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Points of Light 2024 Case Study 22
Transforming Medicare & Medicaid Member Engagement through AI-Powered SDOH Risk Prediction & Personalization
Author
Boyd Stewart
Author
Aurene Wilford
Negative social and environmental factors, such as unsafe housing or food insecurity, can worsen patient health and lead to them overusing the emergency department (ED). In this collaboration, Sentara Health engaged N1 Health to identify social determinants of health (SDOH) for Medicare and Medicaid members and match these individuals with benefits to facilitate better care and promote re-enrollment. The partners also used AI to determine which patients had high risk for housing insecurity so that they could provide housing assistance via a grant-funded program. These efforts lead to reduced ED usage, increased use of preventive services, and higher re-enrollment in Medicare/Medicaid.
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Key Findings:
- Executive Summary
- The Collaborators
- Points of Friction—Challenges to Be Solved
- Action Plan—How the Collaborators Worked Together to Reduce Friction
- Points of Light—Outcomes Achieved through Collaboration
- Lessons Learned—What Best Practices Can Other Organizations Replicate?
- What's Next?—Vision for the Future
Writer
Natalie Hopkins
Designer
Jessica Bonnett
Project Manager
Joel Sanchez
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.