Your How-To Guide to Proactive Care and Risk Management | Part 2: Leveraging Virtual-First After-Care to Transform Member Engagement
Our current healthcare system incentivizes volume over quality and, as a result, fails to deliver real value, perpetuating an escalating affordability crisis in healthcare. Value-based care promises to address this issue, but adoption of this model has been slow and hesitant.
In our previous blog, we discussed the many obstacles that deter health plans from implementing a comprehensive value-driven care model. Those obstacles include a lack of continuity of care, the proliferation of point solutions, and a fragmented consumer healthcare experience that leads to patients disengaging from their treatment plan.
Fortunately, there is an opportunity to transform our complex, fragmented system by meeting patients where they are, as they are, with omnichannel engagement, individualized care profiles, and ongoing follow-up support. In this blog, we’ll examine how Pager's virtual-first after-care solution delivers the continuity of care that empowers members to achieve risk-reducing milestones and revolutionizes patient engagement.
The gap between “Getting Care” and “Lifestyle Medicine”
Our healthcare system primarily focuses on episodic care, leaving patients responsible for their after-care and overall health management. This burden remains with the patient until a new medical need occurs that necessitates another episode of care. Unfortunately, many consumers, lacking support, guidance and encouragement, disengage from their after-care, magnifying risks across entire populations. Moreover, the disconnect between the $4.3 trillion healthcare industry (Getting Care) and the $450 billion wellbeing industry (Lifestyle Medicine) further exacerbates the lack of continuity. This disconnect, what we call "healthcare's greatest gap," generates unnecessary gaps in care, higher costs, and a lack of follow-up support, motivation, education, and insights for patients.
Pager's Integrated Follow-up Model
Pager closes "healthcare's greatest gap" by providing a seamless continuum of patient engagement throughout the entire care journey, from care navigation and proactive care management to ongoing well-being services. Leveraging health risk profiles, actionable insights, and digital nurse and health coach support, Pager meets members where they are on their health journey. By providing ongoing support to help patients reach their health goals and achieve risk-reducing milestones, Pager empowers individuals to take control of their health.
Our after-care solution ensures continuity of care for at-risk patients through convenient virtual access and digital nurse-led engagement. Additionally, with 33 self-guided programs that are prioritized for each member, Pager provides education and direction to help close gaps in care and improve their lifestyle, resulting in a holistic, connected experience.
Transformative Impact for Plans and Members:
Continuity of Care: Pager's virtual-first after-care solution bridges the gap between episodes of care by delivering ongoing support and engagement. Patients receive the necessary guidance and resources to maintain their health, reducing the likelihood of preventable medical events and the need for readmission. Impact: Approximately 70% of encounters navigated to lower-cost care settings.
Actionable Insights: By leveraging health risk profiles and self-guided programs, Pager provides personalized care to each member, at scale. This tailored approach ensures that individuals receive the specific support and information they need, enabling them to actively participate in and manage their healthcare. Impact: NPS 80+
Proactive Care Management: Pager's model focuses on proactive care, with targeted outreach emphasizing early intervention, preventive measures, and lifestyle adjustments for risk populations. By empowering individuals to prioritize next best actions that adhere to their care plan and overall wellbeing, Pager helps members achieve better health outcomes and enjoy an improved quality of life. Impact: Members who digitally opted into the Gap Closure program achieved a 20% higher closure rate
Cost Savings for Health Plans: The proactive, connected care experience facilitated by Pager's after-care solution leads to significant cost savings for health plans. By reducing preventable readmissions, unnecessary medical events, and emergency room visits, health plans can lower expenses while delivering enhanced value to their members. Impact: $210 savings per clinical encounter.
Conclusion
Enabling the shift from reactive care management to a personalized, proactive population health continuum is a foundational building block to advance toward value-based care. A virtual-first after-care solution is at the forefront of this transformation, providing a seamless, connected care experience that combines next best actions with empathetic human support. By focusing on continuity of care, personalization, and proactive engagement, Pager’s holistic approach empowers individuals to actively engage in their health, resulting in better outcomes, reduced costs, and higher member satisfaction. We believe a care solution that augments and integrates with the traditional care delivery system, instead of chasing new point solutions, will prove to be the most cost-effective and sustainable play to achieve the Triple Aim—better care, improved outcomes, lower costs.
