With health equity and access to care being priorities for many healthcare organizations across the globe, healthcare leaders are focusing on holistic case management to improve equity and reduce health disparities. Integrating the online and offline healthcare worlds should be on your agenda, with a focus on ensuring a low-effort, seamless journey for healthcare consumers.
Public health systems are working to navigate the challenges of linking community and clinical services to improve health outcomes. Numerous countries are already implementing innovative programs to move public health in the right direction to digitization, self-care, eased access and improved equity. These plans directly align with consumer expectations for simpler, more coordinated and convenient services.
Europe
The recovery and resilience plans for the 28 EU member states set out the reforms and investments that they're aiming to implement by 2026, including public administration reforms and investments to strengthen their healthcare systems to digitalize hospitals and modernize public healthcare offices.6
United Kingdom
In April 2022, the U.K.’s reform of public health brought all healthcare providers into new, geographically based integrated care systems (ICSs). These ICSs aim to bring together partner organizations to improve outcomes in population health and healthcare and enhance productivity and value for money.7
United States
Similarly, in the U.S., there’s a big shift from treating people to keeping people healthier, with a focus on disease prevention, integrated systems and value-based care.8
Holistic case management in the contact center
Contact centers can provide healthcare brands and consumers increased convenience, quality and value by offering additional services and recommending next-best actions.
For example, Jessica in the U.S. calls her insurance payer about a claim. While reviewing her claim history, the agent notices that she hasn’t had a mammogram in two years. The agent offers to schedule an appointment for her and lets her know about three doctors within her network with five-star ratings.
Jessica tells the agent that she’s elderly and doesn’t drive, so she would have trouble getting to the appointment. The agent lets her know that since she’s on Medicare, she’s eligible to receive a ride to and from healthcare appointments for only $7 through their rideshare partnership, and the agent offers to schedule that for her. Jessica appreciates the help and asks the agent to schedule appointments for the mammogram and transportation.
The agent also lets Jessica know about a health program she can participate in so she can get discounts on the cost of her premiums. In an adjacent approach, the agent routes this information to the insurance payer for later follow-up.
As an extension of ongoing support for their consumers, and building long-term relationships with them, the healthcare payer’s agents are assigned a small group of consumers that they stay in contact with, to ensure they’re updated on activities related to their healthcare coverage.
This full-service approach across the customer journey provides convenience to consumers while at the same time helping healthcare companies retain consumers.
An evolution of the contact center
So, what does this mean for the healthcare contact center? Holistic case management requires an evolution of the contact center from a focus on issue resolution to a coordinated care approach, with agents anticipating the needs of consumers and making proactive, relevant recommendations on the next-best action for them.
Using intelligence solutions such as interaction analytics and AI will help to tangibly improve consumer experiences and satisfaction, care quality, agent performance and compliance, and operational efficiency by revealing insights from every consumer contact in real time. This information will help optimize processes and provide better coaching to agents, as well as improve CX.
6 - European Commission, “National recovery and resilience plans,” ec.europa.eu.
7 - NHS England, “What are integrated care systems?” england.nhs.uk.
8 - Harvard Business Review, “5 critical priorities for the U.S. health care system,” hbr.org.