Case study

How to build a digital adoption ecosystem and deliver greater value to members

Discover how one Blue Cross Blue Shield plan built a digital adoption ecosystem that improved member enrollment and increased member touchpoints.

Low utilization of preventive care led to unnecessary ER and urgent care use

Telephonic outreach alone could not deliver the proactive support or accessibility that health plan leaders wanted and members asked for. Health plan leaders needed a way to increase member onboarding and touchpoints with the staff that they had, while helping give members more direction in their health journeys.

The health plan needed a Digital Care Management solution that would:

  • Reduce unnecessary ER and urgent care use
  • Improve healthcare access and navigation
  • Remove barriers to outreach and communication
  • Deliver value to their entire member population

About the health plan

A Blue Cross Blue Shield plan serving nearly 300,000 members.

Implementing a digital solution that addresses staff and member pain points 

Once the health plan decided to partner with Wellframe to implement Digital Care Management, they targeted three areas of focus:

  • Developing a digital strategy roadmap
  • Managing change through staff education 
  • Building an ecosystem of digital adoption

Developing a digital strategy roadmap

Building out a comprehensive implementation strategy required buy-in from leadership, as well as clear communication across the organization. One of their primary motivations for implementing Digital Care Management was to extend member reach without increasing staffing, while simplifying outreach and improving documentation.

Developing a digital implementation strategy also included developing a member marketing and outreach strategy. The health plan leveraged its internal marketing department to develop an effective member outreach and engagement strategy across multiple channels to increase awareness and encourage onboarding.

Managing change through staff education 

Changing established workflows by introducing new solutions can be challenging for staff and care teams. To help smooth the transition, health plan leadership made it a priority to gain organizational buy-in early in the digital care management process.

The health plan started by organizing introductory meetings to educate their teams on the new solution, and how it would work within the larger digital ecosystem. They engaged with staff and care teams at multiple stages in the implementation process, soliciting feedback and incorporating it into their strategy. Once the Digital Care Management solution was in place, the health plan continued to offer regular training for users to refresh their skills or gain deeper knowledge of the available tools. 

Building an ecosystem of digital adoption

After the initial implementation, it was easier to encourage continued use and more widespread digital adoption. Digital Care Management improved documentation of member outreach for staff and care teams. They were able to send digital surveys, see how often members reached out via chat, send messages, and review their chat history rather than trying to take notes during a phone conversation.

In addition, the digital solution helped care teams target member outreach based on chat messages and digital survey responses—without waiting for claims data. Care managers used this information to proactively engage with members and help them address the root causes of their health and wellness needs.

Finally, the health plan redefined their KPIs and engagement measurements based on their new capabilities. These performance measures include:

  • How efficiently care managers guide members into secondary care programs
  • Digital care program completion rate
  • Access to proactive support and education

Early engagement and targeted messaging resulted in reaching a broader population.

Chief Medical Officer

The results

Leveraging Digital Care Management helped improve healthcare accessibility for multiple member populations. The health plan found that members seeking support for behavioral health were more comfortable engaging through digital chat than telephonically. Additionally, members who are Deaf or have speech impairments were better able to reach out to and engage with their care teams using digital channels.

Digital Care Management tools enabled the health plan to expand their care programs to include health education, which lowered the risk of unnecessary hospital admissions. Educational content is integrated within digital care programs, as well as available on-demand in a resource library. Resources include clinical and benefits information, and are written in plain language for accessibility. The resources and chat capabilities also made it easier for members to prepare for and follow up after in-person doctor’s visits, to clarify information or ask additional questions.

Developing an ecosystem of digital adoption required organizational alignment and a clear vision. Holding information sessions helped staff and care teams get comfortable with the Digital Care Management solution before implementation, and continuing training allowed them to improve efficiency and performance.

Would you like to learn more about how to encourage digital adoption and deliver greater value at your health plan?

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