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Medecision Report: Digital Care Management in Crisis

A recent study released by Medecision, titled "Building the Intelligent Health Plan," uncovers significant shortcomings in digital care management (DCM) tools utilized by health plan executives. The feedback shared by these leaders paints a troubling picture amid rising financial pressures and increasingly complex member needs, indicating that their current digital solutions are not adequate for effective care management.

The report, which stems from a national survey involving fifty health plan executives conducted by Sage Growth Partners, reveals critical gaps between expectations and reality in delivering personalized and efficient care. With health plans aiming for more sophisticated, data-driven management practices, the findings suggest drastic improvements are necessary. Key insights from the report include:

• - Real-Time Capability: A mere 8% of leaders claim that their DCM tools function in real time, highlighting a significant drawback in responsiveness.
• - Member Engagement: Over half (52%) acknowledge their tools fall short in effectively engaging members, an essential aspect of personalized care.
• - Personalized Outreach: Despite 98% expressing a desire to personalize communication, only 10% currently manage to do so.
• - Data Integration: While 65% consider seamless integration of data crucial, only 17% believe their platforms achieve this successfully.

Kenneth Young, president and CEO of Medecision, stated, "This report is crucial for health plan leaders examining their strategies in care management. The objectives are clear: enhance outcomes, control costs, and improve member experiences. However, the existing tools rarely align with these goals, necessitating modern technology and infrastructure that can bridge this gap."

Despite the frustrations articulated in the report, a sense of optimism lingers among health plan leaders. They recognize the next generation of DCM solutions must transcend simple case tracking, moving towards real-time data functionalities, artificial intelligence (AI) for decision making, and scalable personalizations that cater to the diverse needs of members.

Dan D’Orazio, CEO of Sage Growth Partners, observed, "Health plans are aware of the urgency for modernization but require solutions designed to handle today's complex care environment. This research points out the vital opportunity for plans to rethink their digital strategies and invest in enabling technologies that bring genuine value."

In response to these pressing challenges, Medecision has introduced its Care Management with Co-Pilot, a solution specifically crafted to cater to current needs. This tool is designed to either integrate with existing workflows or replace outdated systems, providing:

• - Real-time Outreach: Aiming for proactive engagement with members, ensuring timely interventions when necessary.
• - Scalable Engagement: Ensuring member interaction scales without proportional increases in staffing costs.
• - Intelligent Workflows: Harnessing data from various sources across the healthcare ecosystem to inform smarter decision-making processes.

Young further elaborated, "Health plans don't simply require more dashboards; they need systems that render data meaningful, timely, and actionable. That is where we come into play."

For those wanting to delve deeper into the study's findings and how their health organizations compare, Medecision encourages downloading the full report to gain insights and understand the next steps toward improvement.

About Medecision

Medecision is committed to delivering data-driven solutions that empower risk-bearing organizations in care management, utilization management, and population health. Their platform is designed to enhance efficiency and intelligence, benefiting over 10% of the U.S. population by offering real-time insights, automation, seamless interoperability, and engagement strategies to improve health outcomes while minimizing costs and complexities.

To learn more, visit www.medecision.com.

About Sage Growth Partners

Founded in 2005, Sage Growth Partners is an advisory firm specializing in the healthcare sector, providing extensive market research and strategic communication services. Their deep domain expertise helps healthcare organizations navigate the rapidly evolving marketplace successfully. More information can be found at sage-growth.com.