Patients and member networks expect continuous access to their healthcare team, and resources that serve their members needs. Healthcare professionals are adapting to these evolving needs, but are their systems doing the same? Resilient organizations are expanding virtual care services and enhancing patient engagement—from new patient onboarding through follow-up care.
PwC’s deep healthcare experience and Microsoft Dynamics 365’s secure, data-driven technology are paving the way for future stability and resiliency.
Direct care spending and indirect population health costs are rising. At the same time, digital health technologies and personalized member services are in high demand. Payors are looking for new and innovative business models to efficiently meet their members’ healthcare needs while providing them a seamless — and preferably digital — experience.
Does your network plan have the right providers to meet your members’ needs? Contracting with practices and providers and continuously improving network design is critical to providing the best care at the right cost. Dynamics 365 connects data from multiple systems for real-time insights that improve provider service and network management — bringing high value healthcare services directly into products and consumer experiences.
Do you want to become a more trusted advisor to your members and drive more valuable customer interactions? Payors look to increase the relationship with their members by using inbound service calls as the opportunity to steer the member with better advice. Dynamics 365 helps customer advocates within the health plan to intervene in the most effective moments of a customer service experience and personalize a “next best action” to help their members — using clinical and administrative analytics.
Does your organization rely on tedious manual processes for utilization management, membership data, billing and processing claims? Provide your teams with automations to efficiently manage services operations and risk/value-based reimbursement across commercial, retail and government segments. Dynamics 365 integrates operations into a digital platform that unlocks automation opportunities across the workflow. Empower your organization to learn and lead higher value activities that can scale.
Do you have the tools in place to engage members and caregivers in their care plan and guide them towards better health? Member engagement services can tailor healthcare navigation to individuals’ needs and manage the actions of members (and providers) around care options, care gaps, available services and utilization. The AI services in Dynamics 365 observe patterns from multiple data sources to help continuously improve the performance of care programs, engage based on individual member needs and provide targeted actions to increase adoption and wellness.
Do your sales teams know which products and services are most important to your prospects and members? Ensure your agents and brokers can achieve faster enterprise sales cycles by equipping them with the knowledge and tailored messaging to pursue opportunities proactively — including health history, social determinants, and propensity to act. Connect healthcare information and analyze data with Dynamics 365 to determine who is a candidate for certain health services and products and when/how to approach them. Tailor product and benefit offerings based on prospective member needs and across payor lines of business — commercial, retail, government (Medicare, Medicaid, Duals, etc.).
How do you deliver the ideal possible care outcomes at the lowest possible cost? Personalized and timely patient engagement is essential to improving care outcomes, and critical patient insights reduce time to treatment. Dynamics 365 helps your care teams deliver proactive care management, close care gaps and manage populations through advanced analytics, engagement automation and closed-loop reporting.
How do you identify and measure which marketing campaigns are successfully growing your market share? Dynamic 365 Marketing Automation tools powered by Customer Insights can help providers deliver journey-based campaigns with personalized content that improves outreach and engagement. Dynamics 365 also helps you connect with customers at every point of the care journey across all channels allowing you to measure campaign ROI using advanced analytics and campaign orchestration.
How can you deliver a seamless service experience across both patient and caregiver touch points to improve access, financial outcomes and reduce network leakage? An omnichannel engagement platform powered by a 360-degree view of the patient can help view can help employees improve patient engagement while driving productivity. Dynamics 365 can help contact center and service management teams engage with patients across channels that are powered by case management, knowledge management and workflow automation tools and integrate with electronic medical record systems.
How do you deliver the best possible care outcomes at the lowest possible cost? Personalized and timely patient engagement is essential to improving care outcomes, and critical patient insights reduce time-to-treatment. Dynamics 365 helps your care teams deliver proactive care management, close care gaps, and manage populations through advanced analytics, engagement automation and closed-loop reporting.
Are you taking a data-driven approach to growing your healthcare business and managing your provider network? Physician relationship management, which includes referral management and provider communications enabled by data-based insights, can help expand care services and close referral gaps. Dynamics 365 can provide an integrated view of your provider network, improve referral volume, prevent leakage and help you manage your provider relationships.
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*Every PwC Dynamics project to date has successfully gone live