SUCCESS STORIES
See The Impact of Better Member Choices for Health Plans
When your members make better choices, everyone benefits.
We’re helping health plans across the country help their members make better choices. We are doing this across virtually every line of business (commercial, Medicare, and Medicaid). See health plan clients just like you realizing some pretty amazing results.
Commercial Success Stories
National Commercial Plan
National Health Plan accelerates telehealth adoption by targeting member segments and optimizing engagement
Creating member “nudges” toward virtual care alternatives, NextHealth and its’ payer partnership increased telehealth usage, ultimately reducing av...
View Case StudyRegional Blue Plan
Improved measurement of clinical programs drives cost savings.
Ability to measure clinical programs with efficiency and accuracy to drive cost-saving insights.
View Case StudyRegional Blue Plan
Health plan influences member behavior and realizes significant costs savings and avoidable ER visits.
Ability to measure clinical ER visits declined by 8.1% and costs by $8 PMPM; Avoidable ER visits decreased by 5.1% and $0.35 PMPM.
View Case StudyRegional Blue Plan
Health plan accelerates clinical program evaluation identifies $70 million in savings.
an 8x increase in clinical portfolio evaluation assesses more than 50 programs focused on Total Cost of Care and identifies 15 programs with statis...
View Case StudyMedicare Success Stories
Regional Blue Plan
Health plan influences members to move to in-network providers and alternative settings and realizes $42 PMPM in MSK costs.
NextHealth helped spark shift in Care Manager scripts and deployed an MSK predictive model to steer members to in-network physicians and to Blue Di...
View Case StudyMedicare Advantage
Tailored member engagement strategies improve STARs rating performance.
Health plan sees gap closures per member per year leading to better quality as reflected in STARs rating.
View Case StudyMedicare Advantage
Predictive analytics and better member choices deliver cost savings for this health plan.
Better member choices result in an 8.7% reduction in ER visits yielding a $9 PMPM savings.
View Case StudyNational Commercial Plan
Medicare Advantage plan accelerates enrollment of BH member population.
Health plan helps behavioral health members make better choices leading to a 33% increase in diabetes programs, a 55% increase in behavioral app pr...
View Case StudyMedicaid Success Stories
National Medicaid
See how better member choices improved maternity care.
Health plan sees fewer pre-term deliveries and low birth weight babies through program participation.
View Case StudyRegional Medicaid
Members make better choices and significantly reduce ER visits, cost, and utilization.
See how this Medicaid plan realized a 25 percent reduction in ER visits and a 39% ED cost reduction for a predicted high utilizer population.
View Case StudyRegional Medicaid
Highly targeted member outreach shifts behavior and shifts utilization.
See how this health plan realized a 6.3% reduction in ER visits and experienced a $6 PMPM reduction through better member outreach.
View Case Study
Insights and additional resources for measurable change.
Executive Advisory Council
The NextHealth Technologies Executive Advisory Council (EAC) is an invitation-only think tank of healthcare’s most innovative minds. Senior executives from regional and national health plans, representing approximately 65 percent of the U.S. population, and integrated delivery systems meet quarterly in a collaborative, small-group setting to discuss how to impact healthcare affordability and member satisfaction.
Download our meeting summaries
Blog
- Ghostbusters and the Future of Employer Groups
- How NextHealth Helped Drive Members with Mild Mental Health Needs to Virtual Care
- Mental Health Awareness Month: May 2022
- BlueCross BlueShield 2022 National Summit Retrospective
- Identifying, Stratifying, and Engaging Members in Need of Mental Healthcare
- Impactability Influences Member Choice and Improves Outcomes
- A Celebration of our Female People Managers and NHT Women Influencing their Community
- Three Ways Health Plans Can Address the Growing Demands of Self-Funded Employers
- A Member-Centric Approach Health Plans Can Use to Improve Hierarchical Condition Categories (HCC) Coding Accuracy
- The Fix for the 3 Reasons Health Plan Members Make Bad Choices
- 2021 Year-End Message from our CEO
- Moving Past Assumptions—Discovering Targeted Interventions to Drive Increased COVID Vaccination Rates
- Telehealth Finds its Legs: The post-pandemic future of virtual care
- A Letter from our CEO: Observations from the 2021 Health Evolution Summit
- The NextHealth Hybrid Working Model
- Why NextHealth Technologies Built a Diabetes Optimization Solution
- Two Blue Cross plans to partner with NextHealth with a focus on impacting healthcare affordability
- The NextHealth Culture: NHTisms
- Digging Deep into the Technology Team that Drives NextHealth
- Meet the NextHealth Experts (Part 2)
- Meet the NextHealth Experts (Part 1)
- Introducing the New NextHealth Technologies and Our New Website: A Letter from Our CEO
- Meet our Chief Medical Officer, Michael Poku, MD, MBA
- Our Position on Health Equity
- It’s Time for More Pragmatic Test & Learn Approaches That Deliver Real-World Answers
- The Failure to Learn What’s Really Working in Healthcare Is Driving Innovation
- The Fast Eat The Slow
Case Studies
- Proving the Value of ASO ProgramsA regional blues plan demonstrates the exceptional value of a
- Improving HCC Coding CaptureInnovative outreach and engagement solution increases Medicare Advantage HCC coding Medicare Advantage
- Advancing Virtual Physical TherapyInnovative outreach solution increases Medicare Advantage member enrollment into virtual
- How health plans can optimize diabetes care programs. The high-stakes but solveable problem facing every health plan. For
- Drive Better ROI while Engaging Consumer More Effectively with Machine Learning: A Regional Health plan ER Savings Case Study DOWNLOAD CASE STUDY
- Reliable, independent analysis reveals $70+ million in medical cost savingsIndependent evaluation drives cost-savings, builds employer trust A regional health
- Administrative Services Only (ASO) plan achieves $162 reduction in ER costs per member per year (PMPY)Fast, simple approach targets behavior to help ASO plan decrease
- Increasing Medicare Advantage member mental health enrollment by 33% in only two weeksNational health plan achieves 33% increase in member activation rate
- Step One in Developing a Comprehensive Telehealth Strategy: Assessing Members’ Current Telehealth UtilizationProcess for Optimizing Telehealth Utilization Holds Promise for Reducing Costs
- National health plan accelerates telehealth adoption, leading to $7.91 PMPM savingsAccelerating telehealth adoption by targeting member segments and optimizing engagement
- Optimizing heart failure care management program delivers additional $42 PMPM savingsRobust analysis drives successful program optimization By any measure, congestive
- Reward program improves outcomes and reduces costs by $128 PMPMAnalysis shows better outcomes and 3:1 ROI on incentivized Medicaid
- Groundbreaking 25% reduction in avoidable ER visitsPredictive analytics tackle industrywide problem Avoidable emergency room (ER) visits
- Advanced analytics prove value of health interventionsRegional health plan strengthens client relationships through custom matching capabilities
- Medicare Advantage member outreach closes 4% percent more care gapsTailoring Member Engagement to Improve Medicare Stars When a health
- ER diversion outreach delivers over $275K in cost savingsPredictive analytics and member targeting reduce ER costs Avoidable emergency
- Behavioral Health navigation reduces medical cost trend by 176%A regional health plan wanted to show the value of
- Member Advocacy Program Reduces ER Costs by $8 PMPMProving the Value of Member Advocacy Members increasingly want access
Videos
- 2022 International Women in Engineering Day
- Insights to Impact: Episode 2
- Insights to Impact: Episode 1
- The Top 3 Reasons Health Plan Members Make Bad Choices and How to Fix it in 2022
- Impacting Affordability During a Pandemic: Humana’s Telehealth Experience
- Webcast: Unlocking the Value of PHM Solutions: How to Establish an ROI-Based Approach in the Wake of an Ongoing Pandemic
- On-Demand Webinar: AI and ML’s Role in Impacting Affordability
- On-Demand Webinar: Measure Everything! Establishing a Baseline to Tackle Affordability
- VIDEO: Cambia CEO – Healthcare Needs to be Radically Focused on Consumers
- VIDEO: Professional Sports Offers Lessons for Healthcare in Creating Raving Fans
- Key Elements of the Measurement and Optimization Maturity Curve
- First Comes Data, Then Outcomes
- How NextHealth amplifies Current Analytics Capabilities
- Importance of Impactability
- Randomized Controlled Trials
- What is “Lift”, P-Value, Attribution
- Avoidable ER Use
See what we are working on now
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