Behavioral Health (BH) including mental health, substance abuse, stress management and its integrated effect on overall medical health is a focus area for health plans. Providing members with coordinated care and direct access to BH resources is part of a Payer’s commitment to providing the highest quality, integrated care for members and a convenient, personalized experience.  

Health plans can take various approaches to reach this goal, however, the need for a more robust CRM platform is evident to customize this experience for their members.

Salesforce Health Cloud empowers health plans to leverage data, automated workflows, and comprehensive member management to achieve and exceed health plans’ BH needs. Salesforce Health Cloud brings together clinical and nonclinical data in one place and combines “out of the box” functionality with full customization, using key features such as Case Management, Care Plans, Care Barriers, Provider Search, Patient Timeline, and many more. With the right implementation partner, health plans can see the value of their Salesforce investment upon achieving these goals.

Real World Experience

AArete has been supporting clients by developing Salesforce Health Cloud solutions to address these needs. One recent example was a health plan seeking a BH solution that delivered a more personalized member experience, allowing their team to scale operations, and eliminate manual processes and the use of inefficient tools.

Features included:

• Integrated platform connecting member portal and care management portal
• Member self-assessment which recommends available programs and resources
• Automated workflows to generate cases and trigger member outreach
• Member forms and surveys that provide additional information about a member’s personal needs
• Reporting capabilities to track member engagement and team workload

By leveraging Salesforce Health Cloud for payers, we were able to help our client implement a cohesive behavioral health solution connecting their members to the right teams and resources for optimal outcomes.

Why Implement Salesforce Health Cloud?

Understanding the capabilities of Salesforce Health Cloud for payers that can enable a Behavioral Health solution and other personalized for experiences is the starting point for a sound strategy.  Below are five reasons, or native applications of Salesforce Health Cloud, that can be tailored to meet your plan goals:

Personalized Care Management

Salesforce Health Cloud enables health plans to build a 360-degree view of each member, integrating data from various sources, including electronic health records (EHRs), claims data, and social determinants of health. This holistic view allows care coordinators to better understand the unique behavioral health needs of each member, including their history, current treatment plans, and potential risk factors. By leveraging this data, health plans can create personalized care plans that address the specific needs of members, leading to more effective and tailored interventions.

Automated Workflows

Automation is a key feature of Salesforce Health Cloud that can significantly enhance the efficiency of health plan operations. Creating workflows for routine tasks such as care plans & case management, member outreach, and referral management, team members can have more time to focus on complex cases and member interactions.

Enhanced Member Engagement

Engaging with members early and throughout their behavioral health journey is key to achieving positive outcomes. Salesforce provides tools for proactive member engagement that allows health plans to send personalized communications, educational content, care reminders, and support resources directly to members through various channels such as member portal, mobile application, emails, and text messages.

Data-Driven Insights

Advanced analytics capabilities enable health plans to gain insights into their members’ behavioral health needs and treatment outcomes. Analyzing data on member engagement, services received, program interactions, and care coordination, health plans can identify trends, evaluate the effectiveness of interventions, and assess opportunities to improve their delivery model leading to better health outcomes and reduced costs.

Scalability and Flexibility

Salesforce Health Cloud offers the ability to adapt to the changing needs of a health plan, being able to easily add new workflows, integrate with other systems, and adding features to accommodate new service offerings.

How Can AArete Support You?

A powerful CRM, like Salesforce Health Cloud, depends on a meaningful setup, tailored to unique health plan goals. To optimize Salesforce investment, AArete supports clients throughout their Salesforce journey, from initial strategy & planning to implementation and ongoing maintenance and support. AArete’s services include:

• Strategy & Planning
• Data Architecture & Management
• UX/UI Design
• Implementation & Customization
• Integration & Automation
• Reporting & Analytics