Improving care management data analytics for whole-person health

Utilizing real-time insights

Payer data strategies need to be built to evolve, as member health needs – individually and population-wide – change over time. Access to the most current data sources available can be vital to being adaptable, whether that’s partnering with providers for regular clinical data exchange or integrating evidence-based resources that are continually updated.

For care managers, accessing real-time member data allows for more timely interventions, which experts observe, can help close care gaps and mean the difference between treatment for a manageable condition and a costly hospitalization.

Instantaneous data access and current evidence also allow care management teams to:

• Be more proactive in identifying at-risk patients.
• Enhance care coordination and collaboration with service partners.
• Improve population health management and target interventions and patient engagement based on emerging trends.
• Help reduce hospital readmissions.

Staying current with real-time member insights can also help care management pursue value-based care, for which it is essential to have updated information – potentially collected by providers at patient check-in – on relevant SDOH that might impact member access to care. Evolving data on communication preferences can affect if information is reaching members at all and help care management gain a better understanding of how to engage at-risk populations with a better chance of success.

Integrating evidence-based decision support in planning

According to a Deloitte focus group, 80% of patients who lose trust in a particular healthcare organization say there is nothing that provider can do to get them back.

Because they work closely with high-risk and high-need patients most likely to benefit from personalized care experiences, care management teams are uniquely positioned to build, nurture, and cultivate trust and loyalty among health plan members. When this connection is made, it can be restorative and transformative.

Evidence-based decision support helps care management teams develop personalized member experiences that enhance adherence, build greater trust and satisfaction, and improve health equity and accessibility. Tools and educational materials based in trusted evidence that aligns with what members are hearing from providers helps them become more informed stakeholders and active partners in improving their health and supporting optimal outcomes.

Payer care management teams can build out evidence-based member engagement and education plans using materials that start from the perspective of member motivations. Segmenting members based on psychographic factors will help teams identify and target educational efforts, focusing on patients who will benefit most from evidence-based medical information. It can also help identify those who are at inflection points in their health journey where this type of intervention can be the most helpful in improving outcomes and experience.

Tailoring interventions for holistic health support

Payer leadership should also keep an eye out for opportunities to leverage robust data analytics to flag areas of member need or interest.

To individualize outreach and interventions for whole-person health, teams need a solution partner designed exclusively for the world of care management, specifically intended to help offer personalized member engagement based on data, focus consistently on providing equitable care informed by SDOH, and deliver at scale with a solution optimized for care management workflows.

A member engagement solution designed to amplify the impact of care management teams will provide evidence-based educational materials and interactive programming that allows teams to:

• Provide health information members understand and can trust.
• Offer materials personalized to their age, background, and wellness journey.
• Spotlight topics they most care about – like mental and behavioral health; hypertension; pre-diabetes; nutrition; maternal and newborn health and safety; breastfeeding; and elder care – so members have access to relatable and relevant content and teams can improve outcomes and utilization.
• Amplify value-based care by creating “teachable moments” of providing meaningful member education combined with incentivizing relevant preventive care around a population health issue that has potential to impact a significant number of members with rising risk.

eBook: Personalizing member engagement

While there is no one-size-fits-all approach to engaging members, data analytics provides care management teams an opportunity to hone their understanding of member needs and more effectively target their approaches regarding outreach, education, trust-building, and improving treatment adherence. Clean data is challenging to achieve but with creative strategies and evidence-based solutions to help align workflows, care management teams can stay current and focused on uncovering the insights that serve holistic member health.

Learn more in our eBook, “Care management: Building trust through personalized member engagement.”