The Omaha-based Blue Cross Blue Shield Nebraska serves 500,000 lives across the Cornhusker State. With strong relationships with providers across the state, BCBSN’s leaders continue to try to advance their progress in care management, population health management, and plan member engagement.
In that context, BCBSN’s leaders have been working in improving their care management operations, through enhancing the touchpoints of their plan members, as they transition to post-surgical care, and across their ongoing chronic condition care management. In that regard, they’ve tasked their care managers to more fully engage with plan members, making using of a mobile-based solution to amplify care management so that it’s an ongoing touchpoint for patients in the longer term — with some excellent results. For example, BSBCN plan members have been able to meet 96-percent medication adherence, post-surgery, while case managers are now spending less than half the time it took previously to reach health plan members (from eight minutes down to 3.5 minutes), using that mobile solution.
The leaders at BCBSN have been partnering with the Boston-based Wellframe, which offers mobile patient engagement and care management software. Wellframe’s care programs turn health management into an interactive, personalized, and educational daily to-do list delivered to patients’ mobile devices.
Susan Beaton, R.N., vice president of provider services and care management, at BCBSN, spoke recently with Healthcare Informatics Editor-in-Chief, Mark Hagland, regarding the insurer’s leveraging of mobile technology to support its care management and wellness efforts. Below are excerpts from that interview.
Can you tell me a bit about BCBSN’s overall population health management and care management strategy, and how this mobile-leveraged care management initiative fits into that overall strategy?
About four years ago, we decided to look at our traditional care management programs, which were based on reaching out to members who needed our assistance, but it was done by invitation through the email, through a physician, referral pattern; but we knew times were changing, and that our members needed real-time interaction, and meeting them where they needed us to be. And at that time, we didn’t have a mobile platform, and knowing that we needed to make that switch, knowing that health happens at home and at work, and we knew we needed to meet members where they were, and that’s usually away from their home phone. That’s when Jake [Jacob Sattlemair, CEO of Wellframe] and Joann Schaefer, M.D., our executive vice president—who was at that time our CMO—first touched base.
Susan Beaton, R.N.
And it went fast. Once we started to meet, we realized that Wellframe was really something special. They were able to take a look at what we were doing, and identify what their tool was able to do for us and our members. And in 2015, we were up and running on a pilot program for our nurses and members. Their goals were very similar to ours; we’re very agile and innovative. It became a great collaboration.
What was the core focus of the initial pilot?
We looked at our program that helps our members when they discharge from the hospital and go back home, and looked at how we could interact with them by phone. At that time, that was one of our greatest needs, and that’s where we started. So it launched, and it was successful. We were looking at the interactions our nurses were having with our members: it was real-time, it was relevant.
It was care management-type counseling over the phone?
It was both educating them about their medical condition, and answering benefits questions over the phone. Their medical condition, their pharmaceutical needs, and their benefits. Initially, it was about 1,000 members a month discharged from the hospital, with seven nurses. And it really went very fast, and has expanded ever since. We’ve ended up putting every single one of our care management offerings onto the Wellframe platform.
We have Transitions of Care, Health Coaching, Chronic Disease, Catastrophic Case Management, Maternity Management, Presurgical and Postsurgical Care Management; and Emergency Management will be next. We found we needed to offer everything via both our traditional mode and the Wellframe platform. So it’s been continuous development ever since.
Have you encountered any challenges in developing this?
Well, sure, with any program, you always have challenges, but we were able to address those with Wellframe, and Dr. Schaefer, and our nurses, etc.
Have you used this solution to work on readmissions reduction at all?
We started with a basic measure in terms of interventions. Over half of our members no longer have home phones. So if we were using traditional measures and tried to reach a home phone or send them a letter in the mail, we found that we were often not connecting. Using this mobile solution, we found that our engagement rates immediately went up. Before, we were lucky to get maybe one or two communications every couple of weeks. Using the dashboard, though, they would chat in real time. And nurses were able to get alerts from Wellframe in real time, letting them know what communications had taken place. It was through an app or via the website, that they were reaching out.