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Developing your Company Culture: 4 Key Principles 

Join us for a 4-part series that explores developing your company culture and taking your organization to the next level.

1. A Culture of Impactful Leadership
2. Continuous Development – The Path to Employee Engagement & Retention
3. 5 Simple Steps to Foster Inclusion & Diversity
4. 6 Secrets to Purposeful Collaboration & Equitable Experiences – Coming soon!

Part 2: Continuous Development – The Path to Employee Engagement & Retention

At HealthEdge, our vision is innovating a world where healthcare can focus on people. With this vision in mind, we hire the best and brightest from around the world – as our ability to achieve this vision hinges on our employees’ skills, creativity, capabilities, and leadership from within.

Continuous development is becoming a critical pillar of our company culture – as keeping and engaging top talent requires an intentional approach to their short- and long-term development.

Since “development” can mean different things, these are our top 4 continuous development tenets:

1. Embrace the uniqueness of your team members

As a manager, you have the great responsibility and wonderful opportunity to lead and develop a group of individuals. You get to engage your employees in their current role, help them grow their skills, build the bridge to their next role, and develop the framework for the trajectory of their career.

The key is to get to know your people for who they really are – their unique interests, strengths, and ambitions. How does this role, that’s so vital to your team, fit into their career? How can you help them develop and prepare to be ready for that next step?

Good questions to consider and discuss include:

• What are their career goals?
• In what ways do they need to grow and develop to achieve that next career goal?
• How can you help them achieve their career goals?
• What skills do they need for the future?
• What are creative ways to help them achieve those skills?

2. Understand the Many Facets of Development

When we talk about development, many often think only of attending formal training. Training can be a relevant component of learning – however, it’s only a small part of how we learn and master a new skill. Research (link) shows that learning takes place by doing, trying, and experiencing. It means working on new projects, interacting with new people, and experiencing new things.  All of this can be done “in the flow of work”, meaning deliberate learning can take place while someone is working in today’s role.  This keeps employees engaged and more likely to stay because they are continuously developing new skills.

Facilitate your team members to:

• Attend meetings at the next level above – to see the level of discussion, level of preparedness
• Work on an assignment within a different functional group
• Take on a stretch assignment
• Creatively think about team members, their unique skills and who they can connect with
• Connect with senior leaders and facilitate mentoring opportunities
• Get more exposure – such as speaking opportunities and interactive panels. This is especially helpful for emerging leaders.

3. Leverage Hybrid Work

The rise of flexible and hybrid work environments has led to fewer spontaneous hallway chats, chatter around the watercooler, and opportunities to have those unexpected run-ins with folks from different departments. In this new flexible world, employees often work exclusively with their functional team and only see folks around Zoom meetings.

With the importance of creating opportunities for your employees to grow and learn, how can we do this in a hybrid environment?

Here are some ideas to consider:

• Be purposeful & bring people together when it makes sense – for in-person team meetings or 1/1s, to brainstorm or workshop a topic, to celebrate, socialize, and/or participate in fun or team building activities
• Encourage and empower your team members to come together in the office and create norms that help the team feel engaged and productive
• Create networking opportunities for your team – invite folks from other teams, departments, and levels (both in person and virtually)

4. Change your Mindset to Our Talent to Enhance Engagement, Retention, & Company Performance

Employees join a company to perform a specific role, and it’s common for managers to think about them as my person, my talent, who adds so much value to my team, what would I do without them?

However, when we shift our mindset to being enterprise- and employee-centric, we bring a host of value to the employees, company, and company culture. Each employee represents not only the value they bring to their current role, but the time, energy, and expense of finding, training, and folding them into the company. Retaining employees reduces waste, cost, time, and energy.

When we focus on this enterprise- and employee-centric mentality, our company culture is strengthened. With this outlook, we help employees navigate the organization, grow and expand, and continuously develop so they remain constantly engaged and challenged at the company.

Investment in employee development is priceless.

Learn more about continuous development & life at HealthEdge here.

Readiness

March 2020 represented a critical shift in business operations for local and global companies. For many companies, it was just another day at the office – albeit you were working remotely versus coming to the physical office. Were you prepared? Was it an IT and cybersecurity scramble or were you appropriately equipped? The difference is derived from proper business continuity and disaster recovery readiness, communication, and continuous preparation.

HealthEdge understands the requirements needed to keep up in a fast-paced world. At a moment’s notice, things could change, whether it is a natural disaster, cyber-attack, or other unforeseen events that could have an impact on our ability to meet customer needs. HealthEdge prepares for the unexpected with Business Continuity Planning and Disaster Recovery to mitigate damage, minimize downtime, and reduce the impact on business operations.

Similar to the Global COVID Pandemic, HealthEdge ensures that our business processes, workforce, IT infrastructure and cybersecurity controls are ready for unexpected events – large or small. Our team identifies critical business functions, which includes systems, applications, and essential data that is needed for business operations to continue. Risks and vulnerabilities are assessed for critical business operations and considerations are made for the likelihood of various disasters and the potential impact of data loss or disruption.

Plans

Disaster Recovery and Business Continuity Plans are developed to outline how our teams will quickly recover, relying on backup and contingency plans and alternate work arrangement locations. These plans are tested and updated regularly to ensure they remain effective. While aligned with common themes and content, individual and custom product and facility-centric Disaster Recovery, Business Continuity and Emergency Preparedness Plans are maintained to ensure we are prepared based on geography and product group. The HealthEdge IT Security and Compliance teams maintain these plans. We augment internal efforts with external expertise to help ensure we identify and constantly mature the program based on emerging best practices and global threats. Copies are maintained in the HealthEdge Governance Repository for offsite backup purposes and are readily available should the need arise.

Testing

Team simulations help us to identify gaps or weaknesses in the plans, as well as ensure the plan is consistent with changes to business operations or IT infrastructure. These simulations and live tests occur among small teams, multi-offices and business products, or directly with customers. The ultimate objective is to stress test and be prepared – whether our workforce is located in a major metropolis with regional redundancy or in their village in India where local Internet and communications systems could have reliance issues.

Recent examples include:

• Testing Key Leadership Response Times – Our team uses recent regional events, such as flooding, to determine how prepared Leadership, Human Resources, and IT are to account for and maintain communications with the workforce as the community recovers.
• Testing Remote Access – Our team sends groups to work remotely to assess latency, communications system constraints or home bandwidth issues.
• Testing Alternative Work Sites – Our team evaluates the potential impacts of destruction of physical office space and safely reroutes employees to an alternate location.

As the Boy Scouts motto says, “Be Prepared” since that is what our customers expect of us: safeguard their data, maintain high availability, and deliver as promised.

Education and Awareness

Employee awareness is key in ensuring everyone knows their role should a response be initiated. HealthEdge conducts regular training for employees who work onsite, hybrid, and remote. In addition to this training, we produce education alerts and messages to not only support the employees but also their families. We are accountable for ensuring our systems, networks and data centers are prepared, as well as the home environment of our employees and their families. Protecting the family and home is critical for a “family first HealthEdge”, but to also ensure they are prepared in the event they are called upon to primarily work remotely.

Getting Our Ducks in a Row When Disaster Strikes

We value the trust our customers place with our business and strive to always deliver service, even when the unexpected occurs. As with other facets of information security, business continuity and emergency preparedness is another critical way HealthEdge protects you, your members, and the entire HealthEdge family. It’s also another way we ensure our ducks are in a row.

 

 

Improving payment integrity has been a challenge for health plans since the beginning of time as the constant battle for accurately pricing claims rages on. To help the market better understand the current state of payment integrity and expose the need for alternative approaches to solving payment integrity challenges, HealthEdge^® Source recently commissioned independent research firm, In90group Research, to survey more than 100 health plan leaders.

Current State of Payment Integrity in Healthcare

Respondents represented all types and sizes of health plans along with leaders from virtually every department, and here is what they had to say about the current state of payment integrity:

• Multiple third-party editors: 90% of respondents depend on two or more payment integrity vendors. That means they must maintain multiple datasets, update schedules, and sometimes even multiple instances across their lines of business. The IT burden and workflow complexities associated with approach have become overwhelming for many health plans.
• Claims rework: 55% of payers report that greater than 20% of their claims require rework due to inaccurate first-pass adjudication. Not only does claims rework require additional time and effort from the payment integrity team, but it also creates downstream work for other teams, such as provider relations.
• Number of dedicated FTEs: 70% of payers have more than 10 full-time employees (FTEs) dedicated to prospective payment integrity and 45% have greater than 25 FTEs. When asked what the future looks like when it comes to dedicated resources, 56% of respondents said they expect the number of internal FTEs dedicated to payment integrity to growth in the next one to two years. Unfortunately, this comes at a time when workforce shortages are at an all-time high.

Clearly, the traditional approach to payment integrity is not producing the results that health plans want. That’s likely because payers have historically relied on payment recovery vendors to help facilitate prospective payment integrity.

The result? Stacks of editing solutions, ever-expanding contingency fees, and mountains of siloed data sets that provide limited visibility into opportunities for operational improvement. As staff members attempt to hunt for answers across different systems, the time versus value equation begins to erode. Plus, business leaders are unable to identify and resolve root-cause issues across the organization or make more informed business decisions based on comprehensive data.

Payers are rightfully frustrated with the limited progress they are able to make when it comes to payment integrity improvements. Survey respondents shared their top five barriers to success when it comes to payment integrity:

• 64% – Limited resources makes it hard to keep up with fee schedules and policy updates. As both IT and business resources remained strained across the organization, modernizing payment integrity processes and systems often fall behind other priorities, such as changing regulatory requirements that carry hard-and-fast deadlines. But with constantly changing fee schedules and policies – at both federal and state levels, complexities compound and payment integrity improvement initiatives fall further behind.
• 58% – Hiring and retaining qualified resources to perform complex payment integrity tasks. Furthermore, survey respondents expect this problem to persist, as 58% say they must increase the number of manual resources in payment integrity just to keep pace with the demand over the next two years.
• 56% – Limited visibility into third-party vendors’ findings for root-cause analysis. This is likely due to the contingency-based incentive models that payment integrity vendors have in place.
• 43% – Legacy technology is not flexible enough to meet their unique needs. Historically, the focus of payment integrity has been on content, not the technology that enables the content to be accessible across the organization.
• 41% – Conflicting departmental initiatives/ Key Performance Indicators (KPIs) limit ability to improve payment integrity. With payment recovery goals conflicting with payment integrity KPIs, health plans find themselves challenged to make meaningful progress.

Payers are also frustrated with their third-party vendors. When asked, payers shared the following top challenges with their vendors, and the top five most commonly mentioned challenges included:

• 58% – Cost
• 47% – Lack of innovation/upgrades and solutions
• 37% – Limited savings/value
• 32% – Ineffective at getting results
• 27% – Limited content

What’s most concerning about these challenges is that most of these exactly align with the purpose of these types of solutions.

As the complexities of and frustrations with payment recovery and integrity continue to grow, interest in taking a fresh, enterprise-wide approach to improving the accuracy of payments is growing. This is evident in the research findings where survey respondents were asked to choose their top three payment integrity goals through 2025.

Top Goals for Payment Integrity Through 2025:

When comparing these top goals to the top challenges health plans face, it becomes clear that health plans must take a thoughtful approach to payment integrity, one that relies on highly interoperable technology solutions that can reduce dependencies on editors, minimize the burden on IT teams, and bring insights together from multiple systems and departments to provide a clearer picture of payment issues across the enterprise.

To learn more about how HealthEdge Source can help your organization rethink your payment integrity improvement strategies to make a meaningful difference in 2023, visit the Source page on the HealthEdge website.

 

 

Safety Net Plans face unique challenges as they work to connect and engage with hard-to-reach populations to improve the health of the communities they serve. These challenges include:

1. Working with groups of members requiring very complex care plans
2. Inefficient and costly processes resulting from manual, fragmented workflows
3. Siloed systems that make it difficult to access up-to-date, accurate member data
4. Collaboration with social services groups and systems that don’t talk to each other across organizations
5. Extensive tracking and reporting that creates more administrative burden

All of these challenges come amidst the backdrop of even broader health insurance industry challenges, such as workforce shortages that are driving up costs of labor and care. Regulatory changes are requiring payers to adapt processes and technology to meet new guidelines. Evolving business models are creating new opportunities while driving demand for greater business agility. And today’s healthcare consumer expectations are rising to match their everyday retail experiences.

These challenges were echoed by a recent survey of nearly 300 health plan leaders serving Medicaid, Medicare, Duals, and Marketplace members. The survey showed the top two challenges were managing costs & creating new operational efficiencies. The top goals for the year were increasing quality, enhancing regulatory compliance, and improving provider relationships. The primary steps to achieve these goals were to better align business and IT goals, make significant investments in innovation, and modernize technology.

These findings point to the fact that health plans are ready to start their digital transformation as they bring IT and business stakeholders together and invest in innovative solutions to move the business forward. Now is the time for payers to become digital payers.

What is a digital payer?

Digital payers are identified by five attributes that enable them to rise above the competition and lead the way to better outcomes across the entire healthcare delivery system. Digital payers focus on:

1. Leveraging digital tools to improve end-user and member centricity
2. Achieving higher levels of quality to deliver better outcomes for members and communities
3. Increasing business transparency, breaking down siloes and improving exchange of information
4. Advancing customer service by empowering teams to support inquiries with next-generation solutions
5. Constantly reducing transaction costs through automation and connectivity

These are the payers that will emerge as leaders through this dynamic period of change and truly improve outcomes for every patient and stakeholder across the healthcare ecosystem.

Story of a Digital Transformation: VillageCare

VillageCare is a community-based, not-for-profit organization serving nearly 20,000 seniors, people with chronic care, continuing care, or rehabilitation needs in New York. VillageCare set out on a journey to transform business processes with a next-generation digital foundation that could:

• Support clinical and business operations through integrated work processes
• Support a data-driven organizational culture
• Support VillageCare’s healthcare clinical partnerships through data integration
• Expose data to members and clinical partners using data standards
• Use best-in-class applications that integrate to create a seamless systems environment

VillageCare wanted to implement a digital foundation that would enable mission-critical clinical workflows in a value-based, patient-centric, and fully integrated ecosystem. Their ecosystem of connected SaaS solutions powers mission-critical areas of the business including:

• Care Management
• Utilization Management
• Appeals & Grievances
• Authorization Portal
• Business Intelligence
• Population Health
• Member Services

Impactful Results with HealthEdge

By developing this digital foundation with HealthEdge, VillageCare experienced transformational experiences for stakeholders.

• Members:

Prior to VillageCare’s digital transformation, health plan members struggled through disconnected touchpoints to navigate the process of finding a provider, determining eligibility & costs, utilizing available benefits, & communicating with their care team. As a digital payer, VillageCare streamlined processes by shifting these touchpoints to easy-to-use, self-service tools that consumers expect – delivering all in a single access point.

VillageCare uses digital solutions from GuidingCare® to simplify workflows and improve access to data and information. As a result, they can deliver a frictionless member experience and increase member engagement and satisfaction, while ultimately improving health outcomes.

• Providers

Many of VillageCare’s providers were frustrated by time and manual effort required to gain insight into patient benefits, inefficiencies in the process of seeking authorizations, multiple systems required to get answers, inaccurate claims payments, and managing reimbursements.

VillageCare eliminated provider abrasion by delivering instant access to real-time patient benefit and claims data through GuidingCare. They provided connectivity and access to collaboration tools that enable steps to be completed and information accessed in a single solution.

• Member Services

Prior to their transformation, VillageCare’s member service teams experienced inefficiencies that negatively impacted the member experience, including wasting hours searching for member & provider information, navigating multiple software systems, and uncovering inaccurate and out-of-date information.

VillageCare transformed member services engagement by providing self-service tools and access to accurate, real-time data for members.

• Care Managers

Prior to the organization’s digital transformation, VillageCare care managers were challenged by disparate technology systems, disconnected workflows, and manual workarounds. They spent countless hours hunting for member & provider information, attempting to connect with at-risk members, tracking authorizations & compliance, and accessing and completing care plans & educational programs.

VillageCare empowered care managers by putting real-time important member data at their fingertips in one location, so they can focus on building trust with members and optimizing care outcomes. They now automate authorization and utilization management workflows. This improved the experience for the care managers and improved efficiencies. They also use unified care team communications and real-time care alerts to improve health outcomes.

• IT Teams

At VillageCare, the pre-transformation experience for the IT team involved navigating communications across multiple vendors, managing updates across multiple systems on different schedules, dealing with disconnected workflows and broken integrations, addressing regulatory changes with outdated systems, and advancing business and IT alignment.

After transforming the organization with next-generation solutions from GuidingCare, the VillageCare IT team could operate more efficiently and deliver on business needs more effectively. Now, they have greater flexibility to collaborate with the business and use available tools to ensure technology investments are achieving business objectives. The modern solutions are designed with interoperability as a priority, leveraging HealthEdge’s robust API framework and industry standards, such as FHIR. As a result, the IT team can optimize how their workforce is deployed, improve access to data for end users, and quickly and easily adapt technology to address emerging business opportunities and regulatory changes.

Stuart Myer, Chief Information Officer at VillageCare shared, “Our digital transformation journey has truly changed the way our teams operate, improving the experience for members, providers, member services, care management, and IT. It has allowed us to become a data-driven organization that operates more efficiently and creates better outcomes for the community we serve.”

Learn more about HealthEdge’s care management software GuidingCare.

Enrollment in dual-eligible special needs (D-SNPs) care management plans grew by 20% in 2022, increasing from 3.8 million in 2021 to 4.6 million beneficiaries in 2022. This population now represents just 20% of the Medicare beneficiaries, but they make up 34% of the Medicare spending. They also represent 15% of the Medicaid population and account for nearly 1/3 of the spending.

Dual-Eligible Special Needs Plans (D-SNP) are a special kind of Medicare Advantage Plan for dual-eligible individuals who qualify for both Medicare and Medicaid and Part D coverage.

With such growth in this population comes a growth in the number of health plans serving these complex beneficiaries, with hundreds of health plans now supporting one or more D-SNP populations.

However, the complexities of the dual-eligible experience, from a medical and social perspective, coupled with the highly fragmented nature of Medicare and Medicaid systems, often presents significant care coordination challenges that health plans must be prepared to address.

In addition to the high prevalence of issues such as high food insecurities, behavioral health issues, and cognitive impairment, most D-SNP members live in rural communities that can have limited access to proper healthcare professionals, as well as limited access to broadband services. Other challenges health plans must be prepared for include the ever-evolving regulatory environment that exists at both the federal and individual state levels.

With the modifications CMS made in its 2023 Final Rule, it’s now more important than ever for health plans to have a modern, flexible, and highly interoperable infrastructure, including:

• Robust care management platform
• Flexible and configurable CAPS
• Modern member engagement solutions

Track Record of Success

HealthEdge has supported health plans that service government-covered lives for decades, including those who cover D-SNP. For example, Eldercare, the only 5-star Medicaid Advantage Plus (MAP) plan in New York State, uses HealthEdge’s care management platform, GuidingCare^®.

According to Craig Azoff, Senior Vice President, Health Plan Information Services, “Elderplan specializes in intense, complex care management of our membership, and GuidingCare supports these care management goals as well as our compliance goals, as far as STARS ratings, HEDIS scores, and other initiatives.”

Here are a few additional samples of success stories health plans have experienced by turning to HealthEdge:

• Customer Spotlight 1: The midwestern state was looking to reduce the number of Medicated Managed Care Organizations by one third, and the health plan had to prepare to recompete for its Medicaid business, which represented a significant portion of its members. Its outdated legacy care management system could not accommodate the ever-increasing complexities of state requirements.
  • The solution: GuidingCare + Mobile Clinician + HealthEdge’s years of experience with safety net plans.
  • The results: The plan won the bid with advanced care management capabilities and mobile clinician in addition to HealthEdge’s years of experience with safety net plans.

• Customer Spotlight 2: This health plan needed to transform its operations to reduce operational inefficiencies and eliminate redundant manual tasks. The team was challenged with 30-40% of incoming claims being marked with a pricing inquiry or set up to require manual pricing.
  • The solution: Source payment integrity platform designed to manage both claims pricing and editing in one place using the latest regulatory data.
  • The results: Reduced repetitive building, reduced dollars spent on maintenance, generated six-figure range in annual savings, reduced the number of claims requiring rekeying by 40%, generated 25% savings over previous processes by eliminating hundreds of manual tasks.
  • “The biggest benefit we have seen from Source is the capability it has to do one-stop pricing and editing. When it comes to building and managing claims, I never want to go back to anything else.” – Director of Policy and Editing
• Customer Spotlight 3: This independent, non-profit health plan serving more than 2 million customers, was seeking to deliver more human-centric experiences for members, providers and staff. Other goals for the team included: identify and act on operational inefficiencies; gain a more comprehensive view of member services; and bring new solutions to the market faster.
  • The solution: HealthRules ® Payer + GuidingCare® + Source
  • The Results: Average auto-adjudication rates increased from 50% to 80%, ease of configurability improved speed-to-market and ability to identify sustainable savings, integration between HealthEdge systems delivered new opportunities for automation of manual processes, and greater access to authorization data across systems is reducing gaps in care.
  • “HealthEdge understands the everyday challenges we face, like manual processes, workflow inefficiencies, and data disparity. They are bringing solutions to the table that address those challenges and facilitate greater integration across our claims, care management, and payment platforms because they are now all under one roof. HealthEdge is the source that is fueling our digital strategy.” Staff VP of the Advancement Office

• Customer Spotlight 4: This Pittsburg-based managed care plan servicing more than 534,000 Medicaid and Medicare beneficiaries across Pennsylvania and Delaware was looking for a better way to effectively and affordably deliver government member services while maintaining high levels of quality care. The team knew they needed to become more agile to keep pace with complex and rapidly changing federal regulations and state issued mandates, reduce the overhead costs associated with financial reconciliation for provider payments, as well as correct issues related to managing maximum out-of-pocket, claims tied to duplicate providers, and mismatches between old and new contacts
  • The solution: HealthRules Payer + GuidingCare + Source
  • The results: Improved auto-adjudication rates 50%-93% through better authorization matching capabilities and more accurate pricing, increased the volume of electronic claims submissions, and improved business agility through the use of advanced benefit, and improved payment accuracy through the seamless integration of HealthRules Payer and GuidingCare
  • “As a user of multiple HealthEdge products, we see tremendous value in the tight integration between the platforms. Things like being able to match on authorizations can not only help streamline care management, but also improve payment accuracy to facilitate better relationships with our providers.” — Director of Strategy & Operations

Health plans serving D-SNP members need a comprehensive, highly interoperable platform for end-to-end care management and population health that is effective at simultaneously reducing overall costs and improving care, while ensuring the plan is compliant with state and federal regulations.

To learn more about how HealthEdge solutions can help your organization address the unique challenges of D-SNP, visit the Dual Eligibles page on the HealthEdge website.

Over the past several years, there has been an explosion of interest in social determinants of health (SDOH) data and strategies among healthcare payers, particularly among those who are pursuing value-based and at-risk payment models. However, the ability to systematically incorporate SDOH into an organization’s care management workflows has proven to be more challenging than many expected.

The variability of the data that is available plus the lack of integration between systems that can automate the capture and processing of SDOH data have been key barriers in payers’ ability to rapidly integrate SDOH into their care management programs.

But given the most recent push for health equity and SDOH by CMS and accrediting bodies like NQHA, now is the time for payers to implement practical plans that enable them to embrace SDOH data and strategies in a more systematic way. Going forward, their ability to do so will have a significant impact on their quality scores, member outcomes and satisfaction scores, as well as their financial reimbursements.

Here are five things payers can do today to leverage SDOH to optimize care management programs that optimize both member health and organizational financial outcomes.

• Collect data on SDOH: Payers can start by collecting data on SDOH for their members. This can include information on factors such as income, education, housing, food security, transportation, and social support. By gathering this information, payers can identify which members are at higher risk for health disparities and target interventions accordingly.
• Analyze data and identify gaps: Once the data is collected, payers can analyze it to identify gaps in care related to SDOH. For example, they can look at which members are more likely to have unmet needs related to transportation or housing and develop targeted interventions to address these issues.
• Develop partnerships: Payers can partner with community organizations, social service agencies, and other stakeholders to address SDOH. These partnerships can help payers connect their members with resources that can address their social needs and improve health outcomes.
• Integrate SDOH into care management: Payers can integrate SDOH into their care management programs to ensure that members receive the support they need to address their social care needs. This can involve connecting members with community resources, providing care coordination services, and developing care plans that address both medical and social needs.
• Track outcomes: Payers should track the outcomes of their SDOH interventions to evaluate their effectiveness. This can include tracking changes in health outcomes, healthcare utilization, and member satisfaction.

The GuidingCare^® solution suite helps HealthEdge^® customers rapidly bring SDOH data and insights into their care management programs in several ways, including by capturing member’s data relating to age, gender identity, preferred language, sexual orientation, race/ethnicity, zip code etc. Through GuidingCare’s integration with Findhelp, a leading social services search-and-referral platform, care managers have instant access to localized listings and programs in every ZIP code in the United States, enabling a more efficient process for managing referrals for critical services for members.

Further, GuidingCare is integrated with Wellsky, which enables care managers on the GuidingCare platform to identify, refer, confirm delivery, and track outcomes for member social services needs.

To learn more about GuidingCare’s unique approach to empowering care management teams with the content and tools they need to optimize member care, visit the GuidingCare page.

Incorporating SDOH into care plans can help payers improve health outcomes, reduce healthcare costs, and promote health equity for their members.