Care Management Companies: Growth Through AI and Automation

Care management service provider organizations may  differ in their focus, patient population, or approach to supporting clinicians. Still, they share one common goal: to deliver value to  both providers and patients while maximizing the number of patients they can support with an efficient care management team.

Care management service companies are varied but share common objectives

Some care management service providers focus on a specific patient population—by age or disease—or they specialize in working with primary or specialty care practices or Accountable Care Organizations (ACOs). Others combine services, such as home health, hospice, or palliative care, with care management services.

Despite these differences and the distinct way that each company approaches delivery, they share five directives to successfully grow their businesses and provide high value to customers, including:

• Maximize the impact of their care manager’s time 
• Effectively manage the greatest number of patients with the smallest care manager team
• Streamline tasking and minimize administrative burdens
• Deliver measurable value to healthcare clients and their patients
• Drive greater ROI internally and for clients

AI and automation help care management distributors grow and scale

Artificial intelligence (AI) utilizes technologies, such as: 

• Natural language processing
• Machine learning
• Optical character recognition
• Robotic process automation 

It leverages these technologies to streamline care management functions, automate numerous tasks, and alleviate cognitive and administrative burdens.

Within care management, AI is transformational, enabling care management service providers to deliver more value to clients and their patients through proactive, personalized, and efficient services. 

ThoroughCare helps providers succeed with care management through a software platform and insights from our Clinical Advisory Team, offering a range of AI and automation capabilities. These co-pilot, AI-assistant tools give service providers a leg up by facilitating their ability to:

• Create a distinct competitive advantage
• Demonstrate compliance- and reimbursement-driven competency
• Prove their ability to deliver evidence-based best practices
• Onboard more clients and start engaging patients faster
• Gain traction and build goodwill with patients sooner

In simple terms, these advanced technologies give care management service providers the capacity to attract more clients, demonstrate definitive value, and secure more deals, which are essential for sustainable growth.

How ThoroughCare’s AI and automation features drive more value for care management companies

Clinicians outsource care management to increase their capacity to deliver high-quality care. Those same companies use ThoroughCare to maximize their team’s ability to create positive change efficiently, serving more patients on their behalf.

We’ve built the ThoroughCare platform, along with Advisory Services, to capitalize on the following AI and automation features that optimize efficiency, maintain accuracy and compliance, and scale reach.

ThoroughCare’s artificial intelligence features

Our AI features maximize staff time and deliver enhanced efficiency through:

Automated documentation

AI generates and formats post-call notes automatically, reducing the time care managers spend on documentation while minimizing errors.

Smart task management

AI analyzes call conversations to automatically create tasks, ensuring timely follow-ups and improved task accuracy.

Care plan development

AI analyzes patient data to suggest personalized care plans, including SMART goals and interventions. These tailored recommendations enhance the relevance and effectiveness of patient interactions, promoting active participation in their own care.

Efficient call preparation

AI provides pre-call summaries by extracting relevant information from patient profiles and previous contacts, enabling more focused and effective patient conversations.

Integrated communication

With built-in VOIP capabilities, care coordinators can initiate, receive, and manage calls directly within the platform, eliminating the need to switch between multiple systems. This streamlines communication, making it easier to maintain consistent and meaningful contact with patients.

In our analysis, ThoroughCare clients using AI features have experienced a 50%+ increase in care manager productivity and a 70%+ increase in task accuracy.

ThoroughCare’s automation features

Our automation features streamline the day-to-day volume of care management tasks and duties, including:

Guided assessments

Evidence-based, guided assessments are  easily accessible within the care management platform. This makes it easy for care managers to collect timely information while focusing on the patient, rather than the task of completing surveys.

ThoroughCare offers numerous assessments informed by recommendations from the American Academy of Family Physicians. These range from: 

• Health Risk Assessment
• Behavioral Health Screenings
• Health Related Social Needs 
• Cognitive Screenings 
• Functional Status

Other assessments, like those in the Advance Care Planning module, guide the care team through conversations related to end-of-life planning. 

Additionally, custom assessments geared to a particular client can be added through collaboration with our advisory services team.

Built-in workflows

Each care management program offered through ThoroughCare is available with just a few clicks. Simply add or upload patient information and start coordinating.

Our built-in workflows are designed to meet CMS requirements for enrollment, time tracking, and documentation of care management programs. This ensures that all necessary elements for delivering compliant services are accounted for and addressed.

For example, the Chronic Care Management (CCM) module presents an initial and ongoing monthly workflow. It visually guides the care manager through each aspect of required tasks, such as: 

• Enrollment and consent
• Initial patient-centered care plan development
•  Monthly care plan review and updates
• Documenting patient interactions
• Time logging

Dashboards and worklists

Automated worklists show care managers which patients to engage, when, and why.

This helps them prioritize their work and manage their daily outreach and tasks easily. Sort and filter population data or focus on a specific patient’s profile right from the worklist.

Utilize various analytics dashboards to pinpoint a specific risk level, care gap, or performance metric that requires immediate attention. Manage high-risk patients and intervene more quickly when deadlines, workflows, or remote patient data are not met.

KPI dashboards and reports provide critical insights across five performance areas, including:

• Clinical and patient outcomes metrics
• Patient enrollment and engagement metrics
• Care management and operational efficiency metrics
• Financial metrics
• Population health and care management program-related metrics

For example, the Chronic Care Management dashboard highlights patient health outcomes, care team efficiency, and overall program effectiveness. It also shows rates of patient engagement, participation, and inactivity over time.

The Remote Patient Monitoring (RPM) dashboard focuses on performance, effectiveness, and outcomes. It includes alert notifications, abnormal health metrics, patient engagement and interactions, calls, time, and claims generated.

Data integration and interoperability

Access to key patient information and documentation is essential for managing a large number of patients effectively and efficiently.

ThoroughCare integrates directly with many electronic health records, enabling the automated import and sharing of data. This includes individual patient records, ICD-10 codes, SNOMED codes, as well as basic and advanced clinical and financial information.

Robust interoperability ensures the care management team has seamless access to the necessary patient information. They can utilize that information to engage patients efficiently, deliver targeted interventions, and support timely education, goal-setting, and care coordination activities.

Care management service providers can do more and grow faster with ThoroughCare

ThoroughCare partners with care management companies to help them deliver greater value to more clients and patients through efficient and effective care management. Our AI and automation capabilities accelerate care and maximize every interaction and touchpoint.

By partnering with us, vendors can deliver 10-15x ROI and enable their clinical clients to experience the benefits of outsourcing faster, including:

• Improve patient outcomes and see meaningful changes in clinical performance measures
• Enable new revenue streams for providers
• Reduce the clinical and administrative burden physicians and care teams bear
• Support value-based care contracting
• Reduce the overall cost of delivering high-quality, coordinated care