Anthem: Increasing Engagement in Disease Management Program

Background

Anthem, Inc. is one of the largest health benefits companies in the United States. Anthem offers disease management programs designed to influence individuals to modify their behavior in ways that improve their health and their communities’ health. Anthem’s disease management programs focus on decreasing inpatient admissions and length of stay while increasing office outpatient visits.

The company faced significant challenges in enrolling individuals and keeping them engaged with health coaches after enrollment. To overcome these challenges, Anthem partnered with QualPro to increase disease management program engagement by at least 10 percent.

Approach

QualPro’s consultants analyzed Anthem’s data and categorized Anthem’s members into two groups: first-time members (who had never had an experience with the disease management program) and re-stratified members (who had chronic illnesses and needed program support). Each category required different experiences to drive their engagement.

Next, our consultants assembled a team consisting of individuals from Anthem’s leadership, front-line clinicians, front-line non-clinicians, human resources department, and product and program design team. Together, the team brainstormed a list of over 700 potential improvement ideas. The team narrowed the potential ideas to 34 items Anthem believed would allow them to engage and retain members in the program. The ideas fell into three categories: people, process, and technology. Some examples of each included offering employee incentives, creating clinical and enrollment scripts, and creating email and text appointment reminders.

QualPro’s consultants designed experiments for Anthem personnel to perform. The experiments included 139 Anthem associates across four key care centers and involved 32,000 members. Anthem personnel used different combinations of the test ideas and recorded the results.

The tests revealed that there were two distinct categories of disease management program members. The motives that compelled the two categories to enroll and engage differed. Actions that compelled first-time members to enroll might not compel re-stratified members to re-enroll. A refining experiment identified 10 ideas that effectively increased member engagement and retention.

After analyzing the data, QualPro consultants created recommendations for Anthem to implement. In accordance with our commitment to driving continuous improvement, our consultants worked closely with the company to guide process changes and motivate project team members to exceed goals.

Results

After implementing QualPro’s recommendations, Anthem reached its goal of a 10 percent increase in initial engagement in two months. By the end of the five-month experimentation period, Anthem achieved a 24 percent increase in initial engagement and a 27 percent increase in sustained engagement.