Elevance Health expands concierge care program to chronic conditions like Crohn's disease, diabetes

About a year ago, Elevance Health launched a pilot program to offer digital concierge care to members who were recovering from COVID-19 infections.

Since then, the insurer has expanded that initiative to offer concierge care management to members with a number of chronic conditions including Crohn's disease, cancer and diabetes. Anthony Nguyen, M.D., the chief clinical officer at Elevance, told Fierce Healthcare that the program was born from a desire to be "more engaging with our members."

"The challenge for not only the programs that we have, the traditional ones, as well as others in the market, is that it's not personalized," Nguyen said. "It is not tailored to an 'n' of one."

Greater personalization was built into the foundation of the program, he said. For example, concierge care deploys a nurse matching tool that connects members with a clinician who is likely to connect and resonate well with them, improving the care journey.

In addition, it was critical to have buy-in from physicians and other clinicians to drive the program, Nguyen said. The insurer collaborated with physicians to ensure they would endorse the offering to members who would benefit from it, he said.

"Having that endorsement and collaboration with the physician is also a differentiator," he said.

The programs are designed to last between 12 and 16 weeks, Nguyen said. They combine clinical and care management support, patient education and gamification into an app that's easy for members to use. Members who connect to the app can access the latest educational materials about their condition as well as complete virtual challenges that help them manage their health.

Patients can also connect with their nurse case managers or health educators via asynchronous digital chats within the app. They can log their symptoms in real time, providing those data to the care team to allow them to proactively monitor their status and provide support as needed.

Nguyen said that the gamification element was the third tent pole in developing the program, as they wanted to ensure it was fun for the user.

"There's an intense engagement," he said, "and we empower the individual to continue the learning process."

The team also built the program to address comorbidities and patients who have multiple disease states: for example, providing behavioral health support for people with Crohn's disease who may also struggle with depression or other mental health needs.

Nguyen said the next evolution of the program will be pushing it to be disease-agnostic and instead offering a tailored, personalized care management platform that works for members of all kinds. His team is also seeking to continue building on the capabilities available at Elevance Health's Carelon arm to drive the program forward.

"They are the aggregator of the capabilities that we need," he said. "So they're a one-stop shop, which makes it easy for me to create programs that are going to be relevant and engaging to our members."