Engagement That Drives Outcomes
Member Engagement & Care Access
Proven Performance: Care Access Programs for Enhancing Member Experience, Improving Healthcare Outcomes and Maximizing ROI
Program Overview
Member Engagment & Care Access
Health plans need more than just member engagement—they need a comprehensive solution that provides members a way to take action.
Breaking down barriers isn’t just about calling and sending messages; it’s about completing the action and creating positive experiences, scheduling appointments, completing Health Risk Assessments (HRAs), and engaging members in conversations to ensure they fully understand and utilize their health plan benefits and incentives.
That’s why ReferWell’s systematic and compassionate approach addresses every phase of the member journey—from initial engagement and health assessments to closing care gaps and managing referrals.
ReferWell’s Care Access Programs
Closing Care Gaps
- Improve HEDIS score measures
- Boost Star ratings
- Boost state-level quality scores
- Increase CMS reimbursement
Health Risk Assessments
- Facilitate early identification of high-risk members
- Boost cost savings by addressing health risks early
- Personalize care plans based on the information collected through the HRA
Referral Management & Provider Support
- Give low-performing provider groups the tools (and resources) they need to get members the care they need
- Improve provider satisfaction by increasing member show rate
CAHPS
- Improve member experience (CAHPS)
- Identify high-risk targets, engage them, and offer to schedule them for Annual Wellness Visits
Navigating Access to Care
- Respond to at-home test kit results
- Improve access to PCPs, specialists, mental health and SDoH services
- Reduce health disparities
- Enhance care coordination
- Increase show rate/follow-through
Engaging & Retaining New Members
- Improve new member experience
- Keep members from plan-jumping
- Drive full PCP attribution
- Schedule Annual Wellness Visits
Improving Risk Adjustment Performance
- Schedule appropriate follow-up care
- Meet CMS coding requirements
- Identify high-value targets and schedule their risk adjustment visit
Don’t see the program you’re looking for? That’s OK. We can design one just for you.
We customize programs to fit our clients’ needs and tailor them to drive your specific outcomes.
Trusted & Trained
ReferWell Care Navigation
Building Relationships with Empathy and Understanding
At ReferWell, our Care Navigators are dedicated to exceeding expectations in member engagement. Trained to cultivate trust and empathy, they specialize in connecting with members at the pivotal moment, when they’re poised to embark on their healthcare journey. This strategic approach ensures seamless and integrated care delivery, underpinning ReferWell’s established success in driving superior outcomes for payer and provider organizations.
Actively build trust with members and work to eliminate barriers to care.
Work to understand the needs of the people they are contacting, listen with empathy, and ultimately help them find a solution to get them to the care they need.
Look at all the aspects of why someone may not be addressing their health needs including social determinants of health, location, availability, gender, etc.
Our care operations team members personally verify provider network data.
Download Our
Care Access Complete Brochure
Discover how a strategic, year-round approach to member engagement and care management can elevate your plan to 4 and 5 Stars.
