SOLUTION

Scale Member Care Management

Create personalized post-acute care plans and long-term engagement to drive healthier outcomes.

Here's how it works.

First, identify and segment healthcare consumers by risk level for targeted disease management and wellness programs.

Infographic showing mass population filtered into selected group

Intuitive Member Reporting
Real-time analytics and dynamic reporting of conditions, trends, and health data allows you to provide more targeted care for high-risk members.

Then deliver improved healthcare consumer experiences that drive healthier outcomes at reduced costs.

Intuitive Member Reporting
Real-time analytics and dynamic reporting of conditions, trends, and health data allows you to provide more targeted care for high-risk members.

Infographic with enhanced member experiences connecting to end-to-end connected care through Salesforce

Member Engagement.
Members can take a more active role in their health by tracking their care plan progress on any device, and directly engaging with their care team on any channel, all through secure sites for a personalized experience.

360-Degree Member Views
Health Cloud integrates all relevant member data, from benefits and claims, to clinical events and wellness programs, into a single console, along with a collaboration map showing relationships across household members, care plans, and care teams.

Real-Time Collaboration
Utilization management clinicians and care team members can easily see the status of open care requests, along with coverage and guidelines, to streamline authorizations and make the best decisions for each member. .

Intelligent Prioritization
Case managers can view benefits, pre-authorizations, and clinical data, as well as member interactions, to gain insights and prioritize the best next steps for the best outcomes.

Member Engagement
Members can take a more active role in their health by tracking their care plan progress on any device, and directly engaging with their care team on any channel, all through secure sites for a personalized experience.

360-Degree Member Views
Health Cloud integrates all relevant member data, from benefits and claims, to clinical events and wellness programs, into a single console, along with a collaboration map showing relationships across household members, care plans, and care teams.

Real-Time Collaboration.
Utilization management clinicians and care team members can easily see the status of open care requests, along with coverage and guidelines, to streamline authorizations and make the best decisions for each member.

Intelligent Prioritization.
Case managers can view benefits, pre-authorizations, and clinical data, as well as member interactions, to gain insights and prioritize the best next steps for the best outcomes.

Astro holding healthcare icon in front of laptop showing application screen

Learn how to reinvent patient and member care management.

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What’s included in this solution

Health Cloud creates a 360-degree view of each healthcare consumer to understand care needs and social determinants.

Experience Cloud quickly launches portals and apps for members to access resources and healthcare needs.

MuleSoft integrates data from any system to deliver critical insights and drive efficiencies in a single platform.

Tableau serves up real-time analytics and data visualizations to drive insights for supporting healthier populations.

AppExchange extends solutions with comprehensive partners specialized in Healthcare and Life Sciences.

Of members are willing to switch health plans for a better experience*

Of medicare enrollees are in managed care**

Source: * Connected Patient Report (2016)

** CMS (2017)

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