Data Sheet: Closing Gaps In Care Through Better Member Relationships
Building stronger member relationships can help your health plan access vital care gap information while improving the quality of member outreach and communications.
Closing gaps in care is a significant challenge for health plans, directly impacting member health outcomes and increasing healthcare costs. To effectively address these gaps, health plans must cultivate stronger member relationships by leveraging data and advanced digital engagement tools.
Key Challenges in Data Utilization:
- Claims Data: While valuable, claims data is often incomplete, inaccurate, or outdated. It frequently lacks a comprehensive view of a member's health history or crucial social determinants of health (SDOH).
- Telephonic Outreach Data: This traditional method is costly and time-consuming. The data captured is often inconsistent and poorly integrated, failing to provide a holistic view of the member's health status.
Strategies for Closing Gaps in Care:
Health plans can overcome these challenges and improve outcomes by adopting a digital-first approach.
- Integrate Multiple Data Sources: By consolidating data from claims, electronic health records (EHRs), and SDOH information into a single digital platform, health plans gain a comprehensive view of each member.
- Leverage Digital Care Management: Modern Digital Care Management solutions use AI and machine learning to analyze data, identify at-risk members, predict effective interventions, and personalize outreach through preferred channels like email, text, or mobile apps.
- Improve Health Literacy: Health plans must provide clear, easy-to-understand health information. Using plain language, visual aids, and digital resource libraries empowers members to take a more active role in their health decisions.
- Provide Proactive Support: Utilize data analytics to identify high-risk members and offer preventive care, health coaching, and condition management support. Automating reminders for appointments and medication refills frees up care teams to handle more complex cases.
By empowering care teams with integrated data and advanced digital tools, health plans can effectively identify and close gaps in care, leading to improved member engagement, better health outcomes, and a more efficient healthcare system.
