Medicare Advantage plans are facing a problem—high rates of gaps in care that affect HEDIS (Healthcare Effectiveness Data and Information Set) quality measures … and ultimately revenue. The solution? Not just member engagement, but a strategic and multi-faceted...
Download our case study to learn how a radiology benefits manager used proactive outreach to steer plan members to lower-cost imaging facilities. A leading radiology benefits manager knew that high-quality, lower-priced diagnostic imaging facilities were readily...
Quality measures and scores from the Healthcare Effectiveness Data and Information Set, or HEDIS, are driving the need for not only a comprehensive roadmap that will close gaps in care, but also for a fine-tuned engagement methodology to help health plans and...
When operating at peak performance, a nurse advice line can have a substantial cost and experience impact for health plans and healthcare providers—from decreasing unnecessary ER and urgent care visits to improved utilization of healthcare benefits and resources. It’s...
Providing the Medicare population with the right care in the right setting at the right time is increasingly a challenge. But failure to do so can have a significant impact on outcomes, Star ratings and incentive revenue. Also challenging is engaging with those...
Today’s consumers want healthcare organizations to provide the same anywhere, anytime interactive experiences they’ve become accustomed to in other areas of their lives. That means care delivered in a convenient location (which may be the grocery store down the street...
As the focus on health plan member experience intensifies, so does the understanding that the whole of member experience is made up of both inbound and outbound engagement touchpoints spread across different departments and teams in a plan’s organization. Beyond...
Wellness, care management and other programs are only effective—both in terms of return on investment and results—if program enrollment increases. But that isn’t always easy. In fact, a report from the U.S. Chamber of Commerce noted that about 80 percent of the...
Health plans need to lower ER costs, no matter what type of populations they serve—from Medicaid and Medicare to private, commercial plan members. Non-urgent ER visits cost the U.S. $4.4 billion annually, and ER costs, according to a new CDC report, have doubled in...
