Select which clinical care capabilities we leverage to ensure your members’ receive the right support at the right time – or leave it up to us.
HEALTH CONNECT 360®
A clinical model delivering guaranteed clinical outcomes and financial savings by connecting the right people with real-time data for the right outcomes, paving the way to more affordable care.
Care silos are more common than ever.
Patients have more options than ever about when and where they get health care. But not all health care providers are connected. That means more silos preventing their information from being viewed holistically.
This siloed care leads to poor health outcomes, excessive out-of-pocket spending for members, and complicates the care journey for those with complex medical issues.
Tailored Medicare solutions to support your Star rating goals
Health Connect 360 Flex Medicare evaluates your entire population to determine members AND physicians who would benefit from an adherence outreach or an outreach to address health and safety concerns. The measures improve patient health outcomes and support your Medicare Star rating goals.
Our program, tailored to Medicare populations focuses on:
Improved adherence for diabetes, hypertension, and cholesterol
Closing gaps in care for statin use in persons with diabetes
Providing retroactive health and safety monitors
Fragmentation can raise costs and frustrate the care journey.
80%
of our health is affected by what happens outside of the doctor's office1
1. www.mnhealthycommunities.org/health-happens-outside-the-hospital
2. Centers for Disease Control and Prevention, Deloitte 2018 Study: The Convergence of Health Care Trends
3. Centers for Disease Control and Prevention
60%
of adults live with a chronic condition2
$3.4T
spent on chronic conditions each year3
Health Connect 360 provides total visibility for more holistic solutions.
By improving care coordination across the health care continuum, you can ensure your members receive holistic, quality care and drive down total costs.
Health Connect 360 is the first of its kind in our industry, offering performance-based clinical outcomes that improve your members' health and your total costs of care. Together, we can set clinical and financial goals that matter most to you as each plan’s optimal approach means a different level of guarantee.
Addressing conditions that impact costs most
We’ll customize an approach based on your data and best practices in clinical management, patient engagement, and what’s possible in your peer set. We target conditions that drive higher costs, such as:
+ Diabetes
+ Cardiovascular
+ Digital health support
+ Oncology
+ Geriatrics
+ Behavioral health
+ Opioid use
+ Pulmonary
+ Musculoskeletal
Customizing to lower costs and improve outcome.
Your enrollment in Health Connect 360 offers a customized, consultative way to lower total care-costs and improve your members’ experiences.
Guaranteed outcomes, or financial performance
Clinical capabilities available, such as remote monitoring vendors
Dedicated pharmacist support through a Population Health Manager
24/7 access to your data and insights in the Care Insights Hub
Health Connect 360: 2021 Medicare Performance
86%
of patients maintained or improved adherence4
4. 2021 Health Connect 360 Results: Medicare - An Evernorth Report
88%
outreach to members with ≥1 chronic medication4
$536
total health care savings PMPY4
If we don’t provide the value we agreed upon, you pay less.
Connecting data for more holistic views.
Health Connect 360 links providers with data insights through both specialist pharmacists and electronic health record communications via your Care Insights Hub, available day or night.
The Care Insights Hub allows us to determine which patients are most in need of outreach, helps clinicians tailor their approaches according to what is and isn’t working, and provides members with continuous opportunities for gaps-in-care, omission of essential testing, medication safety, and preventative care.
Health Connect 360 uses medical data to identify relevant, actionable gaps-in-care and health opportunities 14 times faster.5
5. In most cases, medical data is uploaded in bulk every two weeks, continuously refreshed data within 24 hours is therefore 14 days earlier
Social Determinants of Health
On top of traditional data sets, we can uncover even more by applying our analytic capabilities—including potential social determinant of health challenges. Looking at information such as access to food, shelter, and transportation is important because we know that 80% of an individual’s health is affected by what happens outside of the clinical setting. To effectively address clinical needs, we must identify members that may have been missed in the past, while seeking new ways to deliver on social needs.
Unrivaled Care Coordination
Health Connect 360 doesn’t rely solely on automated processes. Our entire care coordination team is made up of clinicians specially trained in providing care to your members and coordinating with their providers as needed.
Your Population Health Manager will be a clinician trained in data analysis dedicated to studying your data each day for suggested clinical engagements and to target individual patients based on their needs.
Through use of data insights, our clinicians helped close over 330,000 clinical gaps-in-care in a single year. That’s around 3,200 clinical gaps closed in a year for around 12,000 lives.6
Each day they will be looking for opportunities to address areas that need clinical attention, keeping you informed about the best available engagement options, making operations across different healthcare services easier and helping you achieve optimal outcomes.
6. Express Scripts PBM, Health Connect 360 book of business results 1/1/2020 – 12/31/2020
Specialist pharmacists provide care to your members, coordinating with their care providers as needed and working with your medical carrier care management clinical teams to understand services available to the jointly managed membership.
More than 15 medical carriers are already integrated and active within the Care Insights Hub.
Our pharmacists identify patients in need of additional care, and refer the case to the member’s care/case management team for additional support via the Care Insights Hub.
Personalized care plans for each member leverage what is best for them, whether it’s a clinical solution we offer in house, or through another vendor you work with. Personalized care plans adjust with each member as needed, and this unique model has resulted in 96% member satisfaction with our specialist pharmacists.7
7. 2019 cumulative Therapeutic Resource Center member satisfaction rating
Care and case management teams can also leverage the Health Connect 360 clinical team to provide necessary member support. This facilitation of member case referrals is executed through the Care Insights Hub, allowing team members to leverage member’s recorded data via remote monitoring devices and perform outreach to the member’s provider to consult on a care plan for the member.
Your case management member consultation can review recent case notes from the Health Connect 360 care teams, to continue the care plan the specialist pharmacist discussed with the member’s provider.
Fragmentation can raise costs and frustrate the care journey.
$62
overall PMPY reduction in medical costs8
8. The Impact of Clinical Care Support on Pharmacy and Medical Cost and Utilization - An Evernorth Report, February 2022
9. Health Affairs, https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2019.01088?journalCode=hlthaff
23%
fewer inpatient hospitalizations for members in the overall Health Connect 360 sample8
$90
PMPY decline in inpatient visit costs9