Supporting At-Risk Members: Encouraging healthy living to facilitate wellness and simultaneously ensuring members have timely access to appropriate, quality care is essential to both your mission and success. This two-pronged approach helps manage costs, improve health/outcomes, and drive member satisfaction, loyalty, and retention. Of course, your members live in a multitude of environments and have varying levels of support and resources. Research shows ‘social determinants’ —circumstances and conditions in which people are born, grow up, play, live, and work — correlate with members’ ability to stay healthy, engage in preventive screenings, and access care. Understanding these correlations and addressing disparities is the key to helping at-risk members stay healthy and access the care they need. New Medicaid Rules: Federal rules governing Medicaid managed care now allow health plans to spend capitation dollars on value-added services not covered by the state to improve quality and/or reduce costs. While the cost of the services can’t be included in capitation rates, they can be included in the numerator of the medical loss ratio (MLR) if they’re part of a quality initiative. This policy shift emphasizes the importance of proactive outreach to members who need assistance obtaining services which support their mental, physical, and emotional well-being. Hierarchy of Needs: Wellness, healthcare, and social determinants are inextricably intertwined. Research shows 40% of health outcomes are attributable to social and economic factors, reflecting a stronger correlation than the link between health outcomes and genetics, health behavior, clinical care, or physical environment3. As an example: every year 63% of low-income households and older adults must make spending choices between food and medical care4. To engage your at-risk members in heathy behaviors and timely care, you must first help meet their most basic needs. Proactive Outreach: • Identifies members most in need of assistance • Provides a member-centric, concierge service with personal outreach via experienced, empathetic advocates • Leverages our robust database of thousands of private and public social programs • Assists members with determining program eligibility and enrollment • Confirms benefits are being received and maintains ongoing engagement Our Expertise and Experience: For over 17 years we have specialized in addressing social determinants of health (SDOH) by identifying barriers to care. With our time-tested engagement process, we assist members with eligibility identification and enrollment for dual status in Medicare/Medicaid as well as with annual recertification, Medicare Part D, and community programs.

Change Healthcare is inspiring a better healthcare system. We are a leading independent healthcare company that provides data and analytics-driven solutions to improve clinical, financial and patient engagement outcomes in the U.S. healthcare system. Our comprehensive suite of software, analytics, technology-enabled services and network solutions take costs out of the healthcare system by driving improved results in the complex workflows of payers and providers by enhancing clinical decision-making and simplifying billing, collection and payment processes, and enabling a better patient experience. We are creating a stronger and more efficient healthcare system that enables better patient care, choice, and outcomes at scale.

Health Hero Employee Engagement & Wellbeing allows teams of any size to create fun and engaging well-being activities and challenges that bring your team and peers together in a fun and healthy work environment. The app is accessible from your browser, tablet, and smartphone. Health Hero for Teams is the only product in the marketplace that brings well-being and employee engagement into the Microsoft Teams ecosystem.

To install, visit: https://appsource.microsoft.com/en-us/product/office/WA200001405?tab=Overview 

Health Hero is AI-Powered Telehealth; Helping hospitals, employers, and health systems build end-to-end health engagement with community organizations to address Social Determinants of Health. Health Hero assists hospitals and organizations with the ability to provide well-being and engagement solutions for returning to work, COVID-19 symptom checking, safety and security, mental health, community well-being, and deliver social determinants of health. We close the loop on social service referrals: We work directly with our community-based partners so hospitals and health systems can effectively manage the full spectrum of patient needs and care, ensuring accountability and assurance that the referral loop is closed. How We Make a Difference: Patient and Employee Outreach Simplified: Use text, voice, and/or email messaging to monitor patient behavior and provide more targeted automated outreach that feels “superhuman”. Relevant Workflows: Return to work, COVID-19 symptom checking, and safety & security workflows to support patients, employees, and community members. Reduce Patient No-Shows: Reduce no-shows through automated text and phone call reminders, while also offering telemedicine options. Telemedicine can help you optimize your appointment schedule and get more patients in and out of your office on time. Whole Person Management Care: Health Hero aims to support the whole person in one comprehensive solution integrating data sources that measure a person’s social determinants of health (SDOH). Identify service gaps and at-risk populations: Generate insights with our customized health risk assessment questionnaire to enable early interventions.

Multichannel delivery of health services via web, mobile, chatbots, text messages, and automated phone calls.