The COVID-19 pandemic upended the entire healthcare industry, and payors and providers are still determining how to move forward in the new normal

Clover Health, a leading American health plan operator and technology company, needed to quickly adjust their processes to adapt to a remote care model and build new communication channels to stay connected with patients and providers as cases of COVID-19 surged in their key markets. Because Clover already relied on Salesforce technology to support key parts of their clinical and customer service functions, leveraging Salesforce Health Cloud tools to rapidly respond to the changing healthcare market was a natural choice. Clover engaged EPAM, due to its deep Salesforce and healthcare expertise, to develop a Salesforce Health Cloud solution. Within about a week, Clover was able to effectively transition to a virtual model and share COVID-19 updates and valuable resources with members.

Key Challenges

With the spread of COVID-19, Clover had to shift their care visits from an in-person model to a virtual model. Since visits were tracked manually, a new scheduling and tracking tool was needed.

In addition to significant operational challenges, Clover was receiving high call volume from members asking about appointments, resources and how to receive medications, requiring the company to implement new communication channels.

Solution Highlights

Clover worked with EPAM to leverage Salesforce’s capabilities to quickly adapt to the changing healthcare landscape in the following areas:

• Launching a COVID-19 resource page that provided frequently asked questions, patient updates and articles to educate members on the pandemic, which reduced call volume and unnecessary wait times
• Building a clinical service console to provide a 360-degree view of members to enable virtual visits and automatically match an appropriate nurse practitioner to a member to schedule appointments based on language, location and availability
  
• Implementing new communication channels, such as email and SMS, to provide critical information to members
  

The Results

EPAM ensured Clover had a holistic and fully- integrated solution across their existing tech stack in accelerated time-to-market. Clover estimates that these tools will allow for a 50% increase in NP productivity, an estimated $4M ROI. With this foundation in place, Clover is equipped to quickly respond to any market changes in the healthcare space by easily adapting to virtual appointments, standing up new resource pages within hours and reaching members through a variety of channels to focus further on specific clinical measures and value-based care initiatives.

Technologies used

• HEAR FROM THE CUSTOMER

Aaron Berry
Director of Product Management, Clover Health