MOBILE-ENABLED CARE MANAGEMENT Implementing a Mobile-Enabled Case Management Strategy to Increase Patient Engagement Health plans are adapting their care management strategies to effectively support the evolving needs and preferences of patients living in the digital era. This white paper discusses care management s enduring challenges and presents an innovative approach to improve clinical and financial outcomes. Additionally, the paper outlines a mobileenabled care management strategy proven to engage high-risk patients, while increasing the capacity and effectiveness of care management teams.
CARE MANGEMENT IS ON THE RISE. BUT IS IT WORKING? With a persistently high prevalence of high-cost chronic conditions, increasing cost pressure and growing emphasis on value based care, care and case management have emerged as a salient medical management service among health plans and managed care providers. Over the last decade health plans and providers have invested a significant amount of financial and human resources to build and expand care and case management programs to support and engage higher risk members with the aim of better managing cost/utilization, improving quality metrics and increasing member satisfaction and retention. In recent years, the pace of investment and expansion of these programs and subsequent expected return on investment have heightened because of value-based payment programs. However, many health plans and healthcare providers remain frustrated that despite this investment, they are only reaching a small fraction of members. In theory, investments in care management should pay off in a big way. When executed effectively, care management improves clinical outcomes, drives reimbursements, reduces overall cost and utilization, and enhances patient satisfaction. But, despite its robust potential, the care management of today fails to turn expected benefits into realities. Why? According to many health plans and providers, programs are simply too limited to reach and support patients effectively, and current methods of outreach (mainly telephonic) used by these programs are not effective and helpful to patients. Mobile-Enabled Care Management 2
TODAY S PROCESS To illustrate, here s how the care management process typically works: 1. CALLING THE PATIENT The care manager (usually a nurse or health coach) makes numerous attempts to call the patient until she picks up. 2. CONNECTING Once on the line, the care manager asks the patient a laundry list of questions about how she has been doing since the last touch point, spends time educating her on relevan topics, and gives instructions for what to do between now and the next call. 3. DOCUMENTING After (finally) hanging up, the care manager manually documents notes in a workflow system. 4. REPEAT When all is said and done typically 20 to 60 minutes later the care manager repeats the process with the next patient workflow system. LIMITED REACH This approach drastically limits the number of patients each care manager can support, as well as the frequency with which each patient can be contacted. A typical care manager might have a panel of 100 patients that they call once every few months. In other words, the millions spent on care management each year reach only a small percentage of patients with sporadic care. Despite its current shortcomings, care management is poised to produce transformative outcomes for patients, health plans and providers alike. But, in order to do that, program must improve patient engagement by embracing the latest consumer and tech trends. Mobile-Enabled Care Management 3
CHALLENGES AND OPPORTUNITIES FACING TODAY S CARE MANAGEMENT Common challenges inherent in care management today include: Recruitment and Retention: With ownership and use of landlines on the decline, care managers have trouble getting patients to pick up the phone. Limited Time and Manpower: When care management professionals rely on telephonic or inperson interviews, they don t have enough time to contact all high-risk patients, let alone support them in a meaningful way. Limited Visibility: Infrequent interactions provide limited insight into patients day-to day behaviors, making it challenging to identify patient needs and effectively support patients toward improved outcomes. Lack of Help for Patients: Patients are on their own without daily assistance and guidance in between telephonic interactions with their care managers. Mobile-Enabled Care Management 4
GAME-CHANGING DEVELOPMENTS AND OPPORTUNITIES Recent developments in technology and healthcare policy open new opportunities to tackle these long standing challenges. For starters, improvements in patient segmentation and predictive modeling help care management professionals identify and target patients who are high-risk and likely to engage with support. Secondly, the trend toward value-based contracts aligns provider and care management incentives, thus opening opportunities for sharing, delegating, or embedding care management services. Most importantly, mobile technology is emerging as the most intimate yet scalable channel for care managers to engage large populations of patients with high-touch support. Mobile-Enabled Care Management 5
SUSTAINABLE, SCALABLE PATIENT ENGAGEMENT THROUGH MOBILE-MANAGED CARE Mobile sets the stage for transformed patient engagement in the following ways: Personalization Tablets and smartphones enable intimate, yet frequent communication between care managers and patients. Convenience Mobile presents a convenient, unobtrusive communication channel with which patients may engage in their own time and space, making communication more appealing and lower friction for both care managers and patients. Improved Visibility With increasingly fast and accurate computing power, mobile technology is capable of collecting robust, real-time, data. Universal Acceptance: Reach more people with mobile. Can mobile really help care managers when it comes to supporting the highest risk and highest cost members? The answer is YES. Without a doubt, mobile phone adoption and use is on the rise. According to a recent study by Pew Research Center, 64% of American adults now own smartphones, up from 58% in 2014. Of smartphone owners, 62% report having used their mobile platforms to look up information on a health condition, suggesting that mobile programs fit seamlessly into patients lifestyles and personal healthcare regimens. Mobile-Enabled Care Management 6
BIGGER, BETTER, FASTER: MOBILE S IMPACT ON CARE MANAGEMENT With these advantages, mobile technology is positively impacting the way care management works. Mobile care management platforms, like Wellframe, are empowering health plans and providers to overcome key roadblocks to patient engagement. For starters, mobile technology mitigates recruitment and retention challenges associated with purely telephonic programs. Through Wellframe s mobile app, for example, care managers can deliver complex care plans in the form of easily digestible, interactive daily health checklists, including educational videos, automatic reminders, and more all via a user-friendly, low friction mode of communication that patients readily adopt. In addition to improving the quality and delivery of care plan content, mobile platforms help care managers overcome human resource limitations by amplifying their reach. For example, care managers can send brief, secure messages through Wellframe to individual patients or patient segments, allowing them to deliver personalized communications on a regular basis. With mobile, dialing patients oneby-one is a thing of the past. Lastly, mobile s ability to collect real-time patient data as opposed to post-hoc, selfreported accounts means that care managers have access to accurate, meaningful insights into patients progress and weaknesses on a daily basis. With this information, they can effectively coach high-risk patients to adopt healthier behaviors. Wellframe s customizable care manager dashboard even helps care managers dynamically prioritize outreach by highlighting which patients require attention on a daily basis. Mobile-Enabled Care Management 7
RESULTS YOU CAN SEE By enabling more widespread, high touch patient engagement, mobile platforms are empowering care management teams to increase their overall value and effectiveness. Improving care management workflow: Equipped with smarter communication tools, automated documentation, better data, and a variety of coaching resources, care managers can recruit, retain and reach an unprecedented number of patients. In fact, care managers who utilize Wellframe s platform reach three times as many patients with ten times the frequency of touch points. Improving patient satisfaction: When care managers use mobile, patients also win. Mobile communication integrates seamlessly with day-to-day life, making patients more willing and able to actively participate in care on a regular basis. Mobile platforms further make it easier for patients to initiate contact with their care manager. Through direct mobile messaging, patients can reach out to care managers any time with questions or concerns. Improving Financial Outcomes: Health plans stand to benefit financially in a number of ways. First, by improving care management capacity, mobile helps plans do more with existing human resources. Second, by enabling higher touch support, mobile helps care management teams improve effectiveness, thereby reducing cost/ utilization among patients. Finally, through robust data capture and more intelligent outreach, plans can move the needle on quality metrics that drive premium revenue. Mobile-Enabled Care Management 7
IMPLEMENTING MOBILE-CARE MANAGEMENT Adopting a new approach to care management services can be challenging. At Wellframe, we do everything we can to make the transition seamless. We iteratively integrate with existing clinical workflows and IT systems, and our clinical programs can beconfigured to match each client s clinical paradigms and priorities. We oversee implementation, patient onboarding, and employee training to ensure that our partners products are optimized for measurable success. On an ongoing basis, we provide analytics and performance reporting, technical support and community management to enhance patient engagement. We do all of this with the aim of ensuring our partners have the most successful care management programs possible. Mobile-Enabled Care Management 8
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