Care Navigation: Chronic Conditions

Proactive Member Engagement for Chronic Care Management

Guide members experiencing chronic conditions to healthier behaviors and offer tailored support to drive better health outcomes and cost savings.
ChartSpan90%

(trillion)
Estimated cost of healthcare spending for health inequities in 2040.

See the report
PWC$4,500

possible savings per patient through better care coordination for members with chronic diseases.

See the report

Where does the current process fall short?

Payers face significant challenges in managing chronic conditions within the current healthcare landscape, primarily due to the system's reactive nature. These challenges include:

  • High Costs and Resource Allocation: Chronic conditions account for a substantial portion of healthcare spending, with 90% of the nation's $4.1 trillion annual healthcare expenditures directed towards chronic and mental health conditions.
  • Lack of Preventive Measures: The traditional healthcare model focuses on treating symptoms after they appear rather than preventing them, resulting in missed opportunities for early intervention.
  • Poor Care Coordination: Effective management of chronic conditions requires seamless coordination among various healthcare providers, but the current system often suffers from poor communication and fragmented care.
  • Poor Care Coordination: Effective management of chronic conditions requires seamless coordination among various healthcare providers, but the current system often suffers from poor communication and fragmented care.

By addressing these shortcomings through a proactive approach, payers can improve member health outcomes, reduce unnecessary healthcare expenditures, and enhance the overall efficiency of the healthcare system.

AI-Powered Automation for Chronic Conditions

Improve Member Engagement and Streamline Processes at Scale

Members with chronic conditions can also be some of the costliest. Trying to navigate a confusing and complex healthcare system can make it challenging for members to find care. Deliver personalized, targeted experiences that can better coordinate and educate members on their conditions for better care that costs less.

Educate

Proactively guide members and deliver resources throughout critical care journey touchpoints.

Outreach

Collect feedback and check-in regularly to assess progress for personalized care plans.

Coordinate

Assist members with scheduling specialists and sourcing resources outside of their plan.

Manage

Automatically process documents and upload data to core systems without any rip and replace.

1

Benefits Literacy & Concierge Services

Members receive proactive outreach, explaining benefits and services.

2

Digital HNA

Members receive proactive outreach to complete health needs assessment (HNA) for health goals and concerns.

Common integrations
3

Care Guidance

Members receive proactive outreach on MSK concerns based on HNA completion.

Common integrations
4

Care Advocacy

Members guided to MSK services as part of benefits to help with MSK diagnosis and treatment.

Common integrations
5

Care Survey

Members receive proactive outreach after 10, 15, or 20 days for feedback related to MSK services & care.

6

Care Management

Members receive proactive outreach from Care Manager to engage via live chat.

Common integrations
7

Provider Lookup & Schedule

Members receive proactive outreach to schedule appointment with specialists from Care Manager

Common integrations
8

Virtual Provider Visit

Members receive reminders for appointments and links to access virtual visits with their provider.

Common integrations
9

Digital HNA

Members receive proactive outreach to update health need goals and concerns.

10

NPS

Members receive proactive outreach to provide feedback on overall experiences and care provided.

Elevate Member Experiences in Weeks

Differentiate your Chronic and Acute conditions and give tailored care information to your members for increased effectiveness, allowing for a greater number of preventative care measures to be taken. Designed by business users and deployed with a single click without the need for a traditional mobile app.

Prescription Refill
Your copay of $30 will be charged to your card ending in 2677. Do you approve?
Yes
No, I'd like to charge to a new card just this once
No, I'd like to provide a new card for charges going forward
Enroll in Copay Assistance
Continue
circle.cx
Customized branding for recognition and trust
A HIPAA-secure rich user experience designed to be intuitive and engaging
Minimal IT and no professional services needed
With integrated analytics to evaluate campaign effectiveness
Customized for each member and reachable 24/7
Customized branding for recognition and trust
A HIPAA-secure rich user experience designed to be intuitive and engaging
Minimal IT and no professional services needed
With integrated analytics to evaluate campaign effectiveness
Customized for each member and reachable 24/7

Security & Compliance

We know PII and security are a top concern. The Ushur CXA platform is HIPAA-secure, TCPA compliant and is HITRUST and SOC2 certified. Rest assured your working in a highly secured platform.

HIPAA logoHITRUSTPCIAICPA SOCCIS logoGDPR logo

Blog

How Digital Care Navigation Improves Chronic Health Outcomes

Despite high spending, the U.S. faces alarming pregnancy outcomes. Discover how digital care and automation, like the Ushur CXA Platform, are revolutionizing maternity care:

  • How advanced analytics and AI can help identify high-risk members and target interventions for maximum impact
  • The importance of addressing both medical and non-medical needs, including social determinants of health, through integrated support
  • Why value-based payment models are crucial for aligning provider incentives with payer goals and driving better outcomes
Read the post
Care Navigation for an elderly woman.

Ushur for Chronic Condtions

Deliver more affordable care through better member outreach

The Ushur CXA AI-powered Platform enables healthcare payers and providers to realize decreased costs in care and increased member and patient quality of care. See how we support both.

40%

NPS score improvement

85%

CSAT score improvement

3

weeks to deploy

42%

outbound calls eliminated

PatientsHealth Payers

Members

Members with chronic or acute health conditions management benefit from Ushur's CXA platform through timely appointment reminders, personalized health education, secure communication, real-time support, and proactive health monitoring. These features empower members with the tools and information they need to traverse a complex healthcare system and get the care they need.

Health Payers

Enable payers to deliver personalized, proactive support to members with costly chronic conditions. By leveraging intelligent automation and omni-channel engagement, Ushur helps payers improve care coordination, reduce avoidable utilization, and drive better health outcomes while lowering costs and enhancing member satisfaction.

Members

“Managing my elderly father's congestive heart failure used to require constant vigilance and coordination between multiple specialists. Ushur has been a game-changer. It streamlines communication, provides helpful reminders and education, and flags issues before they become emergencies. The peace of mind is invaluable.”

Health Payers

“Ushur's AI-powered care navigation platform has been instrumental in identifying and engaging these individuals with personalized outreach and support. By proactively connecting patients to needed services and addressing barriers to care, we've seen a significant reduction in ER visits and admissions.”
AflacEquitableBenefitfocusIEHPUnited Healthcare

eGuide

Guide to More Effective Healthcare Population Health and Wellness Communications

How to Guide Members to Take Better Health and Wellness Actions with Advanced Digital Communications

Payers have a chance to drive better health outcomes thanks to recent advances in automation technologies like process automation and artificial intelligence. Quality of care is just one piece of the puzzle - how plans engage/interact with their members is a central tenet to quality outcomes.

Get the guide

AI from Ushur for the most at Risk

Personalized communication for individualized care coordination

Ushur Experience OS (XOS) platform enables healthcare organizations to deliver personalized care navigation experiences for those with the most expensive conditions. Deliver education and coordination for healthcare navigation without the noise.

Experience OS use case graphic
Chat
Voice
Insights
Healthcare

Chronic Conditions

Educate members and deliver better assessments for cheaper proactive care.

AI Agent

An operating system for better care navigation for the most expensive conditions

A new and bold way to think about care navigation for the most expensive conditions. The Ushur ExperienceOS enables enterprises to deploy skilled AI Agents en masse to scale the human-like touch that customers demand. Design agents with the skills they need to support end-to-end experiences for members with acute and chronic conditions in getting better care.

icons