Healthmine is the industry’s leading quality improvement solution focused on empowering people to take the right actions to improve their health. We build personalized, ongoing member engagement strategies for health plans in all lines of business. These strategies are delivered via our SaaS-based, always-on platform that drives healthy action through customized triggers for clinical, pharmacy, and CAHPS and HOS measures. When paired with intelligent incentives and rewards, the net result is improved outcomes and well-managed medical spend. In addition, Healthmine clients have transparency into real-time, actionable insights on the success of member engagement and satisfaction initiatives, as well as the ability to identify and prioritize areas of opportunity to improve quality measures and Star Ratings.To learn more visit www.HealthMine.com.
Decision Point is a leading member engagement management company that brings holistic predictive analytics and artificial intelligence to everyday health plan decision-making. Decision Point empowers health plans to understand and predict every facet of a member’s health experience, enabling effective targeting and impactful holistic interventions. Decision Point aims to change the fundamentals of healthcare decision-making by predicting and acting on the entire member health experience, delivering sustained improvements in outcomes across satisfaction, retention, quality, and utilization domains.
NationsBenefits® is a leading member engagement, benefits administration, and healthcare company that partners with managed care organizations to provide innovative healthcare solutions aimed at driving growth, reducing costs, and delighting members. Through its comprehensive suite of innovative supplemental benefits, payments platform, and member engagement solutions, NationsBenefits helps health plans deliver high quality benefits to their members that help address social determinants of health and improve member health outcomes and satisfaction. The Company’s compliance-focused infrastructure, proprietary technology systems, and premier service delivery model allow NationsBenefits’ health plan partners to deliver high quality, value-based care to millions of members. To learn more, visit NationsBenefits.com.
FarmboxRx is an engagement and technology solution that breaks down barriers to health equity through nutrition and health literacy. With a focus on addressing the root cause of healthcare inequities, FarmboxRx delivers proactive and preventative interventions through high-tech, high-touch programs. Their customizable member engagement programs support sustainable, scalable, and long-lasting quality outcomes through nutritious foods for Healthcare Organizations nationwide.
mPulse Mobile is reimagining health engagement to inspire healthier lives and deeper relationships between healthcare organizations and their consumers. A leading healthcare Conversational AI platform combines with award-winning health education for the streaming age to deliver tailored digital health engagement that nurtures, educates, and activates healthcare consumers. With more than a decade of experience, 150+ healthcare customers and over one billion conversations annually, mPulse Mobile has the data, the expertise, and the solutions to drive healthy behavior change. To learn more visit mpulsemobile.com.
Standard setters in clinical data optimization, Health Language delivers the kind of confidence that transforms health data and healthcare. Time tested and trusted, its easy, accurate, and actionable solutions are a catalyst for customer and patient results. Powered by the Wolters Kluwer engine, Health Language’s deep domain expertise is grounded in know-how and elevated in data transformation that’s clean, clear, and precise. Enablers of assurance, Health Language translates more than data—it turns confusion and complexity into competence and confidence. The experts clients need for the effectiveness they want, Health Language increases operational efficiency and takes its clients from unstructured data to outstanding outcomes.
PDHI is a software organization that supports white-labeled population health management, point of care, and wellness programs. With a 25-year track record of success, PDHI is trusted by hundreds of companies including health plans, wellness providers and large employers across the United States. For more information, please visit: www.pdhi.com.
Convey Health Solutions is a specialized healthcare technology and services company that is committed to providing clients with healthcare-specific, compliant member support solutions utilizing technology, engagement, and analytics. The Company’s administrative solutions for government-sponsored health plans help to optimize member interactions, ensure compliance, and support end-to-end Medicare processes. By combining its best-in-class, built-for-purpose technology platforms with dedicated and flexible business process solutions, Convey Health Solutions creates better business results and better healthcare consumer experiences on behalf of business customers and partners. The Company’s clients include some of the nation’s leading health insurance plans and pharmacy benefit management firms. Convey’s healthcare-focused teams help millions of Americans navigate the complex Medicare Advantage and Part D landscape. To learn more, please visit www.ConveyHealthSolutions.com.
Since its birth in 2017, RWC has helped over 50 organizations improve their Quality. Highlights include the following:
- RWC clients, on average, outperform the industry by 16 basis points.
- Drive to 5 Stars: Began working with 4-Star plan who was tired of “flirting with 3.5 Stars”. Guided client to improve its accountability workgroup structure, enhance its Executive Steering Committee slides and messaging, have frequent data-driven discussions focused on maximizing the Improvement measures and Reward Factor. Client achieved 4.5 Stars for the first time in the following year, and client achieved 5 Stars for the first time the next year.
- Overall Turnarounds: Began work with a low-performing client in its 2nd year. Guided them to become just the 3rd plan ever to improve by a full Star in a single year after receiving an initial 2.5 Star Rating.
- Member Experience: Established a cross-functional committee focused on reducing the number of CTMs for a client that was a national CTM outlier. Actively engaged functional areas where CTMs were prevalent. Bi-weekly meetings were driven by current CTM data categorized into key drivers.
- Within 12 months, client was no longer a national outlier.
- Within 24 months, client was 4th most improved parent organization in the nation regarding CTMs and 8th most improved for voluntary disenrollment.
- Internal Culture: Developed organization-wide Stars training platform for 4 Star plan.
- The client stated it was the most impactful initiative it had launched in years.
- Stars Council: RWC facilitates monthly Mastermind-type group for Stars leaders, by invitation only, to collaborate across organizations regarding best practices. Special guests have included Pharmacy Quality Alliance, HEDIS® auditors, and behavioral scientists.
Everly Health Solutions, a subsidiary of Everly Health, is a virtual care provider that uses advanced diagnostics and telehealth to improve the early detection and prevention of disease. Our solutions provide the clinical and technological framework to facilitate population-scale testing across the healthcare ecosystem. We serve more than 350 enterprise partners and power over 400 programs, closing gaps in care and creating diagnostics-driven solutions for health plans. We believe that empowering people with convenient access to clinically actionable testing has the power to change lives, improve outcomes, and create a healthier world.
The Managed Care Resource Alliance (MCRA) is an assemblage of industry leaders that provide services, products and/or subject matter expertise to Managed Care organizations. Our alliance consists of prominent and experienced organizations that are partnering to provide transformative solutions to our clients.