HEALTHCARE
Identify high-risk members and coordinate care to ensure timely, appropriate services at the right location
The Client
As a leading healthcare payer operating across multiple states, with over $10 billion in revenue and 15,000 employees, this organization is responsible for providing coverage to 10 million members, including high-risk members with chronic conditions and complex care requirements.
The Challenge
The healthcare payer faced significant difficulties in coordinating timely outreach to high-risk members. Identifying at-risk individuals relied on manual processes and SQL analysis, requiring flat file transfers to each outreach channel.
This fragmented approach lacked transparency and accountability, making it difficult to track essential details such as the rationale for outreach, past outreach efforts, health trends, and which communication channels were utilized.
As a result, the organization struggled to ensure consistent and effective engagement with members, hindering their ability to proactively manage care and improve outcomes.
The Lowcodeminds Solution
Lowcodeminds designed a low-code solution that prioritized streamlining data integration and enhancing care management.
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The platform enabled the healthcare payer to prioritize outreach for high-risk members by automatically identifying those in need of attention and applying business rules to ensure appropriate, personalized outreach.​ Coordination of care was improved , leading to better patient outcomes and more efficient use of resources.
As a result, the payer was able to reduce overall healthcare costs while delivering more timely and effective care to its members.