Today’s empowered and enlightened healthcare consumers require better advocacy and navigation support as they make healthcare decisions. The complexity and lack of transparency in the healthcare system makes it all but impossible for them to do this on their own, and the result is crippling costs across the board. People need an expert concierge-level resource on their side as they interact with the healthcare system, and make choices for themselves and members of their family. We are that expert resource.
Our comprehensive healthcare advocacy and navigation solution combines our Strategic Engagement and Clinical Activation offerings powered by data and sophisticated multi-channel healthcare engagement management technology (our Health Optimization Platform) to expertly guide healthcare consumers through health system complexities. Our Health Optimization Platform provides our team with deep data insight not just to the individual healthcare consumer, but to members of their family as well.
Our main goals are to provide multi-channel, ongoing support in:
- Engagement with items such as welcome calls, ongoing check-ins and member services support.
- Education in areas like primary care provider relationships, prevention, healthy living and transparency.
- Activation through care advocacy and care coordination, coaching and shared decision-making.
- Consumer Empowerment that delivers improved health status and more efficient and appropriate usage of healthcare resources.
Our highly skilled and trained Family Health Advisors are the lead resources in this concierge-level solution, and they engage clinical resources on our team, as well as external resources, as needed to get healthcare consumers the information and guidance they need to make better health choices. They also serve as consumer advocates who clear the path for those who hit barriers to getting the care they need.
Family Health Advisors serve as an ongoing, dedicated guide for consumers and their family members through the simplest to the most complex healthcare details and decisions.
Examples of comprehensive Healthcare Advocacy and Navigation services offered are:
- Member Services Support – in areas such as provider location and scheduling, eligibility, benefits and claims inquiries, plan information and communications.
- Care Advocacy and Care Coordination – in areas such as preventive care, coordination between providers, pharmacists, caregivers and other relevant parties, transparency information and referrals to program resources (e.g. case management, disease management, employee assistance plans, etc.).
- Shared Decision-Making – support for effectively collaborating with physicians, discussion of treatment options, offering provider and site of care options.
- Virtual Clinic – 24×7 telehealth model that seamlessly combines the traditionally separated nurse advice / nurse triage line with virtual medical and behavioral health consults.
This solution was built to cover many areas of market need where clients are facing high costs, high risks, and issues with member and patient satisfaction.
We are making measurable impacts for our clients in areas such as:
- High risk/high cost members
- Potentially preventable admissions and readmissions
- Inappropriate visits to the ER or Urgent care
- Closing gaps in care for HEDIS, Star Ratings and MACRA
- Health Risk Assessment Support
- Medication adherence
- And more…
We are able to proactively work with our clients to identify the areas where we can have the most impact to meet their unique needs.
Our proven people, processes and technologies give us the ability to implement solutions quickly and flexibly for our clients.