80% of health outcomes are determined by all the factors that happen outside clinical care. But traditional, episodic support gives staff an incomplete picture of all those factors that can cause adverse outcomes.
Limited visibility
When health insurance plans extend the reach of digital health, they can give staff a continuous view of members throughout their healthcare journey. For example, mobile surveys can be used to uncover whether a member has recently been diagnosed with a health condition that the plan may not have on record. Plus, biometric monitoring generates novel data that can inform earlier interventions.
Greater insight
Throughout their health journey, your members’ needs may be ever-changing. That’s why it’s critical to offer a digital experience that helps members address all their health needs in one place, whether it’s daily mobile support for lifestyle changes or digestible guidance about healthcare costs and coverage.
Unified experience
When a member needs help understanding a bill, finding a provider, understanding their benefits, or managing a health condition, they may need to turn to a variety of apps, tools, or phone lines to get help.
Fragmented resources
1 in 4 Americans have multiple chronic conditions. But many health plans organize care teams and point solutions, such as member apps, around particular disease states. As a result, the individual guidance a member receives may not reflect their overlapping symptoms or conditions, or the lifestyle and socioeconomic factors that are critical to improving health.
Generalized approach
When members receive proactive daily support from the care manager in the form of mobile, articles, reminders, and messages, they will feel supported from the start. Then, when the care manager reminds the member that it’s time for an annual screening, the member understands why this appointment is relevant to their overall health goals.
Organized around member goals
Oriented around health
plan goals
Clinical and customer service resources should be connected through a digital health management platform, promoting accountability and collaboration across teams and resources, with built in checks and balances that prevent critical care gaps or missed opportunities.
Coordinated services
When a customer service representative learns from an inbound call that a member could benefit from care management, they can only conduct a warm handoff via phone transfer, email or chat—resulting in a disconnected experience for members and staff alike.
Siloed support
Hospitalized for Pneumonia
Assessment
call
Hospitalized for Pneumonia
Gets a cough
Miss follow-up
appointment
Stops taking
medication
Job stress, depressed
Assessment
call
Traditional
touchpoints
Continuous
consumer journey
Traditional
touchpoints
Continuous
consumer journey
Traditional
touchpoints
Continuous
consumer journey
Traditional
touchpoints
Continuous
consumer journey
Traditional
touchpoints
Continuous
consumer journey
Traditional
touchpoints
Continuous
consumer journey
Traditional
touchpoints
Continuous
consumer journey
Traditional
touchpoints
Continuous consumer journey
Traditional
touchpoints
Continuous
consumer journey
The first touchpoint in care management is often a long set of assessment questions. After which, the care manager informs the member they need a screening, such as a mammogram. Once they hang up, the member may or may not follow through with scheduling the appointment.
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Plans should utilize interactive surveys to screen for social determinants such as transportation, financial concerns, social support, and safety that may act as barriers to medication adherence and better health management. Organizations should then deliver personalized health education tailored to those needs, within the context of clinical needs, so the member can visualize how therapeutic lifestyle changes can have a positive, direct impact on health.
Personalized health support
Traditional
touchpoints
Continuous
consumer journey
