Demystifying Digital Care Management Integrations with HealthEdge®
Unlocking the Future with Digital Care Management Integrations
There has been a lot of talk about digital member engagement and integrated care management in the market today. But for many payers, these phrases seem vague and lack the specificity that is needed to pinpoint what exactly is needed to pursue and achieve this heightened state of care management. Questions such as, “Where should we start our digital journey?” and “How will we measure return on investment?” and “How can I put even more work on my already overwhelmed care managers?” and even “Will my members embrace digital tools?” are often asked.
HealthEdge® is helping payers answer those and many other questions about the pursuit of transforming their traditional care management strategies into high-performing integrated care management strategies that leverage modern, digital engagement capabilities. This fusion aims to enhance health outcomes and reduce costs through seamless digital care management integrations.
Integrating Traditional and Digital Care Management
For HealthEdge, integrated care management means the integration of digital engagement technologies with traditional care management workflows to help members, care managers, and health plans deliver better health outcomes and lower costs.
To help payers accelerate their digital care management journeys, HealthEdge made available an integrated solution that brings together GuidingCare® (the company’s traditional care management platform) and Wellframe™ (the company’s digital member engagement platform). The integrated solution enables payers to easily combine clinical data and real-time member insights to create one streamlined mechanism that empowers care managers to meet members where they are on their own terms. Extending the care manager’s reach to members with clinical use cases across the risk pyramid, Care-Wellframe enables health plans to effectively transform care management and drive tangible business impact.
The Care-Wellframe solution also brings a wide range of capabilities and insights to care management team members. Care managers are empowered to more effectively reach and support members while reducing cognitive and administrative burdens.
The solution enables the following integrated care management capabilities:
- Omnichannel communications that help care teams meet members where they are, on their own terms
- Prioritization of care manager outreach based on Alerts and Insights that indicate members who need urgent support
- Access to clinical education resources, benefit plan information,
- and community SDOH resources
- Seamless data sharing between the GuidingCare and Wellframe solutions, eliminating duplicate data entry and working in two disparate systems
Building the Business Case for Integrated Care Management
We sat down with one of our long-standing GuidingCare customers who recently chose to implement Wellframe and asked, “What benefits does your organization plan to see from leveraging both GuidingCare for traditional care management and Wellframe for digital member engagement?”
Here are some highlights of what they expect to see once their integrated care management strategy is fully underway.
Health Plans:
- Mitigate costs and achieve higher industry performance ratings (i.e., Stars) to remain competitive
- Improve effectiveness of health interventions and contain care costs
- Increase member satisfaction, engagement, retention, and enrollment
Care Managers:
- Improve clinical outcomes for members with acute and chronic conditions
- Quickly access up-to-date, actionable member information
- Reduce “swivel chair” and administrative burden of switching between systems
Members:
- Easily navigate their care program and health plan resources
- Obtain answers quickly to eliminate health barriers
- Become active participants in their own healthcare journey
Embracing Digital Trends in Healthcare
In HealthEdge’s recently published Annual Member Expectations and Satisfaction Report, we see that today’s healthcare consumers are becoming more and more comfortable with modern, digital technology when interacting with their health insurance provider.
- 64% of members say they are comfortable using mobile applications to access their health information.
- 65% of respondents said they would likely be interested in health insurers who provided AI-powered tools to deliver more personalized services.
As today’s consumers become more tech-savvy in their everyday lives, they expect to have similar digital capabilities available when interacting with their health insurance providers. This trend underlines the importance of adopting digital care management integrations to meet the evolving expectations of consumers. Embracing digital technologies, like Wellframe, that can support bi-directional, asynchronous communications between members and care managers is becoming more critical to success. These integrated care management solutions help care managers more effectively and efficiently engage with members and help members become more active in their care plans and achieve better health outcomes
To learn more about how integrated care management solutions like Care-Wellframe can help your organization accelerate its digital transformation journey, visit our eBook on Integrated Digital Care Management.
