With ever-evolving standards of care, rising prevalence, and increasing healthcare costs, it is critical for Medicare Advantage plans to improve the effectiveness and efficiency of their chronic disease care management programs.   


Chronic care is complex and requires a comprehensive approach to address the unique needs of diverse member populations. Even when successful programs are in place, resources—such as clinical staff and limited funding—can only go so far. More plans are turning to virtual specialty care to boost the reach and results of existing care management programs. Digital-only solutions are great at attracting and engaging a healthier, wealthier, and younger demographic. But this means many Medicare Advantage beneficiaries are not experiencing the associated benefits. However, virtual specialty care offers a combination of digital and human elements carefully designed to help increase access and accelerate the path to better outcomes—several of which can have a positive impact on a plan’s quality measures.    


1. More members + higher engagement

Engaging members in their care is crucial to improving health outcomes and reducing costs. Engagement is also critical to improving plan performance. Virtual platforms enable this at scale—more interactions, more often, with more members. What’s more, data drives the personalization necessary to effectively reach more members with the right messages based on their unique needs and preferences.  


The key to effective virtual care is a combination of digital touchpoints, powered by data, with a human element.  


Despite all the promises of digital health, people still crave human connection and tend to have better outcomes when they receive psychosocial support as part of their care plan. With expanded access to disease state experts through virtual specialty care, members are guided to self-empowerment using motivational techniques and evidence-based disease state curriculum, powered by a unique virtual platform and reinforced through digital touchpoints like email and text.   


The end result? More members who are active participants in their health journey.


2. Seamless care coordination

For people living with chronic conditions, managing an illness (and, likely, co-existing conditions) within a complex healthcare system can be confusing and intimidating. Virtual specialty care allows for reinforcement of existing treatment plans and seamless care coordination. Members are connected to clinician-led support and education in between office visits, which lessens the burden on primary care. When needed, virtual specialty care includes escalation to a physician for real-time, remote interventions. For example, endocrinologists can enhance care plans through dosage adjustments and titration changes.  


Social determinants of health (SDOH) also play a significant role in health outcomes, especially among Medicare-aged populations. Virtual specialty care allows clinicians to build trusting relationships with members to uncover barriers that are oftentimes related to SDOH factors, and then refer those members to SDOH resources. For instance, if a member living with diabetes is struggling to afford healthy food, their expert clinician can connect them to a local food bank or community resources that can provide support.  


Cohesive care that removes the friction in the patient experience can drive better adherence to care plans and improved member satisfaction.  


3. Improved health outcomes + member satisfaction

Through virtual specialty care, and solutions like Cecelia Health’s virtual clinic, members get access to a disease state expert who provides accountability and personalized education. The goal is to help each member manage their chronic condition through lifestyle and behavior change to improve clinical outcomes. Effective virtual specialty care programs track measures that have the greatest impact on a plan’s performance. And across a range of chronic conditions, including:  

Unfortunately, there is no one-size-fits-all chronic disease care management solution. However, virtual specialty care can be the one solution that fills gaps in existing approaches. Specifically, it can help plans reach more members with access to support that leads to improved outcomes. From engagement to empowerment to enduring self-management, virtual specialty care is the catalyst for more effective chronic care management.