A standardized system delivering predictable Quality improvement in rural populations to Prepaid Health Plans
Prepaid Health Plans understand the value of reducing barriers between their members and primary care providers. Primary and Preventive Care is well studied, and accepted around the world to improve outcomes.
Until today, the challenge has not been that mobile health models do not work to better distribute our scarce provider resources, it's that they can not work across geographies or markets when owned and operated by individual health systems with competing incentives,
Improve Quality. Pay for Performance.
We provide Quality improvement programs in a single- or multi-geography as a contract service. Standard programs focus on a 5x5 Measurement & Evaluation system (reducing unnecessary ED visits, uncontrolled hypertension and diabetes, progression of CKD, and delivering pre- and post-natal care). Dental and behavioral health programs are available as well.
The standard contract is a PMPM covering infrastructure and member engagement with our patent-pending 5CSystem, activating hard-to-reach members and creating a self-funding program.
Data shows a direct short-term financial ROI between 3X and 10X for small rural counties (pop. 50,000, 2,000 Medicaid members) . Other advantages of this approach are unlocking Quality Withholds from state contracts and the inherent strategic advantage of having a tunable and scalable rural health Quality strategy for multiple de novo markets and renewals in a single P4P Master Service Agreement.
Networked Primary Care Satellite Clinics
Step 1: Planning
Our model leverages a 90-120 day launch process, beginning with data analytics (the aggregation of EHR, claims, service utilization, cost data, and care manager notes from a preceding 48-month data set), analyzed by a proprietary neural network-based AI model.
Following a period of fact-gathering, we collaborate with your team, community leaders, and our providers to codesign the intervention.
Step 2. Baseline
180 days post-launch is focused on operationalizing all components, solidifying relationships in our community health councils, and collecting baseline data.
We examine the launch strategy in the 6 dimensions of Access, and either validate the initial assumptions or make adjustments.
Step 3: Operate + Optimize
In a series of 12-week sprints, program planners track lead and lag measures for engagement, outcomes, and returns on the client investment.
Flexibility is inherent in the mobile health model, allowing for continuous refinement of location, frequency, operating hours, clinical services, workflows, and partnerships without a single dollar of additional investment.
Process improvements in every location are shared across the network, creating a exponentially improving network of healthcare delivery that is hyperlocal and scalable across geographies at the same time.
• Your current Quality metrics for rural populations will stay the same year after year; more providers are not moving to rural counties. • As rural health systems close, costs will continue to climb as patients forego treatment even longer until emergency transport and admission are inevitable. • Member experience will deteriorate as more rely on spotty NEMT contractors. • Margins and markets could erode.
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