Explore proven strategies to help your health plan optimize Medicare Advantage Star Ratings when you download Four Steps for Improving Star Ratings by Leveraging the “Force Multiplier” Effect.
Resolve™ for Value-Based Care Reimbursement
The Resolve™ offering focuses on the holistic patient, guided by predictive adherence targeting and telepharmacy intelligent clinical workflow to drive medication adherence, HEDIS® and CAHPS® improvement. The patient relationship management (PRM) uses enterprise social service tools and health plan benefits to overcome SDOH barriers and predictive analytics for the “next best action” based on clinical engagement inputs with patients and providers.
Offered as either a tech-enabled service that combines the mind of a clinician with the heart of a social worker, or a fully configurable SaaS-based solution, Resolve is a comprehensive offering within the Adhere Platform™ that analyzes near real-time data from dozens of sources to maximize health plan outcomes.
Resolve enables plans to improve scale and performance for their clinical teams to target both medication adherence and related quality measures in a patient-centric way, leading to improved outcomes and cost savings for plans across markets.
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Solution Features
Analytics
- Integrates all necessary data from dozens of sources such as pharmacy, medical, CAHPS® and HOS, Healthcare Effectiveness Data and Information Set (HEDIS®), eligibility, hospital discharge, and provider- and patient-reported SDOH
- Stratifies patients into daily call lists based on risk, assigning the lowest-cost clinician for each engagement
- Provides deep insights into call center performance and each projected Star Ratings measure forecast
Patient Experience
- Optimizes each engagement by addressing multiple gaps in care in a single outreach using the platform’s holistic view of the patient's journey
- Allows for patient stratification that mitigates the risk of member abrasion and improves patient experience to positively impact CAHPS® scores and MA Star Ratings
- Prompts clinicians to ask patients about their access to care and provide assistance in navigating across the care continuum
Intelligent Clinical Workflow
- Guides clinicians through behavioral coaching techniques to identify the root of patient barriers
- Enables clinicians to connect patients with multiple SDOH-focused community resources and embedded health plan benefits
Business Analytics & Reporting
- Real-time data visualization of outcomes and program performance across populations
- Connects with hundreds of data sources to create executive dashboards and ad hoc analyses
- Enables multiple scenario-based forecasting combining quality measurement and financial investments
Ready to learn how AdhereHealth’s integrated solutions can improve medication adherence, value-based outcomes, and patient experience?
Solution Benefits
Social determinants of health
Dynamic engagement with patients that focuses on socio-economic issues for access to care
Quality bonus payments
Increased value-based care revenue due to improved quality measures
Cost savings
Actuarial evidence of bending the trend of unnecessary healthcare costs by better medication adherence
Outcome-based guarantee
100% guarantee on each patient measure conversion performance
CAHPS and HOS outcomes
Patient-centric PRM model positively impacts CAHPS measures by addressing multiple measure gaps in a single engagement, mitigating risk of abrasion
Resolving Outcomes
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