For Payers

Model of care for SNPs

Use outsourcing to address the unique needs of each beneficiary while improving compliance, quality, and care/loss ratios for special needs plans (SNPs).

Impact the lives of those who need help the most.

With a focus on delivering an intervention model proven to have the maximum impact on the lives that need the most help, we improve your D-SNP and C-SNP members’ experience, helps your organization achieve compliance, and saves on medical and administrative costs.

What makes us different

Identify more than 100 conditions in members with high risk.
Focus resources on people with the greatest impactability.
Determine the right interventions for each member.
Clinically designed programs are configured specifically with clinical content and business rules.
Leverage our multidisciplinary team to best engage with SNP members.

Achieve and maintain compliance.

Member outreach and contact sourcing processes that exceed CMS’s requirements
- Engaging the PCP and any other providers who may have accurate contact information
- Utilizing community health workers to find members
- Leveraging SMS to communicate with the population

Sophisticated analytics, comprehensive program monitoring and reporting, and expertise in MA care management enable compliance and Star lift

Image of service representative interacting with customer from a work at home setting

Reduce medical expense while improving quality.

Identify and address the root causes of care gaps and compliance failure.
Reduce unnecessary utilization (inpatient admissions and readmissions, ER visits, long-term care placement).
Apply the appropriate scope of member intervention using analytics, disciplined operational execution, and clinical resources that bend the cost curve.

Improve your member experience.

Increase member engagement and participation through channel of choice care solutions (e.g., SMS, telehealth).
Enhance member experience and satisfaction through attention to both quality of life and quality of care.
Identify, track, and close care gaps for improved health outcomes.

Our model of care for SNP program components

Initial health risk assessment (HRA) for every member within 90 days of enrollment

Individualized care plan (ICP) developed and implemented for every member

Ongoing communication among the interdisciplinary care team (ICT) to manage the ICP

Coordination of transitions of care

Reassessment HRAs (within one year of the previous HRA)

This solution is right for SNP health plans who are looking to be compliant, impact their medical care ratio/medical loss ratio, and drive member satisfaction.

Our healthcare accreditations

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Global locations

USA • India • Philippines • Jamaica • Colombia

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