Care Steerage to Achieve 100% CSAT and Drive Engagement and NCQA Accreditation For Provider Partner
In early 2021, a Texas client faced challenges due to care gaps affecting diabetes and asthma patients, leading to delays, compliance issues, and strained customer and provider relationships. Enlisting Sagility’s expertise, they formed a specialized team and implemented a communication-driven approach across seven counties to close care gaps and empower participants through resources and technology.
About the Client
The client in Texas struggled with care gaps impacting chronic condition patients, causing delays and compliance issues. By partnering with Sagility, they efficiently assembled a dedicated team, prioritized communication, and achieved remarkable outcomes, including increased engagement, satisfaction, and NCQA accreditation.
Medicaid Population Gaps
One of the biggest issues that many Medicaid providers face is care gaps within the Medicaid population. This is especially true for those with chronic conditions, such as diabetes, asthma, and others. Unfortunately, this can lead to delays in clinical turnaround time, which has an adverse effect on compliance, member experience, and provider experience.
In early 2021, a client in Texas was facing this exact issue. Thanks to the care gaps that diabetes and asthma patients were facing, the client struggled to keep up with clinical reviews, resulting in delays and issues. This then led to the client losing face with their customers and providers and having compliance issues. To get back on the right track, they enlisted Sagility’s help.
Assembling the Right Team
As soon as Sagility was brought in to solve the client’s problem, they didn’t hesitate for a moment. They began by assembling a team of experts to build a program that could address the client’s issues. The team consisted of the following professionals.
- Diabetes educators
- Social workers
- Licensed behavioral health specialists
- Respiratory therapists
- Health coaches
- Outreach agents
Creating a Nurturing Atmosphere
In addition to gathering together a team of experts, Sagility also strove to create a nurturing and healthy atmosphere where communication was encouraged. The only way to fix the client’s problem was to educate and engage with providers in an effort to build an essential care network. This would take effective communication, as the work was being done across seven different counties.
To open communications, we relied heavily on phone calls, SMS, and videoconferencing. We were able to get the ball rolling and earn the trust of providers and participants alike. Once we were able to engage with the participants and earn their trust, we made headway in addressing the client’s issues.
- We were able to close care gaps by determining the medical needs of each participant and assisting them in finding the right resources if they were available.
- We help participants choose the right resources to ensure a proactive and productive outcome.
- Effectively educate each participant on how to use resources and technology to their advantage. This included using videoconferencing and text messaging to help clients find housing, food stamps, shelters, and more.
- Use our multidisciplinary expertise to teach participants how to learn healthier behaviors and achieve positive outcomes.
Through this straightforward, hands-on, and highly-effective process, Sagility was able to deliver staggering results.
In Client Engagement
Achieved by the Client Thanks to Sagility’s Guidance Program