As accountable care and other value-based payment programs expand across the nation, the demand for care managers has never been greater for both provider and payer organizations. Both types of organizations share similar care management and monitoring goals: to help patients/members manage their chronic conditions, prevent frequent hospital readmissions and avoid unnecessary emergency room visits. Building a care management staff when demand is so great can be an expensive and time-consuming challenge for both the provider and payer organizations. Fortunately, the care manager spot lighted in this post works 24 hours a day, seven days a week by contacting thousands of our client’s members each day across the entire nation. Her name is MaryBeth and she delivers friendly, concise, and effective messaging while guiding members through questionnaires to encourage engagement. Through each call, she gains an understanding of the member’s knowledge levels, behaviors and current health status. Her multilingual platform is able to reach a diverse audience beyond English, including Spanish and Chinese Mandarin speakers. The next level of automated healthcare Although MaryBeth is not an actual person, her automated “personality” still creates a caring interaction by establishing contact with members through conversations designed to encourage a positive user experience. She represents the most advanced interactive voice response system on the market. Her message content and frequency are personalized based on an individual’s risk level, condition, and response to periodic questions. The chronic disease education and monitoring programs that MaryBeth calls about include some of the most profound conditions impacting members today like: Diabetes, Depression, CHF, COPD, Asthma, CAD and Hypertension. Other programs include: Maternal Health, Hospital Discharge and an Emergency Room frequent user program. MaryBeth also interviews new health plan members, who often enroll with little to no historical data. She targets these members with health surveys and/or questionnaires to gather data on self-reported conditions. Information is then leveraged for risk adjustment, quality programs and future care-management outreach to help provide the best service possible. Support based on member preference MaryBeth is supported by Altegra’s Smart Connect platform which encompasses a multi-channel outreach approach including automated phone calls, text messages, emails, or smartphone app messaging, depending on the member’s personal preference. Additional support is offered from a live non-clinical resource, Altegra Health Advocates. So whether your members are low, high-risk, or somewhere in between, MaryBeth’s goal is to help them stay adherent to their treatment plan, avoid unnecessary hospital admissions and ER trips, and increase their overall quality of life. Click here to learn more about our favorite virtual employee.
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