Step 4: Evolve for What’s Next

Discover what providers and payers can do to prepare for the next big challenge in healthcare.


COVID-19 caused a seismic shift in operations for both providers and payers. Care and coverage will continue to change based on the pandemic and society’s response to it, from rapidly expanding provider options and altering payment systems to improving access to care. These changes will prepare organizations for the next big challenge they face, whether it’s a continuation of the current pandemic or another kind of crisis.

Managing health emergencies requires smart segmentation of patient and member populations. Providers and payers must be poised to deliver targeted care, and to scale it up or down in response to need. To facilitate this, they need open channels of communication within and between organizations and with patients, members, and their caregivers.

Patients with a contagious disease may need to enter into a contact tracing program. Individuals with chronic conditions or comorbidities may need ongoing guidance to stay healthy. No matter who your cohorts are, use technology to segment for different types of assistance or interventions.

  • Trace contacts of patients with an infectious disease: A robust CRM platform can organize information around the possible spread of infection and facilitate reaching out to those at risk. 
  • Harness AI: Predictive analytics can surface patients or members with certain risk factors or common conditions and then proactively deliver helpful information or encourage preventive care, such as blood pressure checks or flu vaccines. 
  • Deepen relationships: Personalized engagement based on a patient or member’s real-time healthcare needs strengthens loyalty. This increases the likelihood that they will return for their next appointment or reenroll in a health insurance plan.

When COVID-19 cases were growing exponentially, providers and payers rapidly altered existing systems for virus care and coverage. Once the numbers were controlled, demand increased for many elective and nonemergency care and procedures. Whatever the cause of the next spike in healthcare needs, efficient responses save lives.

  • Plan emergency responses: Implement an emergency response management solution to improve prioritization and rapid responses, while patient and member self-service capabilities divert nonemergency needs. 
  • Expand telehealth: Put in place systems for remote operations to quickly activate, whether it’s because patients are hesitant to come in or because you need to allocate resources differently to manage a crisis at hand while continuing care for those with unrelated conditions. 
  • Address delayed care needs: Help healthcare consumers get the surgeries or treatments they postpone. The Salesforce Accelerate Elective Procedures Solution prioritizes care, enables outreach, smooths intake, and plans for capacity.
Telehealth claims increased 4,347% year over year in March 2020.
Source: Monthly Telehealth Regional Tracker, FairHealth, March 2020."

The COVID-19 crisis revealed how quickly guidance can change from one day to the next. From patient treatment to healthcare worker protection to medical care coverage, keep everyone up to date on critical information when emergencies arise.

  • Enable digital channels: Get healthcare personnel, patients, and members the information they need at the right time on preferred channels. Enable digital channels to handle questions, concerns, and back-and-forth communication.
  • Distribute updates: Use a learning platform to get information out on safety and testing and ensure employee certification through on-demand learning resources.
Stay connected with patients, members, employees, and partners in times of crisis and reopen safely with

Customer Story

Clover Health, one of the fastest-growing Medicare Advantage plans, had a vision to align more closely with physicians by reducing doctor-insurer friction and increasing visibility into the health of each patient. By integrating data and technology on Health Cloud, Clover Health connected teams and data to coordinate and personalize member and provider experiences.
  • The 360-degree view enables Clover Health to deliver the right information at the right time to members and providers with automated touchpoints. 
  • Omni-channel coordination dynamically prioritizes interactions across channels based on the number of members enrolled in the applicable campaign. With Salesforce, Clover Health communicates with members on preferred channels while tracking replies. 
  • Communications to providers are streamlined through a provider resource community.
  • To support primary care physicians in heavily affected areas, Clover Health provides technology support for virtual care. 
  • Clover Health launched a COVID-19 Resource Community with FAQs and updates by county in a matter of days along with a multichannel campaign with automated emails, multi-language text messaging, and outbound phone calls to members. 
  • With the 360-degree view, Clover Health builds continued trust with members by delivering medications to member homes.

In less than 12 months, Clover Health saw a



Email Open rate



Growth in active users, from 40 to over 400

In a post-pandemic world, technology will continue to make engagement easier and more accessible. If you’re ready to build lasting connections with healthcare consumers, Salesforce can help you take engagement to the next level.

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