Your How-To Guide To Proactive Care and Risk Management | Part 3: How Pager's After Care Reduces Readmissions and Drives Medication Adherence

In Part 3 of our Proactive Care series, we delve into the strategic importance and multiple benefits of engaging health plan members after a clinical encounter. Let’s see how Pager's transformative solution improves patient outcomes, enhances quality of care, and increases savings for two costly yet avoidable challenges facing health plans today.

1) Reducing Readmissions 

Pager's Emergency Room Readmission Reduction Program (ERRP) leverages proactive care engagement to address critical gaps in care after patients are discharged from the emergency department. By engaging high-risk patients through their preferred communication channels, such as text, chat, phone, or video, ERRP provides personalized clinical interventions. 

This targeted engagement approach has yielded impressive results, with readmission rates reduced by 40% or more. This not only lowers healthcare costs, it also ensures members receive timely and appropriate care. By virtually activating members after a clinical encounter, health plans can guide members towards the right care pathways, preventing unnecessary hospital readmissions. A plan member's testimonial highlights the effectiveness of this approach: "Without this service, I would be in the ER every other day.... I am leaving this chat at least 15x happier and less stressed."

2) Improving Medication Adherence

Medication non-adherence is a significant challenge in healthcare. Indeed, 25% of hospitalizations each year are related to medication non-adherence. Pager's After Care provides a sustainable solution to address this issue by engaging at-risk members after a clinical encounter to understand their needs and overcome any barriers to adherence.

Consider this case scenario. A patient named Maria has discontinued her diabetes medication due to side effects. Through targeted outreach, Pager Nurse Mia seamlessly connects Maria to a telemedicine visit, where she receives a new prescription and relevant information. Within 48 hours, Mia then follows up to ensure Maria is experiencing no side effects with the new medicine. By engaging Maria after her PCP visit, the After Care Solution ensures she resumes medication adherence and receives necessary support for her overall well-being.

This case illustrates how post-clinical encounter engagement leads to improved medication adherence and better health outcomes. In a recent case study, Pager's medication adherence program with coach-led engagement successfully transitioned over 64% of at-risk plan members to adherence, benefiting a large Blue health plan. 

The Opportunity

Activating members after a clinical encounter can be the most opportune time to engage your members and motivate them to become active participants in their healthcare journey. By seizing this moment, health plans can drive meaningful member engagement, enhance the quality of care, improve STAR ratings, and achieve cost-of-care savings. Post-clinical engagement empowers individuals to take an active role in managing their health, leading to improved patient outcomes and increased value for both members and providers. Stay tuned for our next blog, where we explore additional use cases and programs that utilize proactive care engagement to drive continuity of care and holistic well-being.