go back to it the next year, again, you forgot about that campaign. So by hyper-personalizing at every step of the journey, A, it becomes next best action on steroids because now the journey is about what you're doing, Ilene, and what our reaction to your actions are. And then you feel like, okay, the plan knows me. They are trying to help me. And so you pay more attention because these are now communications for you versus kind of a public service announcement of, hey, it's time to get your mammogram. Everyone should get mammograms.
Ilene MacDonald:Right, right. Sort of like what Amazon does for me when I order something and then based on maybe I would be more interested in something else...scary but very effective.
Kathleen Ellmore:Very effective, because you know what? At the end of the day, you are too busy. We're all too busy. We're living in a tsunami of information overload. If it is not hyper-targeted on something that's relevant to you, it becomes noise. It's the only way our brains can process all of this information that's coming at us constantly.
Ilene MacDonald:You know, you mentioned earlier that other industries have done so well with it, like finance and tech. Why is health care so slow to adopt when these other industries have done so well with them and have been so successful?
Kathleen Ellmore:Sure. Well, it's two things. One is it's the data and the know-how. So I'll talk about the data first. American Express, Netflix, you know, Apple, they're already designed to be consumer-centric. And so the way they capture the data is in a consumer-centric sort of way. And health plans started out to be employer-centric. And so they're trying to get consumer-centric, but they're up against legacy technology, siloed processes. And so kind of it's a lot more challenging to find the 17 different data attributes for this case across 40 different data puddles versus the 22, you know, attributes off that use case. And so they have a big data challenge problem. Sometimes when we go in to get all the data we need, we're kind of going through six different groups or five different groups to pull this, these flags versus that flag. And so it just takes time and it's a lot of work. But again, setting up kind of this consumer centricity changes the game and being able to run agile. Even if you don't have a CDP platform, at least finding a place that you can park the data attributes to prove the models, like even a SharePoint, can work wonders. The other piece is the know-how. And that goes back to what I said about really the fact that we have all of these different walks of life and populations, and then we have all of these different actions. And because we haven't been doing A-B testing that long, we've been doing it for about 20 years in our world, but in terms of the industry adopting it, it's really behind. And so, you know, we're kind of in our infancy of really understanding what works for which individuals to drive which actions. And so, I see a lot of talk about applying AI to engagement, but AI, it doesn't create know-how, it exposes who has it. And so as you think about kind of standing up, getting your data right, getting your methodologies right, then adding your AI, you're gonna get a lot better outcome from that, from that process.
Ilene MacDonald:Are there any thoughts that you have, because you mentioned some of the barriers that are sort of in place, those siloed processes, the legacy systems. How can health plans overcome this f start addressing this kind of approach?
Kathleen Ellmore:I love that you asked. You know, we always talk about kind of moving a health plan, is like moving the Queen Mary. And so we know that it takes time, it takes investment. And so we actually end up what we call agile speed boats. We'll launch agile speedboats to be kind of running alongside the Queen Mary while it's very slowly turning into the North Star. because what happens is if you can do it that way, you start proving the value that then drives the additional investments to go faster and accelerate moving that Queen Mary towards centricity.
Ilene MacDonald:I love that analogy. That's really great. Kathleen, how quickly can a health plan realistically expect to see sort of a measurable cost of care reductions from this approach?
Kathleen Ellmore:Sure. We've for many plans, large and small, we've taken their production time from six months to six weeks. And if you pick something that has a quick turnaround and response curve, you could start seeing value immediately. So, you know, something like ER diversion, it's a really a year-over-year measurement. And so that's, you know, that's not one that you're going to be able to measure the value in weeks, right? But if you pick something else like click here to schedule your screening or, sign up for lower cost med, you can very quickly start seeing the value. And then, within that, in some of these campaigns, we've helped see tens of millions of dollars at scale from just one campaign.
Ilene MacDonald:Amazing. And you mentioned small plans that you've done this. So it can work, whether you're a big plan or maybe a smaller plan that doesn't have as many resources.
Kathleen Ellmore:Yeah, so they both have their advantages. In a smaller plan, sometimes it's easier for them to get the data because they can walk across the hall and knock on their friend's door. And a larger plan, you know, usually their data that, they have every technology known to man, so that's great, but they do have more data silos. But the real kind of trick comes within the A-B testing world. So at a larger plan, we have more volume. And so we might be able to do an A through F test. And a smaller plan, we get more creative and we set up what they call fractional factorials so that we can actually look at multiple tests and still keep statistical significance. So sometimes a plan will say, Oh, I'm too small to do a ton of A B testing, and we're like, actually, you probably aren't. Let me show you how. And so it just gets a little bit more creative, and maybe we run, you know, five tests in the first campaign instead of 12 tests in the first campaign, but we still can learn a ton and really dramatically change results.
Ilene MacDonald:You know, as health plans, there's so much pressure right now between cost, outcomes, never mind all the regulatory pressure. Where do you see agile engagement making the biggest impact in the next couple of years?
Kathleen Ellmore:We're seeing the plans that adopt that are adopting it are already, you know, they they're they're seeing transformative results. And so around cost of care. That's what everyone's pain point is these days. How do we lower cost of care? We've squeezed the doctors, we've done policy changes, we've, you know, narrowed networks. But really, kind of this last frontier is helping consumers both through transparency so they understand their choices better, but also agile engagement so that they're so that we're learning from their choices, we're learning from the interventions, and so we can get better and better relevance, better and better personalization until they truly feel they have a journey of one. And once they have that journey of one, they will understand how their choices impact their health, understand the choice, impact their costs. We've actually done communications where that have been measured in transactional set and have had consumers say, gosh, I finally understand what I'm being asked to do. And so it's easier to take that step. Whereas sometimes when we kind of pull back the aperture and it's more general, it's harder for consumers to say, oh, what do I need to do next to make this happen?
Ilene MacDonald:You know, it's so hard because we agile engagement seems so big to me. But if you could give plans who are listening today one takeaway about why they should consider agile engagement and the value of it, what would it be?
Kathleen Ellmore:I would say pick your highest value cost of care use, you know, cost of care reduction use case and try it. And get out there. And if you're doing three data attributes, make it your goal to do, 12 different personalization attributes or 15. And you'll start to see radical improvement because, again, the more relevance and transparency and impact on them and their lives and their costs for consumers, the more they will be, they will look at you as a trusted partner in this journey.
Ilene MacDonald:And before I let you go, it's always so nice to talk with you. Anything I didn't ask that you think would be important for our listeners today to think about in this new world we're living in and of member engagement.
Kathleen Ellmore:I think they can't wait. I think enough people around them are adopting this, seeing the value, and running fast. So if you're not doing it, 2026 is the year to do it. And also, like I said, your SAT will go up because consumers are frustrated, and we know they're frustrated. They want to have more transparency, more understanding of costs, and they look to you, health plans, as the partner in navigating those benefits and costs to the best way possible.
Ilene MacDonald:Thank you so much.
Kathleen Ellmore:Thanks, Ilene. Always a pleasure. Great to see you.