6 Steps to Create a More Consumer-Centric Care Management Program

Value-based care models, performance metrics and rising consumer expectations have ramped up providers’ care management efforts. Today’s most successful providers and provider groups will be the ones who create a consumer-centric care management program. This includes ensuring care management teams are prepared to deliver the heightened levels of personalization and insight necessary to effectively address the changing healthcare needs of individuals and populations.

Through such a program, care management can play an even greater role with interventions that reduce health risks, lower the cost of care and improve patient satisfaction. Here are six steps you can take to ensure your organization’s care management program is more consumer-centric.

1. Introduce Digital Efficiencies to Care Management Workflows

Today’s care management largely takes place outside of the traditional office visit. While face-to-face interactions remain important to effective healthcare, not every encounter has to be in person.

Providers can optimize clinical resources by introducing digital efficiencies to care management. Digital efficiencies are invaluable in helping to:

• Improve collaboration and data sharing among all care teams involved in treating a patient, enabling faster, more informed decisions, interventions and engagement.
• Provide high-quality home-based care, including access to digital care management programs and telehealth options, as well as remote patient monitoring when applicable.
• Automate workflows, referrals, approvals and other tasks, freeing up staff to focus their attention on less tedious and more high-value tasks, while reducing wait times for patients and increasing overall patient satisfaction.

Providers can also maximize digital efficiencies that introduce new options for patient care and revenue. A McKinsey & Company article from earlier this year looks at “the health benefits and business potential of digital therapeutics,” which “can include multiple points of intervention along the patient journey, including monitoring, medication adherence, behavioral engagement, personalized coaching, and real-time custom health recommendations.” As a tool for disease management, digital therapeutics can improve both clinical outcomes and economic benefits.

2. Optimize Patient Data to Power Your Consumer-Centric Care Management Program

A consumer-centric care management program is one that ensures patient data is optimized for care managers. Ask yourself:

• Does your care management program allow easy access to robust and actionable data that paint a longitudinal 360-degree picture of an individual’s health?
• Does it provide a clear view of an individual’s conditions, care plans, health goals, and involvement in clinical and community-based programs?
• Can it be used to digitally share comprehensive information on hospital and ER visits, medications, labs, claims and authorizations, and current risk scores with every clinician and community-based provider who needs it to guide treatments and interventions?

Such data forms the foundation for care management that reduces preventable (and costly) hospital readmissions and ER use, addresses comorbidities and connects patients with the resources they need to achieve better outcomes.

3. Address Social Determinants of Health for Whole Person Care

Because so many of a person’s health-related needs are nonclinical in nature, a consumer-centric care management program is one that treats the whole person—identifying and addressing behavioral or social barriers to a patient’s well-being whenever possible. SDOH interventions for a particular individual might include providing access to nutritional food, transportation to doctor’s appointments or the pharmacy, and help finding housing or employment, or a program to overcome substance abuse issues.

Care management programs can leverage a digital solution that helps care managers address and appropriately respond to patients’ socioeconomic needs. The solution should connect care teams to both national and local community-based organizations as well as service providers (such as those for transportation) to assist patients in real-time. A collaborative platform that allows care managers to track and close the loop on SDOH referrals is key. This will help ensure patients’ socioeconomic needs are not only identified, but addressed.

4. Actively Engage Healthcare Consumers and Increase Patient Satisfaction

To increase patient satisfaction and improve retention, consumer-centric care management programs actively engage consumers. Active engagement improves healthcare transitions, medication management, care plan adherence, and patient outcomes.

Such engagement starts with meeting consumers where they are—through their preferred channel of communication—and encouraging them to take a more active and informed role in their own well-being. Whether by email, text, app or online patient portal, digital engagement and care management outreach can remind patients of appointments, medication schedules, educational opportunities and other ways to become healthier and less likely to need more expensive care. Engaged consumers are also more likely to share personal information that helps providers better manage their care, improving outcomes and patient satisfaction.

5. Approach Healthcare Marketing and Engagement Like a Consumer Company

While there are clearly differences between healthcare and more sales-oriented industries such as retail, hospitality and entertainment, those businesses have much to teach healthcare about consumer engagement and microtargeting their outreach.

“Sticky engagement,” which is sometimes used to describe the ability to keep consumers regularly engaged and coming back to spend more, is one aspect of “customer stickiness,” which the U.S. Chamber of Commerce defines as “the tendency to gain repeat business.” While “repeat business,” from a treatment standpoint, might not be the precise goal in the healthcare arena, patients who make regular use of preventive services are less likely to require costlier care for worsening conditions.

Likewise, using consumer company strategies such as microtargeting to tailor messages to individuals and groups based on unique information about them can improve all forms of healthcare outreach, from education about chronic disease management to reminders about preventive care. Healthcare is increasingly recognizing the value of this practice, which depends on quality and quantity of data to be effective. Reaching the most appropriate—that is, most receptive—audience requires personalization: knowing the patient as a unique individual rather than a diagnosis. And reaching them at the most appropriate time—such as during care transitions and other key moments in the patient journey—is made more seamless and personalized by a robust rules-based engine and digital patient engagement tools powered by an award-winning data platform and digital care management company.

6. Consider Partnering With a Healthcare Consultant

Partnerships are increasingly essential to sustained success in today’s economy. Providers are partnering with insurers and others to create new health plans, networks, membership-based primary care arrangements, value-based care partnerships aimed at community health, and efforts to eliminate disparities in underserved communities. They’re partnering with digital care management companies to expand their care capabilities and communication channels and leverage automation to improve utilization management and reduce healthcare costs.

Another valuable partnership to consider is healthcare consultants who truly understand the challenges of the healthcare industry, care management, digital engagement, and consumer experiences. The right consultants can help healthcare organizations identify strengths to leverage and weaknesses to mitigate, as well as untapped potential to avoid leaving opportunities on the table. Aveus, Medecision’s healthcare consulting firm, welcomes the opportunity to help you:

• Create strategic clarity
• Redefine digital engagement
• Ensure change readiness
• Engage employees
• Solve complex business challenges
• Design new consumer experiences

Next Steps for Providers

Challenge your thinking to look beyond current models. Ask Medecision how we can support your efforts to create a more consumer-centric care management program. We also invite you to:

• Download our guide “5 Key Strategies for Successful Care Management.”
• Learn more about the healthcare consulting experts at Aveus.
• Download our special report “Improve Outcomes and Reduce Costs: Proven Results for Health Plans, TPAs and Other Risk-Bearing Providers.”
• Subscribe to the Medecision blog for more healthcare trends and strategies like this.