Private Payers News

Payer Launches At-Home Chronic Disease Management, Education Solution

Blue Cross Blue Shield of Massachusetts implemented a Nudge unit to improve members’ options for at-home chronic disease management.

mental healthcare, chronic disease management, member education

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By Mark Melchionna

- To improve member health and overall care, Blue Cross Blue Shield of Massachusetts (Blue Cross) implemented a Nudge Unit that focuses on providing at-home resources and prescriptions for diseases such as colorectal cancer and diabetes.

Nudges are used in healthcare to alter strategies for presenting choices, leading consumers to the ability to make improved decisions. As one of the first health plans in the US to launch a Nudge Unit, Blue Cross intends to provide for various cases through the new platform.

The types of interventions that the Nudge Unit provides include sending a letter to members along with colorectal cancer screening tests and improving messaging that urges providers to order statins for diabetes patients.  

These types of solutions have already demonstrated results. By rewording communications to members and providers, payers have seen a three percent increase in cancer testing and a 14 percent increase in statin prescriptions, the press release noted.

The Nudge Unit will also provide insight regarding how to effectively update the MyBlue app to provide ethnic information and inform clinicians of any prescription omissions.

"One of the most effective things you can do in health care is encourage people to make better choices," said Mark Friedberg, MD, senior vice president of performance measurement and improvement at Blue Cross, in a press release. "The guiding principle behind our Nudge Unit is that better decisions exist - and that clinicians and members are likely to make those decisions if information is presented in a slightly different way. We want to make it easy to make optimal decisions, in a way that respects rather than limits freedom of choice."

Blue Cross selected the Nudge Unit’s leadership with the goal of leveraging the company’s behavioral insights. As of May 2022, the unit has participated in 53 interventions.

Other Blue Cross Blue Shield companies have also taken steps to improve their use of data and make mental healthcare more accessible.

For example, In July 2020, Blue Cross began offering treatment for mental health using a telehealth service known as WellConnection. Members of the organization acknowledged that this care method aimed to solve problems that existed before the COVID-19 pandemic and allow members with mental health needs to obtain access to care. 

In May 2019, the Blue Cross Blue Shield Association worked with Blue Health Intelligence to create claims data analytics, hoping to improve overall health and experience. Open to innovators across the industry, the service located companies interested in highlighting critical takeaways from large amounts of data to eliminate limitations and risks related to care delivery.