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Seamless Health Plan Onboarding for National Home Health Services Organization

Sponsored White Paper

Presented By

CitiusTech

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Published on Dec 23, 2022

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Disclaimer

This white paper represents the views of the author, not America’s Health Insurance Plans (AHIP). The publication, distribution or posting of this white paper by AHIP does not constitute a guaranty of any product or service by AHIP.

Implementing our healthcare data integration and management platform enabled a national home health service provider to offer their payer clients centralized, efficient, and scalable data onboarding along with enhanced and broader advanced analytics.

The Business Challenge

Our client is a leading risk-bearing entity (RBE) and home health service provider extending in-home primary care services to more than 100k members with chronic conditions across 15 states in a valuebased model with 20+ health plans. The client struggled to manage multiple streams of inconsistent data sources and onboarding new health plan clients efficiently. They wanted to establish repeatable, standardized data management processes that would improve efficiency and accuracy, enhance downstream data collaboration, and support high-value business decisions.

Key challenges faced:

  • Every new health plan onboarding was reinvented as a new project with ground-up development
    and no economies of scale by repurposing of existing code
  • Downstream data-sharing was complex, requiring significant custom development
  • Low-data reliability was driving erroneous business decisions like incorrect client billing
  • Staff had to invest considerable time and energy to resolve data anomalies and the negative
    impact on health plan clients