Transforming Traditional Care Management with AxisPoint
Reduce medical costs. Improve regulatory compliance. Increase member satisfaction.
Imagine if you could identify your members by chronic conditions and vulnerabilities, while realizing significant cost avoidance for your members? HGS’s AxisPoint helps you to accomplish both.
Our mission is to make our clients more competitive, by partnering with your members so that together we identify and address the ‘root causes’ of behaviors that worsen physical health. These root causes include undiagnosed/underdiagnosed behavioral health issues, substance use disorders (SUDs), and social determinants of health (SDoH).
Our distinctive approach standout as unique by combining industry leading predictive analytics, a proprietary rules-engine, specialized clinical content, and passionate clinicians who care about the members’ success. Our clinicians are hired for skills including empathy and listening, so that we build trust and focus on the members’ priorities.
The HGS-APH vision is to be the nation’s leading whole person services company across Chronic Condition Management, Model of Care for Special Needs Plans, and Disease Management.
We deliver services nationwide through an integrated set of virtual, digital, and in-person services that includes smart engagement, evidence-based interventions, and lasting member support to drive durable outcomes. Results include a reduction of medical costs, an improvement in meeting regulatory and compliance requirements, and an increase in member satisfaction.
The HGS-APH Whole Person
What is “Whole Person” Care Management?
Our whole person approach prioritizes the human potential. This evidence-based method builds coping skills, enables a healthy lifestyle, and drives self-efficacy by leveraging behavior change models such as Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), Transtheoretical (Stage of Change), etc.
At the heart of our success is our world-class clinical team of nurses, social workers, health coaches, and physicians. We screen, train, and support our team members based upon our core beliefs that trusting relationships matter, that prioritizing a members’ self-identified barriers is crucial, and that providing a truly integrated med-psych solution places behavioral health, SUD, and SDoH at the core of program design. Many companies claim to leverage an integrated approach within their care management practices, but very few actually do it.
Chronic Condition Management
Our Chronic Condition Management program supports individuals with chronic conditions exacerbated by underlying behavioral health, SUD, and environmental conditions. 90% of all healthcare costs are for patients with one or more chronic conditions. These “missed members” comprise 5% of the population and drive up to 60% of healthcare costs particularly when multiple chronic conditions and psycho-social factors are present; and these members do not typically engage in traditional care pathways. This program typically lasts 8-14 months and targets the “impactable” members who is not currently engaged in any other program offered by the health plan, a physician, or another vendor. Our chronic condition management program solves the hidden, high-cost problem of untreated behavioral health conditions, improving member health and reducing medical expense. This solution is ideal for health plans who are looking to impact their Medical Care Ratio/Medical Loss Ratio while driving member satisfaction.
Model of Care for Special Needs Plans
AxisPoint Health is one of the few services providers who offer a full Model of Care (MOC) program for Special Needs Plans (SNPs) as an outsource solution. Model of Care is considered a vital quality improvement tool and integral component for ensuring that the unique needs of each beneficiary enrolled in a SNP are identified and addressed.
Ours is a comprehensive program through which care is efficiently delivered and well-coordinated by integrating all Medicare and Medicaid physical health, behavioral health, pharmacy, and community-based services through an interdisciplinary team. We achieve compliance for SNP plans facing CMS audit remediation and corrective action plan implementations. APH has expert experience across the systems, policies & procedures, processes, and reporting requirements that are necessary to deliver care coordination and care management to D-SNP and C-SNP members. Includes expertise with generating high completion rates for Health Risk Assessments (HRAs) using telephonic, web, and mail modalities.
Program components include:
Initial Health Risk Assessment (HRA) for every member within 90 days of enrollment
Individualized Care Plan (ICP) developed and implemented for every member
Ongoing communication among the Interdisciplinary Care Team (ICT) to manage the ICP
Coordination of Transitions of Care
Reassessment HRAs (within one year of the previous HRA)
This solution is right for SNP health plans who are looking to be compliant, impact their Medical Care Ratio/Medical Loss Ratio, and drive member satisfaction.
Disease Management, Case Management
Our disease and case management (DM/CM) programs support individuals identified by the health plan as enrollees in actively managed solutions. This program typically lasts 8-14 months and targets the “impactable” members who is not currently engaged in any other program offered by the health plan, a physician, or another vendor.
Our turnkey disease management solutions cover CAD, COPD, CHF, asthma, and diabetes; and our case management solutions include complex case management capabilities. This solution is appropriate for Managed Medicaid health plans who are looking to meet state requirements for disease and case management while reducing medical expense and driving member satisfaction. DM/CM are also applicable to Medicare Advantage plans as well as commercial plans and ACOs. These programs also support objectives related to appropriate risk-adjustment (RAF) strategies.
AxisPoint Health partners with you to support your goals and objectives for care management. Our clients often come to us with goals such as:
Reduction of medical cost
Reduction of avoidable inpatient admissions and ER readmissions
Improvement meeting regulatory and compliance requirements
Increase in member satisfaction
Improvement of care coordination with contracted providers
We work collaboratively with your care management team to ensure the best outcomes for your members.
NCQA Accredited Disease Management – 3 years (AxisPoint Health)
NCQA Accredited Case Management – 3 years (AxisPoint Health)
NCQA Accredited Population Health Program – 3 years (AxisPoint Health)
Note: AxisPoint Health has received NCQA Population Health Program Accreditation, NCQA Case Management Accreditation and NCQA Disease Management Accreditation. AxisPoint Health was wholly acquired by HGS in April 2018 and the accredited processes remain intact.