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In a dynamic marketplace, member engagement helps strengthen healthcare market competitiveness for healthcare payers. Health plans that leverage digital engagement solutions can enhance their appeal to employer groups and members across lines of business while achieving substantial cost savings. 

According to the 2024 HealthEdge® Consumer Survey, one-third of health plan members are “very likely” or “likely” to switch insurance plans in the next year. Personalization, transparency, and convenience topped the list of factors most influencing member satisfaction.  

Use Member Engagement for Marketplace Differentiation 

Digital solutions like Wellframe can amplify the impact of healthcare interventions, increasing workflow efficiency and broadening member reach. Wellframe enables health plans to distinguish themselves in a crowded market by offering an integrated, enhancing healthcare market competitiveness by offering an integrated whole-person platform that streamlines workflows and reduces reliance on point solutions. Members can directly engage with their health plan and providers, simplifying the user experience and improving benefits access. 

Health plans that utilize Wellframe have reported significant improvements in member satisfaction, engagement, and clinical outcomes—which contribute to higher retention rates and a stronger market position. Plus, payers can leverage their integrated Wellframe offerings as a value proposition during the RFP process and open enrollment to attract new business. 

Deliver Comprehensive Benefits for Employer Groups 

Employers are increasingly looking to provide their employees with comprehensive benefits that directly affect health and wellness. Wellframe addresses this need through a range of accessible features designed to help health plans achieve organizational goals, such as cost savings, improving satisfaction rates, and reducing vendor reliance. 

Cost savings: Coordinated care management drives cost savings, reducing overall healthcare expenses. The Wellframe solution offers up-to-date information on members’ unique health needs, making it easier for care managers to prioritize outreach and deliver proactive support that lowers long-term care costs. 

High satisfaction rates: Wellframe’s staff dashboard offers tools that enable decision support and facilitate member engagement. Care managers receive alerts based on member risk data, and a HIPAA-compliant chat feature allows them to send messages for members to respond to on their own time. By offering an intuitive and accessible platform, Wellframe increases member satisfaction and engagement with their health benefits.  

Vendor Reduction: Managing multiple vendor relationships and coordinating between multiple systems can be a logistical challenge for employer groups. With more than 70 digital care programs, Wellframe eliminates the need for distinct point solutions by providing an integrated platform that supports a broad spectrum of acute and chronic conditions. The Wellframe solution streamlines administration and reduces the complexity of managing employee health benefits. 

Retain and Win New Members Across Lines of Business  

Wellframe’s platform provides a strategic advantage for retaining and attracting new members across lines of business, including Medicare, Medicaid, and Commercial populations. 

Government Lines of Business 

Achieving high member satisfaction is critical for favorable Consumer Assessment of Healthcare Providers & Systems (CAHPS) scores, which, in turn, contribute to a plan’s Star Rating. Improved Star Ratings not only enhance a plan’s reputation but also lead to increased federal bonus payments and boosted member enrollment. Wellframe’s digital engagement solutions help health plans improve CAHPS scores by providing personalized, consistent support to high-risk and rising-risk members. 

Commercial  

For commercial populations, high rates of member satisfaction can be a powerful marketing tool for attracting new members and retaining existing ones. Offering Wellframe as a solution positions health plans as modern partners in member engagement and satisfaction. Potential members will also compare health plan offerings during open enrollment to find the best fit. A member engagement solution with demonstrated results can drive interest and increase enrollment. 

It’s easier to engage members in their health by providing value upfront with easy-to-access resources and communication tools. This proactive approach significantly improves member experiences and satisfaction, leading to high rates of member retention as well as boosting healthcare market competitiveness. 

In an increasingly competitive healthcare market, member engagement and satisfaction are crucial for success. Wellframe’s digital health management platform offers a comprehensive, unified solution that enhances member satisfaction, reduces costs, and improves Star Ratings. By leveraging the Wellframe solution, health plans can differentiate their offerings, provide superior benefits to employer groups, and retain and attract members across lines of business. 

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To learn more about how the Wellframe solution can help your health plan drive member engagement and satisfaction, watch the webinar on-demand: “Using Digital Care Management to Meet Members & Care Managers Where They Are.” 

Hear about the strategies other health plans use to integrate digital engagement solutions into care management workflows and meet members across the risk pyramid. 

 In today’s rapidly evolving healthcare landscape, solutions such as GuidingCare are at the center of innovation in how health plans operate efficiently, adapt to regulatory changes, and improve internal collaboration to deliver exceptional care to members. As a core system in health plan operations, onboarding new staff efficiently and effectively to GuidingCare is crucial. Traditional training methods alone—such as live classes or reliance on dense technical documents—can result in knowledge gaps, reduced operational efficiency, and missed opportunities for new employees to become productive quickly.

On-Demand, Self-Paced Video Onboarding

GuidingCare University transforms the onboarding process by offering a flexible and streamlined solution tailored to the specific needs of health plans and care management teams. GuidingCare University provides on-demand, self-paced video modules that are easy to follow and designed to fit seamlessly into any schedule. New staff members can begin training immediately without relying on others, waiting for an in-person training session, or independently studying technical documents to learn about the GuidingCare solution suite.

Personalized Learning for Maximum Impact

One of GuidingCare University’s key features is its ability to create personalized learning paths for new staff. Each person can be assigned courses or curricula that align perfectly with their new roles and responsibilities. This targeted approach ensures that new staff receive the training they need without delay or the distraction of unnecessary information for their role.

Tracking Progress and Building Competence

GuidingCare University’s intuitive dashboard allows new staff to track their training progress in real time, ensuring they stay on track and complete their onboarding independently. This functionality can boost their confidence and give managers valuable insights into their team’s readiness. Furthermore, the platform includes knowledge assessments to verify understanding and assure health plans that their new staff members are equipped to perform at their best.

Empower Your Team with Seamless Onboarding and Training for Success

GuidingCare University enhances the onboarding process, making it more flexible, efficient, and tailored to the needs of each individual and their role. By leveraging this platform, health plans can ensure their new hires are well-prepared and fully integrated into their roles starting day one.

Learn more about how GuidingCare University can help your health plan maximize investments in new people and technologies in today’s fast-paced care environment.

Provider abrasion is an ongoing challenge for health plans, resulting in damaged trust, increased workloads, and unhappy providers. The problem usually arises from claim denials, payment delays, and cumbersome administrative processes. These obstacles not only lead to provider abrasion, but also significant financial losses, with improper payments accounting for $200 billion in waste spending in 2023 alone.

Health plans can reduce provider abrasion by adopting a payment integrity solution that uses modern technologies to improve payment accuracy and efficiency.

Factors That Lead to Provider Abrasion

In a recent Payer survey from HealthEdge®, “provider relations” followed closely behind “member satisfaction” in a list of health plan leaders’ top business concerns. These relationships are becoming increasingly important as payers and providers are expected to collaborate to achieve industry-wide goals such as reducing healthcare costs, improving clinical outcomes, and establishing effective value-based-care arrangements.

According to payers, inadequate access to real-time information and data sharing is the key contributor to provider abrasion. This is closely followed by inaccurate and delayed payments, and lack of transparency.

There are various reasons for these frustrations. When providers do not have access to updated information, they are unable to check the status of their claims or current reimbursement data. This lack of transparency can leave providers feeling confused or frustrated due to an unclear and complicated claims process. Additionally, payment delays or inaccuracies can leave providers facing potential financial stress, which can damage their reputation. Plus, the administrative burden of the time-consuming claim resubmissions and appeals process often leads to operational inefficiencies for both payers and providers.

So, how can your health plan ensure accurate, timely, and comprehensive claim payments to reduce provider abrasion?

3 Payment Integrity Features That Can Reduce Provider Abrasion

At HealthEdge Source™ (Source), our commitment to redefining payment integrity and reducing provider abrasion is apparent by the transparency and ease of use our platform offers. We have taken the bold step of rebuilding our original platform from scratch to become the first organization in the market to offer a cloud-based, interoperable payment integrity platform.

The Source solution combines cloud-based scaling capabilities, advanced automation, and an integrated ecosystem of solutions to deliver a robust and effective payment integrity platform.

1. Cloud-based Data Delivery

Our cloud-based data delivery solution streamlines claim processing, shortens payment turnaround times, and reduces provider abrasion. With all medical formats, standards, code sets, claim history, and updates accessible in real-time, Source can eliminate denials and improve claim accuracy. By ensuring your health plan has the most current and secure data available 24/7, you can decrease your reliance on outdated manual processes and fragmented solutions in favor of an effective modern solution.

And with data in the cloud, Source is laying the groundwork for integrated systems, automation, business intelligence, and other advancements in the payment integrity space and beyond.

2. Integrated Platform Ecosystem

Similar to your smartphone, HealthEdge Source’s integrated ecosystem of solutions effortlessly connects multiple claims systems to streamline key functions. Dealing with different vendors with diverse tech stacks, update cycles, and maintenance plans can be stressful. Working with disconnected systems often leads to complicated workflows and greater reliance on manual tasks, increasing operational costs and generating unpredictable outcomes. The single-instance Source solution unifies these elements, reducing administrative overhead, inaccuracies, and recovery costs.

Just as you can easily add apps to your phone, the extensibility of Source allows integration with various third-party solutions—without sacrificing quality. By streamlining these essential processes, Source can empower your health plan to foster smoother provider relationships. This approach enables your staff to focus on strategic initiatives and make more informed business decisions.

3. Advanced Automation And Intelligent Workflows

The integration of automation technologies like Robotic Process Automation (RPA) and Artificial Intelligence (AI) has caused disruptions across industries and contributed to continuous innovations. With Source, advanced automation minimizes user error during the claims process—saving time and money. Automated functions, such as eligibility and benefit verification, prior authorization, and claim management, can help simplify routine tasks, allowing your staff to concentrate on complex tasks that require human intervention.

Optimizing workflow efficiency can lead to substantial cost reductions. Health plans and providers could save nearly $25 billion annually by automating administrative transactions. Source’s innovative solutions not only enhance accuracy, but also transform the claims process, making it a game-changer for health plans and the providers they work with.

How A National Health Plan Reduced Provider Abrasion With HealthEdge Source™ 

HealthEdge Source partnered with a large national health plan to streamline their operations as they expanded their government lines of business and automated claims reimbursement. Their existing systems couldn’t handle the complexity of the new government programs, so they turned to Source to help them better manage payments and scale their operations across lines of business.

Today, more than a thousand of their employees use the solution for tasks ranging from claims operations to provider relations. The system can now handle over one million claims per month, even in complex situations. This has resulted in significant time and cost savings, with automations improving accuracy and saving millions of dollars annually. Over our 23-year partnership, the payer has significantly reduced operational overhead and improved first-pass payment accuracy, minimizing risk and strengthening their relationships with providers nationwide.

HealthEdge Source is an innovative payment integrity solution that can address the root causes of provider friction. Our platform gives health plans real-time data access, simplifies claim processing, and leverages advanced automation within an integrated ecosystem. By leveraging Source, your health plan can improve operational efficiency, build stronger partnerships with providers, and achieve significant cost savings. Here

Are you looking for more information on how your health plan can leverage content, technology, functionality, and analytics to achieve long-term organizational goals? Watch our on-demand webinar at your convenience: Avoiding Payment Integrity Pitfalls with HealthEdge Source™.

The healthcare industry, care management practices, and software that enables health plans to provide exceptional service to members are all undergoing significant changes. Market dynamics, disruptive technologies, innovations in data availability, regulatory pressures, and changing member expectations create new challenges for health plans. But they also promise a more efficient and member-centric healthcare system in the years ahead.  

 

Health plans’ adaptability and the technology that enables their transformations will remain at the forefront of strategic decision making in 2024 and beyond. Let’s explore the key trends that affect care management and raise the bar for software capabilities today. 

 

Trend 1: Rising Member Expectations 

 

According to the 2024 HealthEdge® Consumer Survey, member expectations are evolving rapidly. The survey findings indicate an increasing need for member experiences that are tailored to individual preferences, easy to access, and provide clear information about healthcare costs and coverage. Members’ expectations are increasing due, in part, to highly personalized retail experiences with commercial organizations. 

 

Health plans need to adapt to these changing expectations to stay competitive. Just as retail companies use algorithms to analyze behavior and provide personalized recommendations, health plans can utilize data to offer personalized care recommendations, wellness programs, and effective communication to improve members’ experiences. 

 

In contrast to many online retail experiences, human interaction is essential for success in healthcare. The 2024 HealthEdge Consumer Survey also shows higher satisfaction levels among those assigned a dedicated care manager, for example, but also a growing demand for high-touch care management. This highlights the importance of care managers’ access to member healthcare data, particularly social determinants of health data, to enhance personalized care. It is crucial for health plans to make people available to deliver customer service and, at the same time, to expand the self-service tools and resources that make interactions more efficient. 

 

Member expectations are also at the heart of numerous regulatory changes focusing on cost transparency and interoperability. From the Transparency in Coverage Act to the No Surprises Act, the Centers for Medicare & Medicaid Services (CMS) has stressed the significance of electronic data collection, retention, and utilization to enhance member experiences, improve health outcomes, and reduce inefficiencies in the long term. The pace of change is accelerating, pushing health plans to look further into the future, be more agile to meet member expectations, and update their requirements for a care management platform.  

 

Trend 2: Digital Member Engagement 

 

According to the 2024 HealthEdge Consumer Survey, there is a significant shift toward members looking for personalized healthcare experiences: 64% of respondents expressed comfort in using secure mobile apps to interact with their health plans. This trend is notably consistent across various age groups, underscoring the broad acceptance of digital tools for healthcare management. Today, omnichannel communications unify the member experience across websites, mobile apps, phone calls, and in-person visits, enabling seamless transitions and greater member engagement. This plays a critical role in enhancing member care management in two primary ways: 

 

• By integrating multiple channels, including mobile apps, care managers can customize interactions to individual member preferences, engage members more effectively, and focus on meaningful interventions for positive health outcomes. 

• Through streamlining processes and interactions via digital channels, health plans reduce member wait times for prescription refills, referrals, test results, etc., and empower staff to be more responsive through preferred contact methods. 

 

Adopting an omnichannel strategy, supported by modern care management software, empowers healthcare teams to provide personalized, efficient, and member-centric care—enhancing member satisfaction and improving outcomes. 

 

Trend 3: Increased Market Competition 

Historically, health plan members had limited options for coverage, and were often content to accept the narrow choices of employer-provided benefits, while seniors faced relatively straightforward decisions about Medicare. However, today’s landscape is vastly different, leading to increased competition between health plans: 

• Members now have a wide array of options. Seniors can choose from nearly 4,000 Medicare Advantage plans, offering an average of 43 options in their coverage areas. 

• CMS continues to emphasize the high weight of member satisfaction scores for the 2024 rating year, reinforcing that exceptional member experiences must be a top priority for health plans.  

• Participation in the Affordable Care Act’s health exchange marketplace, individual plans, and Medicaid has surged, leading to many new members comparing suitable health plan offerings. 

• Healthcare and government agencies focus on whole-person care that improves health outcomes and includes specialty areas such as behavioral health. Employers and health plans collaborate to create inclusive benefit plans, while integrating digital tools and virtual care options enable nontraditional care for various conditions. 

Health plans must prioritize personalized member experiences, innovative digital solutions, and cost transparency to attract members due to advancements in whole-person care, new regulations, and higher member expectations. This requires a care management platform that merges data, enables seamless care coordination, and allows effective communication with members on their terms.  

Trend 4: Social Determinants of Health and Person-Centered Care 

 

The Framework for Health Equity, from CMS, serves as a foundational roadmap to advance health equity, expand coverage, and improve health outcomes for over 170 million individuals. The framework addresses the following in pursuit of its mission:  

 

• CMS aims to enhance the gathering of individual-level demographic and social determinants of health data, including race, ethnicity, language, gender identity, sex, sexual orientation, and disability status, to ensure fair care and coverage for all.  

• CMS is dedicated to evaluating its programs and policies for unintended consequences and measuring their impact on health equity to develop sustainable solutions for closing healthcare access, quality, and outcomes gaps. 

• CMS supports healthcare organizations in reducing health and access disparities by empowering providers and organizations to address the root causes at the point of care. 

• The framework integrates health equity into existing and new efforts, driving structural change, eliminating barriers, and enhancing health outcomes through data-driven insights and personalized strategies. 

 

The focus on social determinants of health, person-centered care, and healthcare equity has increased. Modern care management systems play a key role in complying with these regulations, leveraging shared data, and coordinating care in an increasingly complex array of healthcare services. 

 

 

Trend 5: Artificial Intelligence (AI) in Healthcare 

 

The healthcare industry is investing in developing AI capabilities to streamline processes and improve the member experience, especially with the development of generative AI capabilities. Compared to other industries, healthcare has been slower in adopting these advancements, presenting a significant opportunity for improvement. Recent research suggests that increased use of AI could result in a 5-10% reduction in US healthcare spending, including member services.  

 

AI in member engagement shows promise in empowering care managers, assisting members with routine inquiries, and optimizing the care journey. Moreover, the increasing comfort with AI-powered tools reflects a growing demand for personalized and efficient healthcare experiences. About 65% of members prefer health plans that leverage AI for personalization. This technological shift enhances the member experience and enables health plans to provide more tailored and proactive care. For instance, natural language processing could be used in a chat-based interface to allow health plans to provide quick, accurate benefit details to members during live calls. This capability, combining robust data with AI-powered interfaces, will soon become a reality, streamlining benefit inquiries, improving service, and enhancing customer satisfaction.  

 

The march towards AI-powered healthcare is underway, and health plans must focus on the most impactful use cases, the right technology partnerships, how AI affects their roadmaps, and the governance required to use AI for its best purposes.  

 

Adapt to Modern Care Management with HealthEdge 

 

The HealthEdge® GuidingCare® care management software streamlines coordination across the care spectrum, automates care and service planning, and identifies high-risk populations to better enable whole-person, member-centric care. It centralizes health data to enhance care and uses advanced analytics to predict health issues for proactive intervention. The demands and opportunities of care management today lead to more health plans redefining their software requirements and seeking end-to-end solutions to grow membership and improve the care experience. 

 

To learn more about how GuidingCare can help accelerate your care management transformation, visit our infographic: “Secrets of a Successful Care Management Implementation.” 

 

Healthcare consumers are demanding more from their health plans. Personalized experiences are becoming the gold standard across industries. Many health plans are turning to digital health solutions to improve member satisfaction and engagement by tailoring healthcare delivery based on individual needs. So how can your health plan take full advantage of your technology investments to better support your members and increase engagement? 

The Rising Expectations of Healthcare Consumers 

Today’s healthcare consumers are not passive recipients of care services—they want to be active participants in their own health and wellness. Personalized and proactive outreach can build member trust and lead to stronger member relationships. According to the 2024 HealthEdge® Consumer Survey, members said personalization, transparency, and convenience mattered most in experiences with their health plans. 

To remain competitive, health plans must adapt to these evolving consumer needs. Digital health solutions enable care teams to reach more members in less time, improving clinical outcomes and reducing costs. The Wellframe digital care management platform is designed to provide personalized healthcare experiences through one convenient channel. 

Intuitive, Accessible Engagement with Digital Care Management 

Digital care management uses technology to extend the reach of care managers and streamline care delivery. Historically, health plans relied on telephonic outreach to conduct surveys and follow up after appointments. But phone calls can take a lot of time and aren’t always accessible for members. With digital care management, care teams can deliver personalized care and support to more members in less time via asynchronous communication, like HIPAA-compliant messaging. They can also send digital surveys for members to answer on their smartphones, which gives members more privacy to answer personal health questions without feeling rushed. 

With digital care management solutions like Wellframe, care teams and health plans can provide intuitive and accessible engagement opportunities as well as enhance personalization. Members can easily connect with their health plan and manage their health through a user-friendly mobile app. This accessibility is crucial in today’s digital age, where convenience and ease of use are paramount. Plus, members enrolled in digital care programs receive tailored content and proactive health reminders that ensure they feel supported throughout their health journey. 

Improve Retention and Quality Scores Through Member Satisfaction  

When members are happy with their health plans, they are less likely to switch insurance providers—reducing the costs associated with acquiring new members. Digital care management can help increase the effectiveness of healthcare interventions, empowering members and improving their experiences. Better experiences can lead to better satisfaction rates and higher quality scores, which can improve health plan ratings and make them more attractive to new members. 

When it comes to serving Medicare members, achieving high member satisfaction is critical for achieving high CAHPS scores, which contribute to a plan’s Star Rating. Improving Star Ratings has significant financial benefits, including federal bonus payments and increased member enrollment and retention. 

High rates of member satisfaction can also be leveraged for marketing purposes, helping to attract and retain member—and employer groups—across populations. According to the HealthEdge® 2024 Consumer Survey, one-third of respondents said they are “likely” or “very likely” to switch health plans in the next year. To avoid losing existing members, health plans must prioritize member engagement and satisfaction. 

Key Performance Metrics to Assess Member Satisfaction 

Wellframe’s digital care management platform delivers significant value to health plans looking to enhance the member experience. Here are a few ways the platform has demonstrated impressive results when it comes to improving member satisfaction and engagement.  

• App Store rating: The Wellframe app has a 4.7 of 5-star rating in the mobile app store, indicating that members are satisfied with the features and usability of the platform. 

• Onboarding rate: More than 50% of members who are invited to the app by their care managers fully complete the in-app onboarding process, which demonstrates the platforms effectiveness in engaging new members and the relevance of its content. 

• Increased touchpoints: On average, members enrolled in a digital care program on the Wellframe platform averaged 258 touchpoints per case—many of which were to access self-service resources. 

• Benefits utilization: Members in Wellframe’s Maternal Health digital care program reported significantly higher prenatal visits during the last trimester than those enrolled in traditional care management, along with a decrease in emergency department admissions. 

In an increasingly competitive healthcare landscape, member satisfaction is paramount. Wellframe’s digital care management platform offers health plans a way to differentiate themselves by providing a seamless digital experience and personalized interactions. By leveraging digital care management, health plans can improve member satisfaction, retention, and acquisition, ultimately leading to higher quality scores and financial gains. 

Ready to transform your member experience? Explore the benefits of Wellframe’s digital care management platform and start driving higher satisfaction and engagement. Read our blog, 4 Best Practices to Drive Member Engagement in Digital Care Programs. 

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Unlocking the Future with Digital Care Management Integrations

There has been a lot of talk about digital member engagement and integrated care management in the market today. But for many payers, these phrases seem vague and lack the specificity that is needed to pinpoint what exactly is needed to pursue and achieve this heightened state of care management. Questions such as, “Where should we start our digital journey?” and “How will we measure return on investment?” and “How can I put even more work on my already overwhelmed care managers?” and even “Will my members embrace digital tools?” are often asked.  

HealthEdge® is helping payers answer those and many other questions about the pursuit of transforming their traditional care management strategies into high-performing integrated care management strategies that leverage modern, digital engagement capabilities. This fusion aims to enhance health outcomes and reduce costs through seamless digital care management integrations.

Integrating Traditional and Digital Care Management 

For HealthEdge, integrated care management means the integration of digital engagement technologies with traditional care management workflows to help members, care managers, and health plans deliver better health outcomes and lower costs. 

To help payers accelerate their digital care management journeys, HealthEdge made available an integrated solution that brings together GuidingCare® (the company’s traditional care management platform) and Wellframe™ (the company’s digital member engagement platform). The integrated solution enables payers to easily combine clinical data and real-time member insights to create one streamlined mechanism that empowers care managers to meet members where they are on their own terms. Extending the care manager’s reach to members with clinical use cases across the risk pyramid, Care-Wellframe enables health plans to effectively transform care management and drive tangible business impact. 

The Care-Wellframe solution also brings a wide range of capabilities and insights to care management team members. Care managers are empowered to more effectively reach and support members while reducing cognitive and administrative burdens.  

The solution enables the following integrated care management capabilities: 

• Omnichannel communications that help care teams meet members where they are, on their own terms 

• Prioritization of care manager outreach based on Alerts and Insights that indicate members who need urgent support 

• Access to clinical education resources, benefit plan information,
  and community SDOH resources 

• Seamless data sharing between the GuidingCare and Wellframe solutions, eliminating duplicate data entry and working in two disparate systems 

Building the Business Case for Integrated Care Management 

We sat down with one of our long-standing GuidingCare customers who recently chose to implement Wellframe and asked, “What benefits does your organization plan to see from leveraging both GuidingCare for traditional care management and Wellframe for digital member engagement?”  

Here are some highlights of what they expect to see once their integrated care management strategy is fully underway.  

Health Plans: 

• Mitigate costs and achieve higher industry performance ratings (i.e., Stars) to remain competitive 

• Improve effectiveness of health interventions and contain care costs 

• Increase member satisfaction, engagement, retention, and enrollment 

Care Managers:  

• Improve clinical outcomes for members with acute and chronic conditions 

• Quickly access up-to-date, actionable member information 

• Reduce “swivel chair” and administrative burden of switching between systems 

Members: 

• Easily navigate their care program and health plan resources 

• Obtain answers quickly to eliminate health barriers 

• Become active participants in their own healthcare journey 

Embracing Digital Trends in Healthcare

In HealthEdge’s recently published Annual Member Expectations and Satisfaction Report, we see that today’s healthcare consumers are becoming more and more comfortable with modern, digital technology when interacting with their health insurance provider.  

• 64% of members say they are comfortable using mobile applications to access their health information.  

• 65% of respondents said they would likely be interested in health insurers who provided AI-powered tools to deliver more personalized services. 

As today’s consumers become more tech-savvy in their everyday lives, they expect to have similar digital capabilities available when interacting with their health insurance providers. This trend underlines the importance of adopting digital care management integrations to meet the evolving expectations of consumers. Embracing digital technologies, like Wellframe, that can support bi-directional, asynchronous communications between members and care managers is becoming more critical to success. These integrated care management solutions help care managers more effectively and efficiently engage with members and help members become more active in their care plans and achieve better health outcomes

To learn more about how integrated care management solutions like Care-Wellframe can help your organization accelerate its digital transformation journey, visit our eBook on Integrated Digital Care Management.