Member Engagement & Behavior Tracking Software for Value-Based Care
Custom member engagement and behavior tracking software solutions to help payers and providers improve patient adherence, strengthen engagement, and reduce preventable utilization.
In value-based care, patient outcomes are shaped not just by clinical care but also by how engaged patients are in managing their health. Missed follow-ups, poor medication adherence, and unmanaged lifestyle risks all reduce quality scores and increase costs.
At Sigma Software, we develop custom engagement and behavior tracking platforms that unify digital care plans, automated outreach, and real-time monitoring. By combining data from EHRs, claims, wearables, and social determinants of health (SDOH), our solutions help organizations close care gaps, improve satisfaction scores, and succeed under value-based contracts.
Why Member Engagement and Behavior Tracking Matter in Value-Based Care
- Non-adherence drives costs: The CDC estimates that medication non-adherence causes 30–50% of treatment failures and up to 125,000 deaths annually in the U.S.
- Engagement impacts quality scores: CMS Star Ratings and HEDIS metrics incorporate preventive screenings, follow-up visits, and patient experience scores. Low engagement means lower reimbursement.
- Behavior extends beyond clinical care: Factors like nutrition, exercise, and housing can have more impact than medical care alone. Tracking and addressing these behaviors is essential.
- Payers and providers share responsibility: Under ACOs and Medicare Advantage, both groups need visibility into how members engage with care plans.
Without systematic engagement and tracking, organizations struggle to meet quality metrics, increase shared savings, and improve long-term outcomes.
What’s Included in a Custom Member Engagement and Behavior Tracking
1. Digital Care Plans
- Personalized care plans linked to chronic conditions and preventive needs.
- Integration with EHRs to surface goals and tasks within clinical workflows.
- Support for shared decision-making between providers and patients.
2. Automated Outreach & Reminders
- Configurable SMS, email, app, or phone reminders for follow-ups and screenings.
- Targeted campaigns for care gap closure (e.g., flu shots, diabetic eye exams).
- Multilingual support to reach diverse populations.
3. Behavior Tracking & Monitoring
- Integration with wearables, remote monitoring devices, and patient-reported data.
- Tracking of medication adherence, activity levels, diet, and sleep.
- Alerts for care managers when risk thresholds are exceeded.
4. Engagement Dashboards
- Provider-facing dashboards showing member adherence trends.
- Patient-facing apps with progress tracking and motivational nudges.
- Population-level views for payers and ACOs to monitor engagement metrics.
5. Integration of Social Determinants of Health (SDOH)
- Capture of ICD-10 Z codes for non-clinical risk factors.
- Referral workflows to community-based organizations.
- Impact tracking of social support interventions on engagement.
6. Security & Compliance
- HIPAA- and GDPR-compliant data management.
- Role-based access controls and audit trails.
- Consent management for data sharing and outreach preferences.
Applications of Member Engagement and Behavior Tracking Software
For Accountable Care Organizations (ACOs)
- Improve care gap closure rates for MSSP benchmarks.
- Track engagement across attributed patients to reduce avoidable utilization.
- Provide transparent engagement data for participating providers.
For Medicare Advantage Plans
- Support Star Ratings through better member outreach and preventive care.
- Automate reminders for screenings, immunizations, and chronic condition follow-ups.
- Improve CAHPS survey scores by enhancing patient experience.
For Provider Groups & IDNs
- Surface real-time adherence data within provider workflows.
- Support chronic disease management programs with digital care plans.
- Strengthen patient-provider relationships through better follow-up.
For Commercial Payers
- Enhance wellness programs with behavioral data integration.
- Use engagement metrics to guide benefit design.
- Improve HEDIS and NCQA reporting with automated data capture.
Benefits of Custom Engagement Solutions
- Higher quality scores: Better Star Ratings and HEDIS performance through improved adherence.
- Reduced avoidable utilization: Early interventions prevent hospitalizations and ED visits.
- Smarter resource allocation: Focus care management on members with low engagement.
- Improved patient experience: Digital tools and reminders increase satisfaction and trust.
- Measurable ROI: Stronger engagement translates to higher shared savings and bonuses.
Why Choose Sigma Software for Value-Based Care Software Development
- Healthcare domain expertise: Experience building engagement and adherence platforms for payers and providers.
- Custom solutions: Built around your contracts, patient populations, and workflows.
- Interoperability focus: Integration with EHRs, claims, and remote monitoring systems.
- Compliance-driven: HIPAA, GDPR, and NCQA requirements embedded in development.
Custom Integration with Healthcare Systems
Our development process ensures a seamless fit with your ecosystem:
One
Mapping engagement goals to contract requirements.
Two
Integrating EHR, claims, wearable, and pharmacy data.
Three
Building patient- and provider-facing engagement tools.
Four
Configuring outreach automation and dashboards.
Five
Testing and validating with patient and care manager feedback.
FAQ
Engagement directly affects preventive care and chronic condition management measures, which drive quality scores and financial incentives.
Yes. We develop solutions that connect with wearable devices, apps, and remote monitoring tools to capture real-world behavior data.
Yes. We integrate ICD-10 Z codes and community-based resource referrals into engagement workflows.
Through mobile apps, SMS reminders, or web portals that provide personalized care plans and progress tracking.
Most clients see improvements in adherence and engagement metrics within one to two reporting cycles.
Ready to Solve Your Value-Based Care Challenge?
Let’s talk about your unique workflows and design a custom digital health solution that supports outcome-based care, improves population health, and aligns with value-based reimbursement models.
Whether you’re navigating HEDIS metrics, improving care coordination, or optimizing performance-based contracts, we can help.
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Build Your Custom Implementation Plan
Your implementation plan includes integrations, MVP timelines, and long-term support strategies. We build your value-based care solution around real workflows, compliance requirements, and measurable outcome goals.
Launch and Optimize for Outcome-Based Development
Our solutions combine predictive analytics, AI-driven clinical insights, and secure, interoperable data flows. Whether you need compliance tools, shared savings tracking, or a care coordination engine, we align it with your quality metrics, reimbursement goals, and care delivery model.
Ready to Improve Outcomes with Custom Value-Based Solutions?
We design and build custom software for value-based healthcare, built around your data, workflows, and objectives. Whether you need to unify data, support attribution, or track performance across contracts—we’re here to build what works.
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