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We offer straightforward solutions to transform how patient-centered teams coordinate, manage and transition care.

Connecting Care Teams & Communities

Complex Care Programs

Programs serving high-need, complex patients are growing in number across the country. With multiple chronic or complex conditions that are accompanied by mental health and socioeconomic challenges, these patients have unique needs that require involvement from a wide range of medical providers, social supports, and daily caregivers. Effective team-based care coordination strategies and evidence-based complex care management programs are required to improve care and reduce cost for these important populations.

Complex care programs use to:

  • Develop customized, flexible care plans that can be shared internally and externally

  • Implement sustainable, high-quality processes with clear roles, responsibilities and communication across the team

  • Engage and utilize community resources and other non-traditional care team members

  • Facilitate a personalized mobile experience with patients, families and caregivers

  • Track new and unique data to measure team success and patient outcomes


Payers have the opportunity to disrupt healthcare and be the change agents needed to push the industry forward. As risk and responsibility shifts to providers, payers are working to provide them with appropriate financial incentives, actionable data, and validated behavior change programs. This is happening alongside rising consumerism in the industry. More than ever, payers need to compete for every single member. If innovation is a race to be won, then the payers with the right tools for member engagement are in the lead.

Payers use to:

  • Attract and retain members with differentiated member engagement programs

  • Share actionable data, tools, competencies, and care delivery resources with providers

  • Gain visibility into care delivery process and patient engagement

  • Implement care processes and behavior change programs with precision

  • Achieve greater control and predictability in care delivery partnerships

Accountable Care

At the heart of a successful accountable care organization is a high-performing provider network and powerful care management, driving patients toward quality care and appropriate utilization. ACOs need to empower care teams to collaborate, yet they struggle due to heterogeneous IT environments and legacy technologies that inhibit team-based care coordination. To realize savings and improve outcomes, accountable care entities need a high-tech and high-touch approach to bridge the gap between population health data analysis and execution of complex care management with a team-based care strategy.

ACOs use to:

  • Drive effective network management strategies, including closed-loop referrals

  • Gain visibility into the care coordination process and facilitate effective communication across a network

  • Adopt evidence-based protocols and operational best practices across care settings

  • Improve patient access and standardize in-between visit care

  • Engage patients through modern technology with rich content, clear direction, and 24/7 access to their care plan

Hospitals and health systems

Health systems are in a precarious situation, managing capital investments, shrinking margins and rapidly evolving regulatory requirements and penalties. With labor being a health system’s biggest expense, health systems must implement processes to reduce waste, streamline operations, and ensure all clinicians are operating at the top of their license. Understanding this isn’t enough, there is increasing pressure to establish new partnerships with payers and align with other organizations across the care continuum. Team-based care coordination is a winning strategy for health systems to achieve efficiency gains, reduce readmissions, be successful under bundled payments, and prepare for collaborative payment and care delivery models. Health systems that implement a team-based care strategy and empower their teams with modern collaboration technology are better suited to deal with the disruptive innovation at their doorsteps.

Hospitals and health systems use to:

  • Realize efficiency improvements with case management staff

  • Facilitate smooth discharges and effective transitions to reduce adverse events and readmissions

  • Adopt evidence-based practices to improve quality, safety, and productivity

  • Implement growth strategies attracting patients and providers to centers of excellence

  • Pursue innovation and demonstrate readiness for the transition to value-based care

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in days – not months or years.

Old-fashioned health IT requires complex integration and intensive training. We get you up and running on our web-based platform in a matter of days.