A large Blues plan uses Wellframe Digital Health Management to Drive Care Management Capacity and Member Engagement

The Challenge

Care managers are tasked with a critically important job: helping members manage their chronic or complex health conditions. But a large Blue Cross Blue Shield plan found their existing care management processes made resources hard to scale, preventing care managers from engaging with more members and practicing at the top of their license. The health plan faced several challenges in care management and member engagement. Care managers found it difficult to reach and engage members by telephone alone. Plus, time-intensive telephonic outreach meant care teams could only reach a portion of their large member populations. Lengthy phone calls can also make for a frustrating member experience—most people don’t want to be on the phone for an hour answering questions. That only makes it harder for care managers to identify and address member needs or social determinants of health

The Solution: Extending the reach of staff through digital care management

The Blue Cross Blue Shield health plan used the Wellframe Digital Health Management platform to engage more members toward better health outcomes, at scale. Their care teams leveraged Wellframe’s web-based dashboard to manage a higher volume of members. The dashboard helped care teams prioritize member outreach based on in-app activity, such as survey responses, biometrics tracking, and missed care program tasks. Using the dashboard, care managers can add members to digital care programs, send individual or group messages to members, issue digital surveys and assessments, view member app engagement, and more. With Wellframe’s mobile app, members can access their digital care programs and maintain communication with their care teams. Through the app, members receive an interactive daily checklist that’s personalized to their needs. The checklist includes surveys, digestible articles, and tips that can help them manage their health at home. Care teams can see member app activity, enabling timely support and early intervention. Members were also able to ask care teams questions on their own time and build trusting relationships through convenient, HIPAA-compliant messaging

The Results: Digital adoption unlocks efficiency and engagement

91% increase in successful calls to members

Wellframe doesn’t just add digital interactions—it can improve the performance of all member touchpoints. We found that when care managers used digital channels to establish a trusted relationship, members were more likely to answer phone calls from them.

2X increase in active caseload size

Care managers who used digital channels were able to support significantly more members compared to staff who did not use the Wellframe platform.

6X increase in interactions with members

Staff members who fully embraced digital adoption achieved more frequent engagement compared to staff members who did not achieve digital adoption. Wellframe acts as a proven partner to help customers evaluate their care team model, team capacity, and performance measures to ensure staff can use the technology effectively.