A Guaranteed Way to Achieve More Effective Network Steerage
Network steerage really is a good thing. When patients use in-network, high-quality, lowest-cost providers and care facilities, it can have a positive financial impact on a lot of stakeholders—health plans, benefits managers, provider and health system networks,...
Healthcare Appointment Scheduling: What to Look for When You Outsource
Outsourcing appointment scheduling can be a smart move for many providers and health plans, especially those associated with Medicare and Medicaid programs. Annual well visits, lab and other diagnostics, vaccinations—all of these scheduling issues can overload...
Proactive Medication Adherence Outreach Stops Rx Gaps Before They Happen
Read the case study to discover how one of the nation’s largest Medicare Part D plans improved medication adherence, which was instrumental in supporting its 4-Star CMS rating. When this health plan’s leaders wanted to limit gaps in prescription refills—which would...
Support for Your HEDIS and Star Ratings Improvement Efforts
How can Carenet Health solutions help your plan improve NCQA HEDIS and CMS Stars measures? Start with this list, mapped to specific measures. From onboarding to annual well visits to medication adherence and much more, Carenet can help you implement targeted...
Advocacy Programs Are In, But How Do You Find the Right-Fit Member Services Partner?
Consumer health advocacy programs—also known as healthcare navigation assistance and concierge-level member support—are becoming increasingly valuable to health plans, risk-based providers and employer groups who want to help their members and employees get the most...
Eight Ways to Optimize Patient Engagement to Address Social Determinants of Health
Pinpointing and addressing social determinants of health (SDOH) is a growing concern for both payers and providers—identifying those factors can help optimize the health of the member/patient base and ultimately change lives. Awareness of and outreach for social...
One-Stop Behavioral Health Crisis Support Delivers 95% ED Diversion
In this case study, you’ll learn how one health plan redefined on-demand behavioral health crisis support, reduced costs and got ahead of changing regulations. When a large, 15-state health plan wanted to offer its Medicaid and Medicare Advantage members a better...