Resolve is the only end-to-end medication adherence customer relationship management (CRM) system designed to address and resolve consumer barriers to care that lead to poor measure performance, including social determinants of health (SDOH), provider, and pharmacy access. The solution has been integral to achieving value-based care outcomes for more than a decade, with a high level of focus on government programs such as Medicare Advantage Star Ratings, Managed Medicaid Pay for Performance (P4Q), and the Commercial ACA Quality Rating System.
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 within a streamlined intelligent clinical workflow to maximize health plan outcomes.
Resolve proactively and dynamically identifies and analyzes which consumers are at risk of medication non-adherence, gaps in quality measures, and poor Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and Health Outcomes Survey (HOS) results, stratifying at-risk consumers for outreach to optimize engagement. The Adhere platform’s flexible integrations with SDOH and pharmacy partners enable clinicians to seamlessly connect consumers to the resources they need – thus improving outcomes and individual Medicare Advantage Star Ratings measure performance while elevating the consumer experience.
Resolve enables plans to improve scale and performance for their clinical teams to target both medication adherence and related quality measures in a consumer-centric way, leading to improved outcomes and cost savings for plans across markets.
Dynamic engagement with consumers that focuses on socio-economic issues for access to care
Increased value-based care revenue due to improved quality measures
Actuarial evidence of bending the trend of unnecessary healthcare costs by better medication adherence
100% guarantee on each consumer measure conversion performance
Consumer-centric CRM model positively impacts CAHPS measures by addressing multiple measure gaps in a single engagement, mitigating risk of abrasion
Carla struggled with high blood pressure and her losartan prescription was out of refills. AdhereHealth’s pharmacist reached out to Carla due to medication adherence analytics identifying medication gaps and subsequently contacted the physician for the refill order and improved quality of care.
Margaret’s chronic asthma benefits from a rescue inhaler for flare-ups. AdhereHealth's analytics showed a prescription gap and during AdhereHealth’s CMR discussion, our pharmacist discussed the issue with Margaret, prompting outreach to her doctor for an order to prevent asthma emergencies.
Ed has type 2 diabetes and is at risk for heart disease and/or stroke. AdhereHealth’s analytics identified a gap in statin usage for his diabetes and this prompted our nurse to reach out to Ed’s doctor. The doctor prescribed lovastatin to Ed and it addressed the quality issue.
Greg’s hospital discharge plan included new medications to treat his cholesterol. AdhereHealth’s analytics identified a high statin dosage and upon a discussion with our pharmacist, it became clear Greg was taking two statins prescribed by two physicians. Greg met with his doctor to resolve the error.
Karen was taking two antidepressants and during a CMR, AdhereHealth’s analytics alerted our pharmacist to a potentially dangerous medication duplication. Our pharmacist discussed the issue with Karen and subsequently the consumer addressed the issue with her doctor. The doctor modified her regimen thus improving her overall care plan.
Stephen was prescribed lisinopril for high blood pressure but missed doses increasing risk for cardiac arrest. AdhereHealth’s analytics identified the risk and upon our clinician’s discussion with Stephen about his apparent memory issues, a pill organizer was facilitated ultimately improving adherence.
Wanda is on 13 medications to support her multiple health conditions. The AdhereRx™ program helped Wanda synchronize her medication refills and couriered to her home monthly. Our pharmacist also helped Ms. Jones order a blood pressure cuff to monitor her blood pressure.
Mrs. Robbins’s heart disease requires simvastatin and clopidogrel to reduce heart attack and stroke risk. AdhereHealth's medication adherence analytics prompted our pharmacist to discuss these risks. Mrs. Robbins supported the plan, improving quality and reducing her risk of hospitalization.
Julie was taking a high-dosage of morphine for pain, but due to side-effects her physician changed medications to hydrocodone, oxycodone and acetaminophen. AdhereHealth analytics identified a acetaminophen dosage guideline issue, prompting our pharmacist to contact Julie’s physician to discuss alternatives and ultimately improved the chronic pain management.
Ida R. has type 2 diabetes and misunderstood how her insulin would regulate glucose release during the early dawn hours. AdhereHealth analytics identified insulin fill gaps that increased Ida's risk of complications and future hospitalizations. Upon our clinician intervening, Ida was educated about the importance of insulin and diabetes educational support. Ida returned to her prescribed care plan, improving her quality of care.
Roberta is 67 and her muscle pain was being treated with methocarbamol, which increases the risk of falling for consumers over 65 or older. AdhereHealth analytics identified tizanidine as a safer alternative, alerting our nurse to discuss the gap with Roberta’s clinician prompting a medication change.
Keith is in a long-term care center and was taking blood thinners warfarin and dabigatran as part of his daily regimen. AdhereHealth immediately contacted Keith's provider about the oversight. The provider agreed to discontinue one of the blood thinners. AdhereHealth's OptimizeMTM™ platform caught the therapy duplication preventing severe bleeding and other potentially life-threatening complications for this consumer.
Josh’s medication was changed from lisinopril to losartan for his hypertension. AdhereHealth analytics identified Josh hadn’t filled the lostaran which increased risk for stroke. Our clinician contacted Josh who was confused and followed up with his pharmacist and physician to close the gap.
David’s cholesterol medication refill was months overdue and during AdhereHealth’s CMR, he stated the discontinuation was due to receiving positive lab results. Our pharmacist convinced David the good lab results were a result of the medications, addressed the serious health risks with him and the consumer immediately refilled the medications.