AccessMeCare – 6 Use Case Benefits for Payors

The Medicaid Market is adversely impacted by the complex interplay that exists between healthcare providers, social programs, and the Medicaid Beneficiaries they serve. This translates into unmitigated risk at every transition of care due to a common set of barriers (i.e. culture, distrust, fear, health beliefs, knowledge, language, literacy, and transportation) at the hand of Medicaid Beneficiaries who are:

  • Twice as likely to misuse the Emergency Department for non-emergent or primary care treatable illnesses,
  • Require additional social support to become and remain healthy, and
  • Remain vulnerable to illness because of poor health behaviors, lack of access to care, socio-economic factors, and their environment.

These factors contribute to the high rate of avoidable (non-emergent) Emergency Department visits, unnecessary hospital admissions and readmission, mental health disorders, pre-term births, and other such population health problems. In particular, the Medicaid Market has been challenged by their inability to exert influence beyond the medical perimeter and, up to this point, have had not a sustainable solution that aligns medical care with the social determinants of health.

Here are 6 things AccessMeCare does for payors –

  • Encourages beneficiaries to seek care at the right time and place.
  • Increases coordination of care between primary care and behavioral health providers.
  • Enables health care providers to make social service referrals.
  • Improves the efficiency and effectiveness of case workers.
  • Engages and empowers community members to serve as health navigators.
  • Equips Community Health Workers to better serve their beneficiaries.
  • Improves performance and increase market share.

This ultimately translates to 5 points of value –

  • Increasing Access to Care,
  • Improving Population Health,
  • Expanding Prevention Services,
  • Eliminating Health Disparities, and
  • Reducing Avoidable Healthcare Costs.