Conventional methods of cost control such as provider contracting, product design, cost shifting, and medical policy have collectively proven insufficient for curbing escalating medical costs. It’s why improving consumer engagement and experience is one of the top payer initiatives in 2018 and is driving substantial investments in Population Health across all market segments. Currently, most payer population health programs are connected to disease management, wellness programs, concierge services, and other conventional programs. The missing link in Population Health to improve outcomes is knowing and engaging members outside of a medical event or claim.
What happens to members that have pre-condition symptoms but haven’t yet experienced a claim? Or members who are affected by social determinants of health, lack health care literacy, or frequently do not engage with their providers or health plan? What happens is that you end up engaging with them for the first time in the emergency room. To effectively bend the health care cost curve requires identification of risk across your entire population.
Gary Call, M.D.
Chief Medical Officer
Dr. Call has more than 25 years of experience in the practice of medicine and managed care. Prior to coming to HMS he most recently served as the Corporate Vice President of Clinical Programs at Molina Healthcare.
His duties as the HMS Chief Medical Officer include innovation and thought leadership around clinical analytics, collaboration with HMS clients and leadership of HMS clinical program development and execution.
Dr. Call graduated from the University of Washington School of Medicine and completed his residency training at the University of Utah. He is a board-certified family physician.
Ellen Harrison, RN, MBA
Senior Vice President, Market Strategy and Consulting
Ellen is SVP for market strategy and direct to market consulting for HMS. She brings over 20 years of experience in strategic planning, managed care operations, and consulting experience.
Previously Ellen consulted for managed care organizations and served in leadership positions including Vice President of Medical Management for Martin’s Point Health Care; VP, Shared Decision Making Products at Health Dialog; President, HMOs for Trigon BCBS of Virginia; and, Vice President and General Manager, CIGNA Healthcare of Connecticut.
Ellen is a registered nurse with a BS in Nursing from Syracuse University and an MBA from the University of Connecticut.