Case Study: After Care Drives Member Engagement and Fills Care Gaps
As virtual healthcare evolves, we see lower costs for the insurer and their members, as unnecessary visits to the ER, Urgent Care and doctors’ offices have been slashed. Patients may have reduced co-pays and can receive care for common issues wherever they are at the moment they need it. The benefits are obvious.
But for as transformative, convenient, and cost-effective as virtual healthcare can be, it can leave some care gaps that don’t necessarily exist in brick-and-mortar healthcare:
Members can feel alone in their health journey.
Interactions with care providers can be more transactional than personal.
Next steps in care may not always be clear to the patient.
Care can feel issue-specific and not take into account the bigger picture of the member’s health.
With these challenges in mind, there is one question that drives the work we do at Pager:
How do we ensure the member has an authentic, human connection with their care providers while also filling the gaps that traditional virtual care creates?
One way we answer this question is with what we call Pager After Care.
The Pager After Care solution allows us to check in on the wellbeing of patients several days after their initial visit with a Pager care team member to address any gaps and barriers patients are experiencing. For example, our nurses will schedule a follow-up appointment with the patient at the end of their initial visit with a doctor, and during the follow-up itself, the nurse reviews the patient’s progress and response to their care plan, adherence to medication, or preventative steps they’ve taken to alleviate recurrence of the issue.
We see the After Care solution as an opportunity to form a personal relationship with the member, whereby the member inherently feels cared for by real people aided by technology and not the other way around.
Joe Martinez, Vice President of Virtual Care at Pager, sees After Care as a critical element to developing better holistic care. “After Care gives us an opportunity to provide more robust care. Maybe it's another nurse triage, helping patients find a doctor, scheduling an appointment for them, or connecting them with the appropriate resources they need.”
“We're seeing more patients utilize virtual care than in years past. Patients are thankful our care team members are routinely checking in on them to make sure they are doing better- a practice that is unique in virtual healthcare. And when they feel better, they have more energy to talk to us about other concerns that we can help address, and therefore be proactive about how we manage their care holistically,” says Pager’s Nurse Manager, Matthew Morin.
While we continue to implement new and improved After Care protocols on a rolling basis, the data shows the value of the program to health plan members:
The member response rate to the Pager After Care Program is 68%, showcasing how many members need - and benefit from - clinical follow-ups.
73% of members reported improvements to symptoms after speaking with the Pager nursing team.
72% of patients who did not previously have a Primary Care Physician were connected to one in-network.
45% of members were provided additional education on diet/exercise, injury prevention, and family planning.
78% were prescribed new medications post navigation, and of these, 45% required additional education on medication, information on side-effects, and details on claims and benefits, to name a few.
Joe Martinez adds, “After Care gives us meaningful health data that provides us an opportunity to build a partnership with patients, since we have a moment to talk to them and inquire about what's important to them.”
As the data we harness continues to get more sophisticated, we’ll be able to help patients with long-term and specialty care. There will be opportunity to leverage our established relationships with them to see the big picture of their overall health, and because of that, patients will be cared for in an even more specific and personal way.
Matthew Morin is excited about the future of Pager After Care. “We see ourselves building in more preventative screenings and adding questions to address additional needs. As our processes evolve along with our systems, we’ll find new ways to target individuals so that we can provide more specific questions that relate to them and their health journey.”