Advanced Member Engagement

To improve healthcare, the next evolution of member care is necessary. In a study by The Physicians Foundation, 27 percent of Americans do not have a Primary Care Physician (PCP) and of those that do, 22 percent do not visit their PCP on a regular basis. Patients fail to follow care plans and medication guidelines, or do not to take the basic steps to care for themselves.

13.3 min.

The average amount of time a patient spends with their Primary Care Physician.

68 min.

The average amount of time Advance Health NPs spend with a health plan member.

 
 

As a result, they utilize more health care resources. Additionally, those who do see their Primary Care Physician only get a few minutes for a review and to ask questions or receive guidance. They might see multiple specialists who rarely communicate with each other. And while insurance companies have information on health plan members, it’s scattered across multiple records and data files.

The result: members are not engaged, care that is fragmented and providers and health plans do not have a complete picture of the member’s health. Advance Health engages managed care members where they are most comfortable. Doing so enables our professional NP staff to collect more specific member information, clearly assess their care needs and utilize workflow technology to close care gaps. We share that information with providers and health plans to help improve communication, coordination of care, care quality, efficiency and appropriate plan reimbursement.

Advanced Solutions

Health Assessments

Advance Health provides a comprehensive approach to health assessment services. We know what it takes to reach and to engage health plan members. We have an industry-leading track record getting members to participate and with our ability to collect accurate and timely information.

Campaigns are tailored to the needs of our clients and their members. And while health assessments are an excellent way to engage many members, we believe the most successful programs will ultimately include a range of touch points including:

  • Primary Care Physician offices
  • Clinics
  • Mobile health
  • Home based programs

As with all our initiatives, our detailed health assessment services include

Readmissions Prevention Programs

Home Connect Frequent Admitter Program Pre-Op Program

 

We realize the difficulty in getting patients into a provider’s office for a complete review or health screening. Unfortunately, the result is often an increase in medical complications, a progression of disease states, an escalation in preventable emergency visits and readmissions to the hospital.

In an effort to improve quality and reduce expense, Advance Health developed readmission reduction programs that help health plans and physician groups proactively identify opportunities for improved patient health. Effective engagement strategies allow us to capture additional member health status details that support providers’ care coordination and treatment efforts and ensure appropriate reimbursement documentation.

 

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Reduction in Readmissions

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Care Management

Now is the time for a paradigm shift in chronic care management which is why Advance Health developed a program that proactively targets members that will benefit from an in-home visit. Our program has substantially improved management of some of the most costly burdens on our health system. Once members are engaged, integration with existing Quality / Care Management initiatives is seamless and follow up care can be provided by a Primary Care Physician or Advance Health. Through this type of targeted, integrated engagement we are seeing meaningful results such as those recently achieved amongst a high risk, least adherent population of chronic condition management. Over 60% had English as a second language and previous engagement efforts had all but stopped.

However, through 6 months of effort, we were able to engage 85% of the membership and saw the type of improvement that only comes about from a new approach in chronic care management.

85%

of membership was engaged with the Advance Health Program
  

39%

of members were at the HbA1c goal (<7). No members were at goal prior to the program

82%

of members were at the LDL goal (<100). No members were at goal prior to the program.

73%

of members were at the BP goal 140/90 or less. No results were known prior to the program.
  

Learn how we reduced 30-day
readmissions by 61%