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Engage At-Risk Members


Many health insurers are hampered by outdated care management systems that cannot keep up with the imperatives of care coordination and population health.

This inhibits their ability to embrace the shift to new benefit and payment models including value based reimbursements, achieve desired levels of efficiency with reduced clinical costs and provide a superior customer experience. Health plans must strive to improve the overall quality of care, create better outcomes with management of at-risk populations and drive overall member engagement. A 360 degree view of the member is essential, taking into account all the elements of care impacting overall health and well being. The most complete technology platform is necessary to remain competitive in the emerging, consumer-centric marketplace, stay compliant in the face of new regulations, achieve quality metrics and increase customer satisfaction while reducing costs.

Leading health plans utilizing the HealthRules CareManager solution are proactively reaching out to patients to improve engagement, launching effective care coordination initiatives resulting in a happier and healthier member population, optimizing quality measures and reducing clinical and administrative costs.