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NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Altegra Health Addresses Social Determinants of Health Organization Overview • Change Healthcare is committed to driving value among payers, providers, and patients by using data analytics to deliver predictive insights to these stakeholders • Change Healthcare operates the single largest financial and administrative healthcare network in the United States • Altegra Health, a Change Healthcare company, provides risk adjustment services, quality performance, engagement solutions, and advisory services to healthcare companies Background It is well-documented that an individual’s overall health is correlated to his or her ability to overcome socio-economic challenges. Altegra Health is committed to advancing resources that address the social determinants of health, an underlying force behind cost and overutilization of avoidable high-cost services. Product Details Altegra Health’s Dual Eligible Enrollment service identifies Medicare Advantage (MA) beneficiaries who may receive additional benefits from dual enrollment, including payment of their Part B premiums, by assisting them as an authorized representative in applying to the appropriate state Medicaid agency. Similarly, Altegra Health assists MA beneficiaries who may qualify for the Medicare Prescription Drug Coverage low-income subsidy (LIS). Altegra Health’s COMMUNITY Link product guides health plan members through an extensive database of more than 10,000 public and privately-sponsored community programs for which they may qualify. Altegra Health proactively reaches out to these beneficiaries using multi-channel communications to advise them about the COMMUNITY Link service and its benefits. In addition, Altegra Health provides advocacy and enrollment assistance to help beneficiaries access these programs. COMMUNITY Link program categories include, but are not limited to: • Energy & utility assistance • Home care & repair • Nutritional assistance • Rx discounts • Telephone assistance • Transportation assistance An Initiative of the 63 | Altegra Health to Address Social Determinants of Health
NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Value Delivered Dual Eligible Enrollment services add value by: • Increasing participation among those eligible for but not currently enrolled as a dual eligible or LIS beneficiary • Providing much-needed assistance navigating the complex dual eligibility and enrollment process for MA low-income beneficiaries • Raising MA beneficiary satisfaction with their plan • Improving health outcomes for MA low-income beneficiaries COMMUNITY Link services add value by: • Mitigating social determinants of health by facilitating participation levels in community programs for low-income health plan members • Raising member satisfaction with their plan • Improving health outcomes for health plan members Path Forward • Altegra Health is committed to assist health plan members with meeting their socio-economic challenges. Value of Altegra Health Products 37 Million Members served across all products and markets $2.1 Billion Total Part B premium member savings $150 Million Community benefits delivered annually 10,000 Programs Available through COMMUNITY Link TM • The MA program is currently undergoing significant changes in how it reimburses plans for their dual eligible beneficiaries. Altegra Health urges CMS to ensure that MA plans have adequate resources to meet the member socio-economic challenges. • Altegra Health welcomes the opportunity to work with policymakers in exploring innovative programs that incentivize health plans and other stakeholders in addressing member socio-economic challenges. Altegra Health to Address Social Determinants of Health | 64
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NDHI<br />
NAT IONAL DIALOGUE FOR<br />
Healthcare Innovation<br />
Value Delivered<br />
Dual Eligible Enrollment services add value by:<br />
• Increasing participation among those eligible for<br />
but not currently enrolled as a dual eligible or LIS<br />
beneficiary<br />
• Providing much-needed assistance navigating the<br />
complex dual eligibility and enrollment process for<br />
MA low-income beneficiaries<br />
• Raising MA beneficiary satisfaction with their plan<br />
• Improving health outcomes for MA low-income<br />
beneficiaries<br />
COMMUNITY Link services add value by:<br />
• Mitigating social determinants of health by facilitating<br />
participation levels in community programs for<br />
low-income health plan members<br />
• Raising member satisfaction with their plan<br />
• Improving health outcomes for health plan members<br />
Path Forward<br />
• Altegra Health is committed to assist health plan<br />
members with meeting their socio-economic<br />
challenges.<br />
Value of Altegra Health Products<br />
37 Million<br />
Members served across all products and<br />
markets<br />
$2.1 Billion<br />
Total Part B premium member savings<br />
$150 Million<br />
Community benefits delivered annually<br />
10,000 Programs<br />
Available through COMMUNITY Link TM<br />
• The MA program is currently undergoing significant<br />
changes in how it reimburses plans for their dual<br />
eligible beneficiaries. Altegra Health urges CMS<br />
to ensure that MA plans have adequate resources<br />
to meet the member socio-economic challenges.<br />
• Altegra Health welcomes the opportunity to work<br />
with policymakers in exploring innovative programs<br />
that incentivize health plans and other stakeholders<br />
in addressing member socio-economic challenges.<br />
Altegra Health to Address Social Determinants of Health<br />
| 64
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