How Digital Care Management Can Improve Effectiveness of Healthcare Interventions

August 8, 2024

HealthEdge

For healthcare payers, offering digital health solutions to members is no longer a novelty—it has become table stakes for organizations looking to improve engagement and outcomes. The right digital tool can elevate care management interventions and help health plans make a greater impact on more members than with traditional care management alone.

Wellframe’s digital care management solution is designed to improve the effectiveness of healthcare interventions by equipping care management staff with the insights needed to close gaps in care and improve clinical outcomes in less time. One study even demonstrated $1,923 in cost savings per member over a three-month period.

Table of Contents:

How Wellframe digital care management enables cost savings

Increasing member engagement with care management resources

Engaging members in their own care management is critical to achieving long-lasting improvements in clinical outcomes. Wellframe transforms traditional member engagement using a comprehensive digital platform, which is designed to meet members where they are.

By offering a library of accessible self-service resources, Wellframe empowers members to manage their health proactively. Members can read articles relevant to their health conditions and benefits coverage at any time using the app and follow up with their care teams later. Instead of enduring the inefficiencies of phone tag or trying to find reliable information online, members gain a trustworthy, streamlined channel to connect with their care teams, improve their health literacy, and manage their health effectively.

Enabling Real-time Health Interventions

Wellframe enhances the ability of care managers to deliver timely and effective interventions. The platform also triages members based on risk level, ensuring care teams stay informed of urgent member needs. As members complete digital surveys and assessments, chat with their care teams, and submit biometric data, Wellframe notifies care teams of critical insights that necessitate immediate follow-up.

This proactive approach ensures that potential issues are addressed promptly, thereby improving overall care outcomes and increasing trust between members and their care teams. Improving the effectiveness of healthcare interventions can also positively impact quality scores such as HEDIS and Star ratings through improved clinical outcomes and care gap closures.

Enhancing Member Outcomes with Advanced Digital Care Management

Lowering Blood Sugar Levels

Nearly 1 in 10 Americans have diabetes, and about 1 in 5 don’t know they have it. Properly managing diabetes is crucial to preventing life-threatening complications like chronic kidney disease, nerve damage, and liver disease. Diabetic members using Wellframe’s digital care management programs have shown significant results:

Prediabetes: Up to a 10.9% reduction in blood sugar.

Diabetes: Up to a 25% reduction in blood sugar.

These improvements are achieved through Wellframe’s comprehensive Diabetes and Prediabetes Support programs, which include educational resources, biometric tracking, and secure messaging with care teams.

Managing Hypertension

Managing hypertension effectively can prevent severe health complications and readmissions. Members using Wellframe’s app demonstrated impressive results:

Stage 1 Hypertension: 7% reduction in blood pressure.

Stage 2 Hypertension: More than 9% reduction in blood pressure.

Wellframe’s digital care programs, including Adult Biometrics, provide integrated tools for logging and tracking health data such as blood pressure, blood sugar, step tracking, medication reminders, and more.

Measuring Impact and ROI

Effective care management interventions can significantly reduce healthcare costs in the long run. With Wellframe, healthcare providers can achieve notable savings by reducing unnecessary emergency department visits and readmissions. In one study, members who used the Wellframe app after being discharged from a hospital stay reported a 33% reduction in subsequent readmissions and a 25% reduction in ER usage over the following 30 days.

Higher HEDIS and Star ratings not only improve a health plan’s competitiveness in the market, but also lead to increased member enrollment and federal bonus payments. In a recent study of members enrolled in Wellframe’s maternal health program, health plans reported an 8% increase in HEDIS PPC outcomes, higher prenatal visit rates, and decreased third-trimester ER utilization. These metrics are essential for health plans aiming to optimize their financial performance and member satisfaction.