At a time when patients and members are craving more personalized outreach and tailored healthcare experiences, payer care management teams are positioned at the crossroads for many patients. Their role is not to treat or even recommend a course of treatment, but to offer their members the right tools to understand their next steps, have the most productive conversations with their providers, and then make informed decisions for their own care outcomes and wellbeing.
That requires a careful approach to personalization that balances member-specific customization with privacy concerns and the ability to scale.
When you think about a care manager’s priorities, what you're trying to figure out is how to best help people who are in the process of making an important decision, making them aware of different potential options based on their claims or diagnostic codes and other appropriate factors. There are several ways that tailoring educational content, decision aides, and outreach to a member’s needs can be achieved:
- Batch outreach for everyone who fits into a certain patient population or meets certain criteria.
- Individualized content for members who self-select to receive follow-up on a particular condition or treatment option.
- Tagging content to specific coded conditions or claims.
- Utilization-based outreach to specific claims or procedures to help improve preparation and outcomes.
- Education to augment or enhance employer-based incentive health coaching.
Scaling personalization through batch deployment
For more common conditions and care decision scenarios, the ability to send educational materials and programs in batches to population cohorts of members enables care managers to address the need to personalize care and provide a more tailored member experience while still using resources at scale.
Some effective examples of this approach include:
- Targeting programming that discusses the pros and cons of both colonoscopy procedures and at-home test kits to all members about to turn 50 at low risk for colon cancer to help inform their decision-making.
- Reaching out to members for awareness around hypertension and understanding the risks associated and potential options available – including medications or lifestyle changes – to help them consider what might be right for them when discussing with their providers.
Individualized education for members who self-select follow-up
In addition to offering useful, pertinent information at scale, the batch approach gives care management teams the ability to initially reach out en masse to their members at risk for a certain condition or recovering from a certain procedure and then offer the opportunity for them to contact their care manager to engage in a more detailed consultation or follow-up with more programming. This way, what started out as a larger-scale communication allows members to self-select into deeper personalization or even one-on-one discussions.
