付款人如何利用新的和未开发的数据利用下一代护理管理模式

The Art of the PossibleHow Payers Are Leveraging a Next-GenerationCare Management Model RESEARCH BY: Lynne DunbrackGroup Vice President, IDC Jennifer EatonResearch DirectorValue Based Healthcare IT Transformation Strategies, IDC Navigating This InfoBrief Click on titles or page numbers below to navigate to each. Executive Summary3What Is Care Management?4Understanding Member Motivation5Meeting Members Where They Are:Today and Tomorrow6Key Strategy: Leveraging Data to Drive MoreMeaningful and Personalized Member Interactions7Key Strategy: Achieving the Five PatientExperience Rights8Key Strategy: The Evolution of Care Management9 Key Benefits of Next-Generation Care Management:Improved Care Collaboration, Quality,and Experience10The Art of the Possible: Creating aNext-Generation Care Management Culture11Accelerators of Innovation: Modern, Customizable,and Efficient Technology Solutions12Essential Guidance13The Future Is Now—Let’s Get Started14About the Analysts15About the Sponsor16 Executive Summary The Next-Generation Care Management Model is a vital engagement and collaborationstrategy for patient, payer, and provider as they strive for the quintuple aim. Payers and providers face a growing number of challenges andpressures in today’s healthcare landscape. One of the toughestchallenges remains supporting each member in achieving theirpersonal healthcare goals, thereby increasing member satisfaction,improving quality of care, and lowering the total cost of care delivery. Key Findings: 4Payers and providers must expand strategies to includeproactive approaches to reducing healthcare delivery costs whileoptimizing member and provider engagement. 4Transitioning to next-generation care management is vital andshould be positioned as an extension of the core clinical teamto aid in delivery of consistent, meaningful, and personalizedguidance. 4Leveraging additional data and analytic insights leads to moremeaningful, timely, and effective member management. What Is Care Management? The Next-Generation CareManagement (CM) Model isrelevant and necessary to supportwhole-person health throughenhanced engagement andcollaboration. Care management is a vital component tomember healthcare management and shouldbe positioned as an extension of the coreclinical team to aid in delivery of consistent,meaningful, and personalized guidance. Traditional care management solutionshistorically failed to show demonstrableROI, resulting in an unfocused effort towarddeveloping a comprehensive vision of payercare management. Understanding Member Motivation Today’s healthcare ecosystem is laying the foundation for a care managementevolution, partly out of necessity to keep members healthy while lowering costs,but also as part of a bigger movement toward population health management. Members want convenience, self-service, and on-demand support. They also want to see a financialincentive for being good health stewards. How much would the following incentives increase your interest in sharing healthinformation from your wearable device or remote health monitoring device? Meeting Members Where They Are:Today and Tomorrow Asynchronous communication channels promote convenient and efficient virtual interactions, creating a more robust,frictionless, self-service experience for members while accelerating a digital care delivery model through digital intelligence.Younger consumers (18-34) are more likely to prefer text messaging, mobile alerts, and chatbots than consumers 55 and older. Key Strategy: Leveraging Data to DriveMore Meaningful and PersonalizedMember Interactions Utilizing new and untapped data will paint aclearer picture of each member’s profile, whichcreates the foundation for more meaningful andpersonalized collaboration and care. Key Strategy: Achieving the FivePatient Experience Rights 1. The rightconsumer 2. With the rightmessage 3. At the righttime 4. For the rightreason 5. On the rightchannel Key Strategy:The Evolutionof Care Management Empowering members to be active participants on their healthcarejourney starts with engaging at key decision points. Key Benefits of Next-GenerationCare Management:Improved CareCollaboration, Quality, and Experience Scalabletechnologysolutions toaccelerateimpact in atimely and cost-conscious way The “fiverights” areoptimizedto elevatepersonalizedmemberinteractions Digital-firststrategies toengage andbenefit allmembers Consistent andequitable caremanagementstrategies areimplementedacross theentire memberpopulation Behavior-based,personalizedengagementstrategiesempowermembers Data-driven,proactiveinterventions/care arefocused onwhole-personwellness Trustingrelationshipis establishedbetween payer,member, andcare team The Art of the Possible:Creating a Next-GenerationCare Management Culture Prioritizes the memberexperienceby providingfrictionless, multichannel access andengagement opportunities whilemaintaining the “human touch” Supports multiple valuesour