Case Study

HGS Population Health Management: Driving Better Outcomes for Providers and Patients

Industries
Healthcare
Solutions
Business Process Optimization
Download

In the changing healthcare marketplace, technological efficiencies and strategic service offerings have started to revolutionize the way care is provided. With this shift from volume to value, population health management (PHM) is a key area of focus for providers and payers. Today’s healthcare professionals have significant opportunity to optimize population health—from insights gained through the analysis of administrative and clinical data that includes case histories to outcomes from patient care and coaching services. HGS provides end-to-end support from data mining so healthcare professionals can positively affect patient/member health outcome, through PHM processes that also bend the cost curve. Our 16,000 healthcare professionals, including 1,500 clinical resources, employed across our provider and payer business lines, are brand ambassadors for our clients, actively supporting health information lines, nurse triage, level-of-care assessments, and wellness solutions.

These team members bring:

  • Professional certification in their respective specialties
  • Protocol adherence
  • Deep domain knowledge
  • Agile workflow innovation
  • Call center expertise with an empathetic and patient engagement service focus 

How We Do It HGS’s unique combination of team and technology work together to optimize patient outcomes. 

HGS’s clinically skilled team members deliver:

  1. Patient Community Analytics, including Cost-of-Care Analysis
  2. Home Health Coordination
  3. Health Coaching
  4. Fall Prevention Support
  5. Medication Adherence
  6. Behavioral Health Support
  7. Wellness and Preventative Services
  8. Community Health Events Support

According to the Deloitte Center for Health Solutions survey of hospital CEOs, population health analytics investment is the highest-rated priority for healthcare organizations.

Our Value HGS can provide Population Health Management to drive real outcomes, such as:

  • Cost containment, supported by our rightshoring approach and innovative solutions such as intelligent automation and omnichannel support
  • Enhanced patient and provider satisfaction, with enhanced Star ratings and NPS and CSAT scores
  • Responsive and proactive customer care, with preventive and proactive patient care management and dramatically improved outcomes
  • Omnichannel (voice, chat, text) focus for optimized patient engagement
  • Reduced re-admissions through remote patient care and coaching
  • Provider-payer lifecycle expertise and focus comprising of PHM-focused data-insights and guidance
  • Cost savings and better understanding of patient/member populations gained from extensive data analytics
  • Intelligent automation to relieve providers of the capital and time investment in developing these capabilities in house

The datasets held by payers and providers can be different. For example, payers possess data on claims, financial analytics, and risk models. Providers have administrative and clinical data that includes case histories and outcomes. HGS has the payer and provider lifecycle expertise best positioned to assist, by bridging the data gap between these two  organizations.
 


 

Listen to Melissa O'Brien discuss who leads for Voice of the Customer

HFS