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A Health Plan Finds Success in Using mHealth For Care Coordination

Blue Cross Blue Shield of Nebraska is using mHealth to increase touchpoints with its members, thereby boosting member satisfaction and improving care coordination. The program offers a good example of how mobile health should be used by payers.

Source: ThinkStock

By Eric Wicklund

- Officials at Blue Cross Blue Shield of Nebraska are hoping their new mobile health platform will not only improve communications with members, but give those members more opportunities to talk about health and wellness with their care team.

BCBSNE launched its mHealth pilot late last year, targeting members who’d recently been discharged from a hospital and needed follow-up care, especially in the 30 days following discharge when an unchecked health concern might lead to an unreimbursed trip back to the hospital. They’ve since expanded the service to several populations, including those involved in chronic disease care and health coaching programs.

Norine Domenge, the health plan’s manager of care management and care coordination, says the mHealth platform, encompassing both phone calls and messages, gives members an always-there platform for having their questions answered and concerns addressed. That’s much better, she says, than the old process of occasional phone calls to check up on the member.

“People want that instant ability to get their questions answered on their time,” she says. “And they feel the mobile platform makes them more connected to the nurse.”

Payers call these extra connections “touchpoints,” and they work both ways. While members are able to get their questions answered at any time, health plans use these moments to gather more information from members about their care and offer advice on care management and coordination. The idea is that a more informed and engaged member will take better care of himself or herself, reducing the need for costly medical interventions and improving healthcare outcomes.

The idea that better patient engagement leads to better clinical outcomes isn’t a new one, but there are many different methods to tackle this issue. And the payer community is still trying to stake out its part in this puzzle.

Domenge sees BCBSNE as the facilitator for care management and coordination. Health plans use mHealth tools to ensure that the member is following the care plan laid out by the provider, in turn making sure that the care plan is reducing wasteful expenses and improving health; that, in turn, ensures that the provider is reimbursed for the care provided.

That process couldn’t always be maintained through a couple of phone calls.

“Waiting on a phone call was like waiting on snail mail,” she says. Aside from the occasional and incomplete communications, the process was inefficient in keeping a member to a care plan, or in heading off medical concerns before they become serious.

With an mHealth program that offers education, appointment scheduling, follow-up care surveys and a link to the patient’s medical record, she says, the member is much more likely to stay on track. In fact, among the members enrolled in the post-discharge follow-up care program, some 96 percent were able to demonstrate medication adherence.

“You really would like to get people on board before there’s a problem,” Domenge points out.

The program has, in turn, changed how BCBSNE approaches member engagement. Care coordinators and managers are assigned to areas where, according to member surveys, engagement is limited. And nurses are assigned tasks based on what they like to do and what they’re most comfortable doing. The idea there is improve not only the frequency of the touchpoints, but the quality.

“The more mobile the platform, the better the connection” between member and nurse, Domenge says. “And with the nurses, the productivity follows the passion.”

BCBSNE, which uses an mHealth platform designed by Wellframe, expects to expand the program to other populations.

“Our ultimate goal is to get this in the providers’ hands,” Domenge says, noting the health plan to working to include the program in local accountable care organizations. “We want to enhance that relationship.”

By incorporating providers into the mHealth platform, she says, the health plan can extend care coordination and management out to whoever is actually providing the care. The health plan can then help handle those many touchpoints, giving providers a chance to improve care management outside the doctor’s office without negatively affecting the workload.

“If we can be successful with this from the payer’s side, they’re going to have even better success,” she says.


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