High-Quality Healthcare for High-Risk New York Medicaid Members
Fidelis Care provides quality, affordable health insurance coverage for more than 2.4 million children and adults at all stages of life.
As a Medicaid program offering care management to high-risk members, the Fidelis Care Concierge provides a more personalized member experience and relevant education on conditions management while increasing the impact of the care plan by integrating the Personal Concierge program into day-to-day workflows.
| PROGRAM OBJECTIVES: | PROGRAM OUTCOMES: |
|---|---|
|
73% decrease in ED claims (referred) pafter starting the program
77% decrease in ED claims (not referred) after starting the program |
|
6-7% closure in gaps in care for engaged members in multiple categories |
|
88% decrease in number of hours per month spent by case management
42% reduction in case management costs due to less time spent per case |
|
67% of members who responded to surveys said the program is helpful in managing their health Over 11,400 enrolled with 95% program retention rate 16% of participants clicked the links in messages for additional content and support |
Program Components
Care Communications:
Upon enrollment, participants receive text messages to address their physical and emotional conditions, with some including links to a library of resources (see Care Companion). Topics are condition specific and include access to local resources, health reminders, behavioral health condition management, co-occurring condition education and treatment adherence guidance.
Care Companion:
This cloud-based learning management system (LMS) provides vetted educational content that is personalized by participants’ self-expressed priorities and interests, structured into easy to- follow sections to promote independent education, learning and self-care management.
GoMo Chat:
Much like a typical text conversation, GoMo Chat allows (secure) live messaging between participants and their care team, enabling in the - moment, on demand conversations.
Secure Data Collection and Reporting:
Engagement and experience data is collected and analyzed and reported back to providers for ongoing quality, clinical delivery and service improvement.
