Medicare

Increasing engagement, ratings and revenue with high-touch service

In an era where costs are increasing and revenue is estimated to drop 12 to 14 percent over the next five years, avoiding penalties, raising your star rating and Quality Bonus Payment and optimizing your revenue is absolutely critical.

Because we work with members, providers and payers every day, we play a pivotal role in uniting all stakeholders to coordinate care. Our unique position enables us to transform the member experience by enhancing their relationship with you and their providers and by increasing their participation in their healthcare.

For 25 years, Carenet has helped Medicare plans overcome their challenges from member compliance and retention to meeting all the regulatory changes and optimizing revenue. We have the know-how needed to help you—and your members—thrive.

Designed to meet these needs through increasing member engagement and close clinical gaps, our high-touch Medicare Star Advantage solution will:

Optimize risk adjustment premium revenue
Maximize your star rating and quality bonus payments
Elevate member retention and acquisition

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By combining personalized live support and multiple touch points with progressive technology and actionable data, we enhance member compliance, well-being and satisfaction.

Our solution is further supported by additional cost containment solutions such as Post Discharge Management, 24/7 Nurse Advice and Care Advocacy, which provide immediate access to medical information improving member vitality and resource and healthcare dollar utilization. Live and automated services, such as agentless messaging, ensure members receive expert care 24/7 via the web, email, chat, phone and SMS text.

By joining forces with Carenet, you will increase member engagement, improve health and loyalty while enhancing revenue through improved HEDIS scores, star ratings, quality bonus payments and optimize your revenue. Time is off the essence. Call Carenet now and let us help you reach your goals!

Performance-Driven Solutions

Education Elevates Exam Compliance 160%

Personalized outreach by highly skilled engagement specialists elevates exam compliance, outcomes and rating.

Imaging Information Saves Members $11.5M

Proactive outreach guides members to lower-cost facilities saving an average of $400 per test.

Personalized Support Propels Enrollment

Expert engagement specialists enroll 45% of members in prescription drug mail-order service.

Drug Switch Cuts $4.7M

Engagement team switches members to generic statins saving up to $500 per prescription and $4.7 million annually.

Advocates Enhance Employee Well-being

Expert care given to US Intelligence employees and their families eases stress and boosts productivity.

Screenings & Savings Amplified

Engagement and education amplifies mammogram compliance exceeding goal by 165% and generating $2 million.

Performance Jumps 200%, $9M Generated

Multi-touch strategy empowers Medicare members to get exams boosting clinical and financial outcomes.

ER Use Down, Savings Up $3.25M

Clinical team minimizes nonurgent ER usage by 65% saving a premier plan $3.25 million.

78% Switch to OTC Drugs, $1.3M Saved

Direct contact and cost-saving information motivates members to switch to OTC equivalents.

Proactive Outreach Reduces Readmissions

Immediate, personalized post-discharge care reduces readmission rate and associated costs.