Enhanced speed and efficiency
Coordinated care at scale
Optimized interventions
Comprehensive member profile
The challenge
Addressing fragmented care and improving member experience
A Fortune 100 health plan faced significant challenges with fragmented clinical care plans delivered by different internal teams. This disjointed approach led to costly, reactive care, ineffective coordination, and a confusing experience for the members. To address these issues, we implemented Health Triage, an Azure-based end-to-end care management solution, which identified and prioritized members with critical health needs. The solution facilitated personalized and coordinated healthcare, improving the overall experience.
Key challenges
Delayed responses led to increased costs
Separate teams handling interventions caused lack of coordination
Unintegrated models missed proactive intervention opportunities
Fragmented data led to incomplete understanding of member health
The solution
Empowering healthcare teams for smarter, faster decisions
Personalized care
Unified clinical history
Prioritized urgent members
Tailored real-time interventions
Five-pillar framework
Stratification: Segments by risk
Identification: Predicts at-risk members
Prioritization: Ranks by urgency
Implementation approach
1
Team collaboration
Centralized data for teams
Streamlined decisions
Quick member prioritization
2
Data-driven interventions
Integrated models for timely actions
Personalized care plans
Prioritized actions
3
Continuous improvement
Power BI for insights
Continuous model refinement
Feedback loop for enhancement
The impact
Transforming care delivery
Enhanced member experience
Personalized, coordinated care
Enhanced member satisfaction
Simplified connections
Increased efficiency
Identified 5,000 members weekly
Reduced intervention time by 80%
Streamlined care delivery
Better health outcomes
Optimized chronic care prevention
Boosted health outcomes
Increased healthy days
Looking ahead
Enhanced predictive analytics
Continuously improve model accuracy for more precise interventions
Scalable healthcare solutions
Expand capabilities to reach a larger member base efficiently
Improved member engagement
Foster stronger relationships with members through personalized care
