Health Plans

Proven Solutions that Help Reduce Costs and Improve Care and Quality Outcomes

Health Plans
Health Plans

For health plans, effective member engagement has a direct impact on every metric of success: lower costs, better clinical outcomes, member loyalty and member retention. We help you achieve all of those goals by delivering personalized member engagement, multi-channel health coaching and education that can be tailored to the unique needs of Medicare, Medicaid or commercial populations. Together, we help drive healthier member behaviors to improve clinical and financial outcomes.

A Tailored Population Health Management Solution Based on In-Depth Individual Member Data

The key to any successful member engagement campaign is a deep understanding of your audience. Our team of analytical and clinical experts has developed a powerful Care Pathways framework for identifying and stratifying member populations, with an emphasis on truly understanding a member’s clinical needs, future risks, likely behaviors and receptivity to change.

Everything is taken into account: each member’s conditions, behavior patterns, age, socioeconomic factors, geographic location, language, accessibility to technology, the supply and demand of healthcare resources in the region and more. This gives us the population health information we need to develop motivational campaigns and health coaching programs that meet the specific needs of that member.

Our Population Health solutions combine:

  • Powerful analytics, using our Pathways Engine, that segment populations and drive strategies for delivering the right intervention to the right member at the right time
  • Member engagement campaigns that capture individuals' attention with personalized messages that promote positive behavior changes
  • Telephonic coaching services that provide the one-on-one support each member needs to address clinical issues and overcome barriers to care and medication adherence
  • Health content and shared decision making tools that educate members on their conditions and risk factors, guiding them to make their own best decisions about treatment for conditions where there are multiple viable treatment options, known as preference-sensitive conditions
Medication Adherence
Medication Adherence Management

We identify members at-risk for nonadherence, determine the best method for engaging them, and coach and educate them to encourage ongoing, medication-taking behavior.

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Nurse Advice Line
Nurse Advice Line

Give your members 24/7 access to a live registered nurse who can provide clinical advice, help members navigate the healthcare system, refer services, impart skills and knowledge, and provide relevant health education materials.

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Wellness and Lifestyle Support
Chronic Care Management

Our healthcare experts provide one-on-one health coaching through personalized outreach and interventions to help identified members better manage their chronic conditions, such as asthma, diabetes and heart disease.

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Shared Decision Making
Shared Decision Making

Empowering patients with multiple viable treatment options to manage their care and collaborate with their physicians on treatment decisions.

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Medication Therapy Management
Medication Therapy Management

Boost your plan's Stars Scores with an MTM program that provides interactive person-to-person comprehensive medication reviews (CMRs).

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