Payers face multiple industry headwinds, ranging from healthcare worker shortages to the high prevalence of chronic conditions, disjointed member experiences and disengaged members. These headwinds result in gaps in care, unnecessary emergency department (ED) readmissions and other issues.
At Becker's Hospital Review's 2023 Payer Issues Roundtable, Amwell sponsored an executive roundtable to discuss how virtual companion technology can engage members and reduce healthcare costs. Two Amwell experts in the payer and clinical space led the conversation: Cathy Hartman, general manager, payer solutions, and Carrie Nelson, MD, chief medical officer.
Five key takeaways were:
1. By leveraging virtual companions, payers are able to engage with members at greater frequency and scale. Virtual companion technology can better support members throughout their care journey. These chat-based interactions use member-generated health data to determine the next best action in member care. "These engagements can be customized to your populations' needs," Ms. Hartman said. "You may want to target specific chronic conditions or address social determinants of health. The real-time member insights that are generated are actionable, allowing you to triage, escalate and manage members more effectively."
2. Easy user experiences lead to high activation rates. Amwell Automated Care Programs, enabled by the Amwell Converge™ platform, leverage virtual companion technology to better engage users and don’t require app downloads, making them easy to use. This results in high activation rates and strong engagement. Interactions can range from a nudge about a prescription renewal to an ongoing chat to identify members with rising health risks. "We have a library of over 100 clinically validated, automated programs that address different use cases. These can be customized for each client's needs," Dr. Nelson said.
3. Automated care programs can reduce ED readmissions and improve job satisfaction for staff. Spectrum Health (now Corewell) uses Amwell Automated Care Programs to lower ED readmissions. The program delivers 90 percent consumer satisfaction and eliminates 30 calls per day. The total reduction in the cost of care is over $1 million. "Many times, care managers call people without knowing whether it's a good time to speak with them," Dr. Nelson said. "With this program, nurses can be very targeted about who they reach out to and do so at a time when they are most likely to be influenced."
4. Virtual companions are effective at uncovering high-risk pregnancies. Northwell Health partners with Amwell on an automated maternity program that had 95 percent consumer satisfaction. "Just through the chat, they were able to identify an additional 16 percent of high-risk pregnancies. There's so much that is not uncovered during an office visit that can be identified in an interactive chat," Dr. Nelson said.
5. SilverCloud by Amwell delivers behavioral health support at scale. These evidence-based digital mental health programs have been proven to show improvement in symptoms for mild to moderate health conditions for up to 80 percent of users, and the user satisfaction rate is 93 percent. The solution leverages clinically validated content, interactive tools, user videos and optional coaching to better support mental health needs.
"Amwell brings clinical validity to the table along with expertise around conversational messaging," Ms. Hartman said. "By balancing those two things, we keep members engaged and activated."