9 Care Management Platform Must-Haves for Payers
Too many obstacles stand in the way of implementing a person-centered model of care. Complex workflows. A lack of coordination among medical, behavioral and community health organizations. Inadequate partner and patient engagement. No access to real-time, actionable data. An inability to identify gaps in care. And more.
If your organization strives to improve member health outcomes and better manage costs, these are the 9 care management platform must-haves:
- Deep Clinical Expertise
Robust understanding of clinical operations, regulatory compliance and technical aspects of the business, bridging the clinical and technical is critical.
- Leading Innovations
Market-leading capabilities enable the most complex clinical models today, with significant investment and growth toward composable digital health solutions.
- Ease of Integration
An out-of-the-box integration suite facilitates easy connectivity across your vendor ecosystem for lower costs and better member outcomes.
- Operational Efficiency
An advanced rules engine and user-friendly workflow capabilities automate business processes to streamline operations.
- Reimagined Implementation & Upgrades
Using the latest technology innovations makes it easy for payers to incorporate standard new functionality and innovations frequently and easily for a lower cost.
- Resiliency to Change
Highly configurable features and workflows enable payers to embrace change, stay competitive, and take advantage of opportunities created by a variety of market dynamics.
- Actionable Insights
Near real-time business intelligence arms your leaders to make informed key operational and clinical decisions.
- Regulatory Support
Managing the ever-evolving state and federal requirements so you can stay compliant while improving member engagement and satisfaction, STAR ratings, health outcomes, and more.
- Security & Compliance
HITRUST certification is a must to reinforce robust enterprise compliance and security safeguards.
HealthEdge’s GuidingCare
The GuidingCare suite of solutions enables health plans to support care management, utilization management, appeals and grievances, authorizations, and population health in a next-generation, fully integrated platform. The unique solution enables digital payers to transform care management by improving mission-critical workflows and delivering access to real-time data that drives superior financial and health outcomes. Learn more here.
