Harnessing Member Data to Schedule and Close Care Gaps

Health Plans can revamp their member outreach and appointment scheduling process to close care gaps faster by using insights gained from member data. 

Healthcare has invested heavily in data solutions to identify members with open care gaps. Still, plans often struggle to get these members to schedule care gap appointments (for a few reasons). And, now that they've identified the members with the greatest need, the next hurdles to overcome are improving the scheduling processes, addressing additional barriers that the members face, and doing it all while improving member experience. The result: close care gaps more efficiently while improving member experience.

If you're a health plan, the first step is to implement a care gap closure strategy focused on two things: addressing barriers and scheduling appointments. To do this, you should target specific populations, identified by your member data, with appointment scheduling interventions. If you select the right partner, these solutions can drive 10 times the impact you see today. The keys to success here are: Focus – make sure you have a program dedicated to reaching every member on your list. Provider Matching – this is critical; if you don't have good provider data, getting the member to the right place is nearly impossible. Oh, and the member experience suffers as you try to call multiple providers while the member is on hold. Scheduling – Finding the providers is half the battle; you still need to get the member scheduled. Make sure your partner can actually schedule appointments and not just send reminders that they need to do it on their own. Follow Through – Appointment reminders, provider follow-up, status updates… they're ALL important. Without that, you won't have the data you need to prove the efficacy.

It may require reconfiguring your resources, but it's well worth the effort. By using member data in the right way and being ready to take action, health plans can revamp member outreach to find the right doctor and schedule appointments in just 5 minutes. And that allows you to close care gaps more quickly and efficiently, ensure timely access to care and deliver a positive member experience.