In Q2 2015, CMS issued guidance to states for Medicaid MCOs to dedicate a minimum portion (85%) of rates to medical loss – the first significant Medicaid managed care regulation issued since 2002. NCQA’s Standards for Member Connections and New York’s DSRIP program continually emphasize patient-centered care, services in health education, wellness and prevention, and improved care coordination across an expanded care team that includes community-based organizations. Transforming health delivery and empowering members is at the forefront, and Medicaid Plans ability to add value in these areas offers significant opportunity.
HealthTrio Smart Series enables extending your reach and results with capabilities that enable:
- Improved member engagement through desk-top and mobile connections to ease administrative interaction and improve clinical results;
- Automated delivery or Health education specific to known health status or conditions;
- Delivery of alerts and notifications that advance effective use of services and care plan compliance to improve health and/or recovery;
- Improved care collaboration and connection with an expanded care team of non-traditional services such as community-based organization, behavioral and mental health, and other organizations that may or may not have the digital capabilities; and
- Analytics for population health and taking action to address cost and quality.
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