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Points of Light 2024 Case Study 11 Points of Light 2024 Case Study 11
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Points of Light 2024 Case Study 11
Using EOB Data to Create Complete Clinical Profiles & Close Care Gaps during In-Home Wellness Assessments

author - Boyd Stewart
Author
Boyd Stewart
author - Aurene Wilford
Author
Aurene Wilford
 
May 1, 2024 | Read Time: 1  minute

Socioeconomic factors, from food insecurity to lacking health literacy, can prevent health plan members from being involved in their health and lower the quality of their health outcomes. Additionally, payer and provider organizations are unable to fully care for and support members when they are unaware of the factors impacting members’ wellness. The payer and provider organizations in this collaboration worked together to create data transparency for clinicians, thus improving member engagement and health outcomes as well as compliance with HEDIS measures.

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Key Findings:

  1. Executive Summary
    • The Collaborators
  2. Points of Friction—Challenges to Be Solved
  3. Action Plan—How the Collaborators Worked Together to Reduce Friction
  4. Points of Light—Outcomes Achieved through Collaboration
  5. Lessons Learned—What Best Practices Can Other Organizations Replicate?
  6. What's Next?—Vision for the Future
author - Natalie Hopkins
Writer
Natalie Hopkins
author - Jess Wallace-Simpson
Designer
Jess Wallace-Simpson
author - Joel Sanchez
Project Manager
Joel Sanchez
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.