HCL’s Member Engagement Program


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The healthcare system in the U.S., when compared to similar nations, is one of the costliest in the world with higher levels of healthcare spending, costlier hospital stays and higher prices of prescription drugs. A major reason for the steady rise in healthcare expenditure over the years has been the episodic treatment approach that has been prevalent in the U.S. These inefficiencies are further exacerbated when factoring the impact of chronic conditions which contributes to roughly 84% of the total healthcare cost.

HCL realizes that innovative approaches to population health management – like offering personalized intervention plans to participants of a chronic disease management program – is key for a payer to maintain their customer centric approach and differentiate their services from a traditional care management program.

Gain health and wellness of member population through HCL’s personalized, scalable, multi-channel, multi-lingual, cost-effective Member Engagement Program. To know how, please click here: http://microsite.hcltech.com/gainwithchange/care-management.asp

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HCL’s Member Engagement Program

  1. 1. Copyright © 2014 HCL Technologies Limited | www.hcltech.com HCL – Healthcare Payer Solutions Patient Engagement Platform
  2. 2. 2 Copyright © 2014 HCL Technologies Limited | www.hcltech.com Healthcare Challenges… Payer PharmaProvider  $300 Billion in redundant or ineffective healthcare  Effective Care Management and Reduced cost of care  Regulatory Compliance and Reporting  Consumer Engagement Explosion  Administrative overheads  $290 billion annual in prescription non-adherence  Proactively managing quality and outcomes  Improving efficiency of care delivery  Managing Financial Risk and Incentives  Regulatory Compliance  One in four seniors take between 10 and 19 pills a day  1.5 million annual avoidable adverse drug events  Pharma companies are not pushing Pills alone anymore, but looking at total solutions  Drug Cost vs. effectiveness;  Regulatory Compliance and Transparency
  3. 3. 3 Copyright © 2014 HCL Technologies Limited | www.hcltech.com HEALTHONE  Make better and informed decisions  Have greater responsiveness to Care  Be more discriminating, efficient and effective users of healthcare resources  Have a greater adherence to health, wellness and quality guidelines  Follow best practices Payer - Member Care Management Provider - Patient Engagement
  4. 4. 4 Copyright © 2014 HCL Technologies Limited | www.hcltech.com Patient Engagement Life-cycle Member Stratification  Burden of Illness + Utilization based score  Member Demographic Member to Provider Attribution  Member attribution to PCP  Analyzing Claim data for Member attribution Set care delivery goals and incentives  Track Current Costs  Set benchmarks and targets for incentives Care Delivery to Member – Execute Care Plan  Care Plan for members with chronic or severe disease condition  Define Key patient problem and provide guidelines  Referral Management Enable Follow up care through Patient Engagement  Call Scheduling  Multi-channel patient outreach  Alerts and Adherence Monitoring Enable Self Managed Care – Member Tool kits  Patient Education  Self-Managed member tool kits to measure and track health parameters Measure Care Outcomes  Measure Outcomes based on the set benchmarks  Degree of appropriate use of services
  5. 5. 5 Copyright © 2014 HCL Technologies Limited | www.hcltech.com Member Stratification & Attribution MEMBER SEGMENTATION ANALYTICS ENGINE PCP ATTRIBUTION DATA SOURCES  Member Stratification and Segmentation based on Burden of Illness score  Member Attribution to PCP based on Member visits based on frequency and recent visits to a PCP
  6. 6. 6 Copyright © 2014 HCL Technologies Limited | www.hcltech.com Care Delivery through Patient Engagement Nursing Coordinator SMS/ E-Mail Snail Mail Online Resources PCP DISEASE BASED CARE PLAN PATIENT ENGAGEMENT PATIENTS  PCP assigns a Patient to a pre-defined Disease Protocol based on the Patients Disease condition, stage and need for a Care Plan  Patient is supported by a Care Plan administered through multiple Channels and is provided online resources/ toolkits for self-managed care
  7. 7. 7 Copyright © 2014 HCL Technologies Limited | www.hcltech.com Setting Care Delivery Goals and Measuring Outcomes  Track Current Costs and set benchmarks  Measure Outcomes based on the set benchmarks and identify outliers  Measure degree of appropriate use of services
  8. 8. 8 Copyright © 2014 HCL Technologies Limited | www.hcltech.com Patient Engagement Platform Counselor Pool PEP PLATFORM Nurses Pharmacologist Life Science Graduate  Enrollment through physicians  Direct enrollment thru marketing channels PATIENT PROFILING & SEGMENTATION  Program benefits to patients  Biological behavior mapping with disease symptoms and patient support program correlation PATIENT ENROLLMENT ONGOING CAREPATIENT COUNSELING Dietician Therapeutic Area Diabetes, Asthma, Rheumatoid Arthritis, Osteoarthritis, COPD Channel O/ B Calls SMS E-Mail/ Snail-Mail Online Resources  Reminder calls scheduling  Education on ongoing treatment  Gather adherence data points  How much knowledge – disease & treatment  How concerned about the disease  Perceived control of their health
  9. 9. 9 Copyright © 2014 HCL Technologies Limited | www.hcltech.com For Questions, Please Contact: contact.lsh@hcl.com
  10. 10. 10 Copyright © 2014 HCL Technologies Limited | www.hcltech.com