CarePoint

Transforming Traditional Care Management with CarePoint

Imagine if you could identify your members by chronic conditions and vulnerabilities, while realizing significant cost avoidance for your members? HGS’s NCQA-accredited CarePoint helps you to accomplish both.

CarePoint is a case management program that drives positive outcomes, improves member engagement and satisfaction by using data informed by analytics to target your most impactable members. Rather than the typical Core 5 conditions approach, CarePoint is able to accurately identify members with 1 or more of 100 chronic conditions and more than 60 care gaps, which allows for immediate care plan adjustments. With customized care tracks, that benefit members needing support the most, we are able to transcend care gaps and assure adherence, achieving better outcomes.

Here is how we’ve solved problems you may be facing:

  • Readmission Avoidance: HGS’s CarePoint solution redirects on average, 82% of callers with intent to visit the Emergency Department

  • Medication Adherence: our proprietary clinical algorithms assign a coach from our skilled team to drive behavioral changes and actionable intervention

  • Member Engagement: our multi-channel communication options and easy to use custom App drives increased engagement by up to 60%

  • HEDIS/Star: produced targeted, multi-channel campaigns that provide members with the ability to adopt new behaviors that improve compliance rates

CarePoint takes unique data and makes it relevant, actionable, and impactful. The most current and relevant biometric, symptom, lab, pharmacy, claims, and non-traditional consumer data are leveraged from a continually updated data warehouse to create a comprehensive, real-time 360-degree view of each member.

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