Payer care management teams are at a crossroads for many patients when patients and members are eager to have a more personalized outreach and a customized healthcare experience. Their role is not to treat or recommend courses of treatment, but to understand members about the next steps, have the most productive conversations with their providers, and make informed decisions for the outcomes and well-being of their care.
This requires a careful approach to personalization that balances member-specific customization and privacy concerns with scaling capabilities.
When you think about your care manager's priorities, what you're trying to understand is how you best help people in the process of making important decisions. There are several ways to coordinate educational content, decision-making assistance, and outreach to member needs.
Batch outreach for all those who meet a specific patient population or meet certain criteria. Individual content of self-selected members to receive follow-ups of specific conditions or treatment options. Tags content to a specific coded condition or claim. Outreach based on use to specific billing or procedures to improve preparation and outcomes. Education that enhances or enhances employer-based incentive health coaching.
Scaling personalization with batch expansion
The ability to send in-batch educational materials and programs to member population cohorts for more general conditions and care decision scenarios allows care managers to address the need to personalize care and provide a more customized member experience while using resources of scale.
Effective examples of this approach include:
Targeting programming that discusses the pros and cons of both colonoscopy procedures and home testing kits with all members, it helps to reach 50 years old at low risk of colon cancer and informs decisions. It will help you reach out to members for awareness about hypertension and consider what's right for them when discussing with your provider to understand the risks involved and options that may include drug and lifestyle changes.
Individual education for self-selecting follow-up members
In addition to providing large and relevant information, the batch approach provides care management teams with the ability to first reach members at risk of a particular condition or at risk of recovering from a particular procedure, and then contact care managers to participate in more detailed consultations or follow-up with more programming. In this way, what began as large-scale communication allows members to self-select for deeper personalization and one-on-one discussions.
