Navigating Digital Care Management Transformation at Health Services for Children with Special Needs (HSCSN)
In a recent webinar hosted by the Association for Community Affiliated Plans, Anna Dunn, the president of Health Services for Children with Special Needs (HSCSN), shared her experience implementing digital care management transformation with Dr. Sandhya Gardner, Chief Medical Officer of HealthEdge.
The discussion underscored how digital tools can improve care for vulnerable populations, foster engagement with enrollees, and create efficient workflows for care management teams. Dunn also emphasized that following change management best practices is vital for achieving new digital capabilities and desired organizational outcomes.
Serving a Community with Complex Health Needs
HSCSN, a Medicaid-managed care organization and subsidiary of Children’s National Hospital in Washington, D.C., supports children and young adults with disabilities in underserved communities. The health plan focuses on high-risk populations with complex clinical and social needs, such as physical and intellectual disabilities and behavioral health conditions.
To improve enrollee engagement and streamline care workflows, HSCSN embarked on a care management digital transformation journey.
Why Digital Transformation Now for HSCSN?
Historically, HSCSN did not leverage technology to manage care. However, Dunn noted that the COVID-19 pandemic drove demand for digital engagement offerings, as enrollees increasingly used digital health tools out of necessity.
HSCSN’s enrollees now use smartphones broadly, and their feedback emphasized expectations and the need for digital tools that streamline communications and support care coordination. This shift led HSCSN to prioritize digital transformation to bridge communication gaps and offer real-time, omnichannel support to meet enrollees’ evolving expectations.
“Enrollee engagement is not a care management issue, it’s an organization-wide strategy and priority. Every single employee of the health plan bears responsibility for being part of that enrollee engagement.”
Anna Dunn, President of Health Services for Children with Special Needs (HSCSN)
The push for digital transformation at HSCSN reflects a broader trend among health plans nationwide. With rising member expectations and regulatory pressures, health plans must adapt to provide digital access and more effectively meet member needs, especially for populations with the most complex health needs.
Rethinking Care Management
Integrated Care Management combines digital engagement technologies with traditional care management workflows to deliver personalized, coordinated care. At HSCSN, this approach addresses enrollees’ complex needs through a team-based model enabled by digital engagement integrated with modern care management workflows.
To enable this integrated model at HSCSN, the health plan chose GuidingCare® and Wellframe from HealthEdge to connect care managers and enrollees in real-time. GuidingCare supports person-centered care management workflows, while Wellframe enables digital engagement. Together, these tools offer mobile access, secure messaging, and seamless communication, reducing administrative burdens and allowing care managers to focus on quality interactions.
Change Management Strategies: Lessons Learned from HSCSN
Dunn emphasized that the transformation to Integrated Care Management must be supported by best practices in change management. The key lessons learned by HSCSN include the following:
1. Overcome Trepidation Through Champions
Dunn emphasized that resistance to change is a natural response to digital transformation, especially for care teams already carrying heavy workloads. To overcome this, HSCSN worked to validate the perspectives of diverse team members and created a supportive environment that leveraged internal champions. These champions played a crucial role in fostering enthusiasm and mitigating resistance.
“What we did leverage is the enthusiasm of our champions… this enthusiasm is contagious. They really saw this as an opportunity to reduce their workload, to reduce administrative burdens, and increase efficiency.”
Anna Dunn, President of Health Services for Children with Special Needs (HSCSN)
2. Foster Internal Alignment and Collaboration
HSCSN recognized that successful digital transformation required buy-in from the entire organization. By positioning digital care as an organization-wide initiative rather than a single department’s responsibility, HSCSN fostered a collaborative environment where each team was invested in enrollee engagement as a shared priority. Its quality team also designated enrollee engagement as a quality improvement initiative, ensuring accountability and focus.
3. Choose the Right Digital Transformation Partner
Dunn emphasized that HSCSN’s approach to selecting technology to enable its transformation was to find a partner who was not just a vendor. According to Dunn, HealthEdge provided technical expertise, holistic best practices, and thought leadership, including introducing HSCSN to other health plans for shared learning. This partnership was integral to the project’s success.
4. Take a Stepped Approach to Change
HSCSN implemented new tools in phases, starting with a pilot program to gather feedback and address any challenges on a smaller scale. This incremental approach allowed the organization to refine the process, ensuring a smoother transition for staff and enrollees.
5. Be Clear About Desired Outcomes and Measure Them
HSCSN prioritized clear, measurable outcomes to evaluate the success of its digital transformation, focusing on the value that integrated care management could bring to the organization and its enrollees. The key areas where they have focused on measuring the value of their digital transformation are:
- Market Competitiveness—HSCSN aimed to differentiate itself in the Medicaid market to improve the growth and retention of enrollees in a competitive landscape.
- Enrollee Reach—Increasing the number of enrollees actively engaged with digital tools was essential for expanding reach and ensuring that more enrollees could benefit from personalized, accessible care.
- Enrollee Experience—HSCSN tracked enrollee satisfaction to assess the quality of the digital experience that featured new capabilities such as mobile access, real-time communication, and educational resources.
- Utilization Management and Quality Outcomes—HSCSN focused on improving operational efficiency and health outcomes. Metrics included reductions in medical costs, improved care quality, and efficiency gains.
This approach to measuring value and progress allowed HSCSN to continuously refine its approach, ensuring that digital transformation met both organizational goals and enrollee needs.
Take the Next Step Towards Integrated Care Management
Through thoughtful planning, a strategic partnership with HealthEdge, and a commitment to person-centered care, HSCSN has created an Integrated Care Management model that enhances their enrollees’ experiences and streamlines care workflows.
For health plans across the country, the journey toward digital transformation is an opportunity to improve member engagement, streamline workflows, and meet the growing demand for personalized, accessible care. As demonstrated by HSCSN, a strategic, phased approach to digital transformation—supported by strong partnerships and a commitment to measuring impact—can create lasting, meaningful change for health plans and vulnerable populations.
To learn more, view the recorded webinar here and visit HealthEdge.com to explore solutions for Integrated Care Management.
