Carenodes
Carenodes
Program Eligibility
Providers and payers meeting eligibility criteria are invited to submit a request for an invitation to join the pilot.
PROVIDERS
Primary Care Service Lines
- High-volume solo and small group physicians (1 to 10 PCPs).
- Community clinics with at least 300 Medicaid assignments per provider or 1000 Medicaid assignments as a community clinic.
- Mid-sized provider groups (10-50 PCPs) with an average of 250 Medicaid paneled lives per provider or 10,000 Medicaid lives combined.
- Operating with capitated Medicaid contracts.
- Seeking an opportunity to receive significant revenue above capitation while increasing preventive screening rates and significantly improving performance on HEDIS metrics.
PAYERS
Health Plans and Risk Bearing Organizations
- At-risk entities managing at Medicaid, Medicare Advantage, and/or Dual eligible lives.
- At least 10,000 lives at-risk.
Approach
Human-Centered Design (HCD) to developing adaptive digital health platform.
Human-Centered Design
A replicable method for scalable problem solving.
Rigorous Methodology
Value mapping of pain-points to solutions.
Scalable
Scalable & Sustainable
Expanded capabilities as platform usage increase.
Pilot Program Opportunity
Given the complexities of healthcare roles and workflows, successful health technology solutions necessitate rigorous usability testing pre- and post-deployment to truly grasp the user's journey and deliver a solution as opposed to contributing to the burden. As such, carenodes is seeking pilot partners for testing -- business goals, scalability, and sustainability.
Revenue
Top Line Revenue Streams
Experts indicate that, on average, an organization leaves 30% of the reimbursement value of at-risk populations on the table due to inaccurate HCC capture and documentation. Citing lack of awareness around the potential financial rewards tied to closure of care gaps
Cost
Bottom Line Efficiencies
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