Why It Matters

We drive member behaviors that improve quality outcomes

We help plans improve overall quality performance by tailoring our approach to your members and your goals

From HEDIS and Stars measures to state and market level quality initiatives, we accelerate gap closure and strengthen member experience outcomes (HOS/CAHPS) with reporting that clearly attributes results to your investment.

From engagement to quality outcomes

Program Design

Why it matters: Our programs are designed around target populations and priority quality measures, including HEDIS, Stars, and state‑ and market‑level quality initiatives. We take on the operational lift, so members receive relevant support that drives member engagement and measurable movement toward health plan goals.

Early Engagement

Why it matters: We reach hard‑to‑engage members early through trusted, accessible outreach that expands your reachable population and creates the foundation needed to remove barriers and influence the behaviors that influence quality performance.

Guided Navigation

Why it matters: Navigating the healthcare system is overwhelming for members, especially those with complex needs. We guide them through their care journey, connect them to the right resources, and remove barriers, making it easier to access needed care to close gaps.

Member Activation

Why it matters: Activation turns a member’s care plan into meaningful action. With clear guidance and support, members build self‑efficacy, and confidently complete visits, screenings, and follow-ups that close each care gap, driving both quality and utilization outcomes.

Quality Outcomes

Why it matters: Sustained member action reduces avoidable utilization and strengthens performance across priority initiatives – with clear attribution to the program elements and needs addressed that generated meaningful impact and return on quality.

Engagement & activation outcomes

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higher rate of engagement vs. industry average

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complete a targeted health screening

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of member-reported barriers resolved in real time

(NPS) net promoter score, best in class member satisfaction

Utilization outcomes

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overall cost reduction

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decrease in unhealthy days/month

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reduction in ED admissions

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decrease in hospitalizations

Population Outcomes

Diabetes

Managing diabetes can feel overwhelming when multiple care gaps exist. Support to help all members sustain the behaviors that support diabetic management is essential. We improve screening and day-to-day behaviors that support A1C control, especially where social barriers are high.

38% average closure rate for all diabetic care tasks
10% increase in A1c screening vs previous year
4% higher compliant A1C, <8%, vs. control
98% agreed the program improved their completion of recommended diabetic care tasks

Chronic Conditions

Comprehensive care and targeted activation helps members with chronic conditions take and sustain the actions that improve quality outcomes and reduce avoidable utilization. (Plan-specific metrics available on request.)

46% of members completed all open care gaps
36% increase in medication refills
57% decrease in ED admissions in behavioral health population
79% more confident managing their chronic condition

DSNP/Duals

Members’ complex care needs, coupled with inaccurate or outdated contact information, make this population a challenge to connect with and manage quality measures. Activation moves the needle.

38% average gap closure rate
9% point increase compared to previous year
3.9% rate of contact information correction
44% obtained an A1c screening
44% completed a diabetic eye exam
39% completed a kidney health evaluation

Maternal

Timely and consistent maternal care is essential to improve quality metrics and reduce avoidable utilization, especially when care is difficult to access and high-risk conditions or mental health needs may go undisclosed.

71% of members reported prenatal visit and maternal history data at opt-in
20% increase in post-partum visit attendance
55% reduction in depression among maternal members

Youth & Family

Caregiver support helps families establish early well-child visits and stay on track with preventive care, from immunizations to conversations about mental health.

34% completed 2 or more well-child visits
44% received an age-appropriate vaccine
23% visited their dentist
98% caregivers agreed the program helped their child to complete needed health activities

Behavioral Health

Early identification and ongoing engagement prevent behavioral health crises and reduce high-cost utilization.

18% improvement in PHQ-4 scores
5% decrease in hospitalizations
57% decrease in ED admissions
47% improvement in BH 7-day follow-up

Preventive Care and Compliance

Closing preventive care gaps for members who put off care because they feel well supports early detection, improved quality score, and helps avoid higher-cost care.

38% completed an annual wellness visit
10% increase in breast cancer screenings
16% completed a colon cancer screening in Q4
91% completed an annual vaccination