Case Studies

A leading Iowa-based PHSO sought to reduce its overall healthcare expenditures by optimizing its skilled nursing facility (SNF) utilization and costs across the network. Increases in the average length of stay (LOS) and daily charges meant utilization reimbursements varied, and the PHSO struggled to deliver cost-effective care.

One of the nation’s largest healthcare systems approached Innovaccer with the goal of improving its care management technology. Its mission is to provide high-quality, cost-effective care to enhance community health. It operates in 19 states and is comprised of 105 hospitals, including four academic medical centers and teaching hospitals; 30 critical access facilities; community health services organizations; accredited nursing colleges; and home health agencies; and other services.

Over the past decade, payers and providers have made significant improvements in the safety, effectiveness, and efficiency of medical care, and the shift to member-centered, value-based care models has only increased the need to deliver high-quality care.

Members are at the core of any health plan. However, the aftermath of COVID-19 poses new challenges for payer organizations when it comes to member enrollment.