The balance between the cost of care, quality of care, and patient engagement is pivotal for health plans success. Identifying gaps of care, using member data for decision making, and implementing effective care management is what keeps a member healthy. In addition, the paradigm shift from service centric model to value based model and new mandates such as the accountable care – health plans have to continuously re-invent themselves.

What can we do for you?

          Axiom healthcare experts network can help you with this continuous transformation. While we can help you with traditional issues such as core systems consolidation and provider network management, we can lead you in population health management, patient data aggregation, and care management platforms. This will enable you manage entire patient population of varying degrees of risk and target high-risk subpopulations with targeted care programs. Our Member 360 view initiatives supported by the supporting services such as clinical messaging, master patient index, and portals will increase your patient outreach and satisfaction.

Areas of Impact

  1. Member 360 View: Innovation data aggregation strategies to combine clinical, administrative, and third party data (labs, pharmacies, exchanges, etc.) to identify gaps in care, integrate with health information exchanges (HIE), and advanced care management.
  2. Stratify Populations: Stratify members based on claims data and identify subpopulations for targeted care. We also have an innovative model that goes beyond the identification but also measures and tracks the impact of clinical programs on these subpopulations.
  3. Care Management: Implement care management platforms and other initiatives such as medical, utilization, and pharmacy management for better outcomes.
  4. Improve Ranking: Measure and help improve critical ratings such HEDIS and Medicare STARS.