Case Study: Denver Health Medical Plan Customer Spotlight
Member populations have escalating needs. Meanwhile, digital healthcare and care management solutions have created an opportunity for big returns on care management dollars.
Next-Gen Care Management at Denver Health Medical Plan
Denver Health Medical Plan (DHMP), a nonprofit health plan embedded within a safety net hospital system in Denver, Colorado, is navigating the complexities of Next-Gen Care Management with the help of HealthEdge’s GuidingCare and Wellframe solutions. This Customer Spotlight highlights DHMP’s strategic approach to transforming care management despite limited resources, aiming to optimize existing tools and improve the overall member experience.
Key Challenges and Solutions
1. Member Population Complexity:
- Over 120,000 members, primarily Medicaid beneficiaries.
- High rates of chronic disease, behavioral health issues, and social determinants of health challenges.
2. Optimization of Existing Resources:
- Leveraging GuidingCare for enhanced care management.
- Conducting an environmental scan to identify and upgrade necessary tools.
- Collaboration with technology partners to maximize tool usage.
3. Transformation for Better Work:
- Improving care management processes to create more comprehensive patient profiles.
- Increasing member engagement through multiple communication channels.
- Realizing that transformation doesn't make work easier but improves the quality of care.
Collaborative Success and Future Prospects
GuidingCare Ride-Alongs:
- Collaborating closely with GuidingCare representatives to identify gaps and optimize tool usage.
- Enhancing the efficiency and satisfaction of care managers.
Continuous Improvement:
- Recognizing the importance of ongoing upgrades and optimizations.
- Planning to integrate additional HealthEdge solutions like Wellframe for extended care reach and improved member engagement.
Looking Ahead
DHMP’s ongoing partnership with HealthEdge demonstrates that even resource-limited health plans can achieve significant transformations in care management. By reassessing current resources, leveraging partner support, and continuously optimizing existing tools, DHMP is paving the way for innovative and effective care management.
To learn more about how HealthEdge solutions can help your health plan succeed, visit HealthEdge.
