The MHN model of care moves care management to the primary care practice and empowers care managers to work closely with patients to prevent readmissions and improve outcomes. The model creates a structured approach to care management by providing the appropriate tools, processes, staffing and sharing of care plans. Dedicated care teams coordinate their efforts across settings to ensure that healthcare delivery is appropriate and timely. Innovative technology allows the care team to use a collaborative, team-based approach to care by tracking patients across the health care continuum. In addition, care management at the primary care level help prioritize care coordination, support timely interventions and streamline care transitions. The process starts with an innovative screening tool, MHN's health risk assessment, which incorporates medical, behavioral and social factors and promotes whole-person care. This comprehensive approach stratifies patient health risk into high, medium or low risk cohorts, and enables providers to prioritize care, directing resources to the patients that need them the most.

Medical Home Network (MHN) is a not-for-profit collaborative that has fundamentally changed how care is delivered. Our proven model of care unites provider communities and diverse healthcare entities around a common goal: to redesign healthcare delivery and transform the way care is managed at the practice level. It starts with providers and patients working together to improve health. Care teams drive engagement by developing relationships with patients that extend beyond the four walls of the primary care practice. We provide the tools and processes to help care teams engage patients and help them become an accountable member of the team. Research shows that patients who are involved in making their healthcare decisions tend to be healthier and have better outcomes. By connecting providers and delivering real-time information, we enable coordinated care management, improve transitions of care, and promote timely follow-up. But the most important change is that patients receive better care where and when they need it.

Artera Pulse Outreach:

Dynamic, Recurring Patient Outreach for All of Your Populations

Artera Pulse Outreach makes flexible, automated bulk messaging as easy as 1 – 2 – 3. With three simple steps, our highly flexible solution enables your team to reduce staff time spent on manual outreach while improving patient care.

• Dynamic lists that automatically refresh based on data cohorts and imports
• Flexible integration with unlimited data sources (EMR, Pop. Health, CRM, and even Payers)
• Comprehensive reporting suite to monitor Pulse Outreach and track value
• Deployable for a wide range of use cases, including care gap closure, pre and post-visit communications, medication adherence and more
• Support for custom recipient links, images, and file attachments, to provide a personalized messaging experience

Manage Outreach For All Of Your Populations

• Effortlessly coordinate outreach for multiple patient groups through an intuitive workflow setup

Measure Messaging From Outreach to Outcome

• Track the deliverability, response path, appointment scheduling, and appointment status driven by your outreach

Easy Workflow Configuration, Maximum Impact

• Improve quality measures and close care gaps
• Reduce staff time spent on manual outreach
• Reduce avoidable cancellations
• Drive revenue and increase patient awareness of new or existing programs available to them
• Enroll patients in clinical trials, medication adherence programs, and other available benefits

Artera is a SaaS digital health leader redefining patient communications. Artera is trusted by 800+ healthcare systems and federal agencies to facilitate approximately 2 billion communications annually, reaching 100+ million patients.

The Artera platform integrates across a healthcare organization’s tech stack, EHRs and third-party vendors to unify, simplify and orchestrate digital communications into the patient’s preferred channel (texting, email, IVR, and webchat), in 109+ languages. The Artera impact: more efficient staff, more profitable organizations and a more harmonious patient experience.

Founded in 2015, Artera is based in Santa Barbara, California and has been named a Deloitte Technology Fast 500 company (2021, 2022, 2023, 2024), and ranked on the Inc. 5000 list of fastest-growing private companies for five consecutive years. Artera is a two-time Best in KLAS winner in Patient Outreach.