Hero - Health Plans

Health Plans
Efficiently Manage At-Risk Populations to Optimize Revenue and Improve Outcomes

The shift to value-based care requires health plans to share and manage risk across all business lines and provider networks while optimizing member health and well-being. A holistic view of member health—including insight into the medical, behavioral, and social determinants that impact outcomes and cost of care—is critical so you can focus scarce resources on managing those members who need the most support and avoid unnecessary ED and hospital visits.

We can empower your entire ecosystem – from your front-line care team, to your network, community partners and more – with near real-time information and tools that help you more efficiently manage the entire care continuum, from your healthiest members to the most complex, including PACE populations.

We’ll help you consistently apply your care model protocols while personalizing and optimizing member experience to ensure that the interactions you have with your members are productive and satisfying and that your members receive the right level of care. And, we can help you reduce the administrative burden of meeting state, federal and NCQA requirements.

Medecision supports the health of consumers and your business

For more reasons health plan clients choose Medecision, see how we support:

Icon - Digital Care Management


Digital Care Management

  • Connect healthcare ecosystems
  • Personalize and orchestrate care for all consumers
  • Use integrated data intelligence from across the care community

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Icon - Consumer Engagement

High-Tech, High Touch

Consumer Engagement

  • Ensure care experiences are personalized and proactive
  • Offer omnichannel engagements
  • Meet quality metrics and value-based goals

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Care Coordination

  • Increase operational efficiency and improve turnaround times
  • Proactively manage gaps in care and increase satisfaction for both providers and consumers
  • Manage network leakage through preferred provider set-up

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Utilization Management

  • Automate tasks to reduce costs
  • Improve throughput and turnaround times
  • Increase your competitive edge

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