Payor Article

It's no secret that reimbursement is a major barrier to deploying digital health. Providers know the value of solutions like remote patient monitoring, but the question of who will pay for it often holds them back from offering RPM to their patients.

During the pandemic, decreased regulations and increased reimbursements — and sheer necessity — drove health systems to invest in and deploy telehealth. But for many of those health systems, whose razor thin profit margins were already under strain before Covid, doing more than the bare minimum was not a financially viable option.

Babyscripts’ Joint Deployment model was conceived to address these barriers to deployment — to create realistic financial pathways for health systems to use technology in the delivery of care by bringing the payor into the equation. Through the Joint Deployment model, payors sponsor the cost of Babyscripts for their members at participating health systems.

Among its many benefits, digital health enables early identification of high risk patients, one of the most significant factors in achieving cost savings. For that reason, payors have long been on board with investing in digital health, but traditionally this investment has been in direct-to-consumer solutions, unlike Babyscripts, which is a digital health tool connected to the provider.

At the close of 2020, we talked to the team at AmeriHealth Caritas DC, one of the largest MCOs in the District and a Babyscripts partner, about what motivated AmeriHealth to reimburse Babyscripts for their members instead of using a direct-to-consumer solution.

From them, we learned that while a lot of the payor community has been working with direct-to-consumer digital companies, those investments haven’t moved the needle on outcomes or cost. A strategy based on engaging the member directly, without involving the provider, produced a massive gap in engagement.

Members don’t see the payor in the same light as they see the provider — they’re less engaged because the stakes seem much lower. A member is much more likely to follow a directive that comes from their doctor than one that comes from their insurance provider.

In addition to offering Amerihealth members a connection to their providers, Babyscripts helped the insurance payor tailor messaging and marketing to the needs of their individual pregnant members, helping to foster the kind of relationships that are essential for engagement.

With the data from Babyscripts, Amerihealth has been able to track an increase in women engaging in prenatal care in the first trimester. This is a huge gain that partially comes from the messaging of Babyscripts and the relationship it fosters with the provider.

Now more than ever, people engage in a large portion of their lives without ever being in the same room as another individual. Digital tools can help cultivate the sense of relationship that is being lost in our isolated times. Amerihealth is using Babyscripts to help manage individuals within a community context, so that women are empowered to take charge of their own health and ownership over their wellness.

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