Nascate

How Fixing Health-Related Social Needs Fixes Healthcare for Members and Payers Unmet social needs significantly drive poor health outcomes, increased healthcare utilization, and high costs. In fact, Health-Related Social Needs (HRSNs) account for as much as 80% of healthcare spending. For payers, addressing these needs is critical—not just from a care standpoint but from a financial one as well. The challenge? Accurately assessing the efficacy and ROI of community care networks and Community Care Hubs. These networks provide essential services such as housing support, transportation, and food security, but measuring their impact on health outcomes and healthcare spending can be complex. Many payers need help determining which social services providers deliver the best outcomes and offer the most value for the healthcare dollar. This is where a more innovative, data-driven approach to Combined Risk (clinical + social) can be transformative. By analyzing members' clinical and social needs, payers can better understand how to optimize their community care networks and maximize returns. Here’s how this approach benefits payers: Pinpointing member needs: By calculating the combined risk of clinical and social factors; payers can prioritize the most vulnerable populations and target services. Building high-performing networks: With performance data, payers can contract with the most effective social services providers. Measuring impact and ROI: With better insights into network performance, payers can make smarter contracting decisions and more efficient resource allocation. Community Care Hubs—which serve as central points for coordinating care across various providers—are becoming increasingly crucial in value-based care models. These hubs can significantly improve care coordination, but without the correct data, it’s difficult for payers to determine the true ROI. If you're a payer navigating these challenges, now is the time to rethink how you build and manage your community care networks. A more strategic approach that leverages data to measure both the clinical and social aspects of member care can lead to better health outcomes, smarter spending, and more effective partnerships with social services providers. Let’s start a conversation about how your organization can better understand the ROI of your community care networks and ensure that your members receive the comprehensive care they need. If you’d like to learn more about enhanced value-based care and community care network contracting, comment below or visit www.Nascate.com. #HealthcareInnovation #CommunityCareHubs #SocialCareROI #ValueBasedCare #HealthRelatedSocialNeeds

#HealthcareInnovation #CommunityHealthCenter #PayerContrating #ValueBasedCare #HealthRelatedSocialNeeds

Client Success: How Community Care Hubs Are Using Nascate to Calculate Impact and ROI Community Care Hubs (CCHs) are dealing with new market pressures, resource scarcity, and increased service demands. Our Pathfinder analytics suite clarifies and simplifies how CCHs understand their market, measure impact, and build transformational partnerships with healthcare stakeholders. Community Care Hubs are using our Pathfinder platform for: Strategic Analysis. Pathfinder helps CCHs analyze social and clinical risks within their client base. Assessing ROI and performance, it quantifies savings in downstream healthcare costs for high-risk clients. Iterative Data Strategy. Pathfinder’s iterative approach meets CCHs at their current analytic readiness level, ensuring relevant and actionable insights. Targeted Services Impact. Analyzes how targeted community-based services affect clients with high clinical and social complexity, quantifying the impact on downstream healthcare costs and utilization. ROI Management. Helps CCHs manage towards ROI using healthcare savings, supporting broader contracting strategies with payers and healthcare providers. Optimal Care Allocation. Ensures clients receive the proper care at the right time and in the right setting. Network Curation. Supports the selection and prioritization of clients to achieve results and contractual goals. Resource Allocation. Aids in resource allocation, budgeting, and payment models to ensure operational sustainability and success. Additional examples of how Nascate is empowering CCHs and their results:    - Enabling strategic partnerships with healthcare stakeholders.    - Enhancing the efficiency and effectiveness of community-based services.    - Achieving significant healthcare savings and improved client outcomes.    - Navigating market pressures with data-driven insights and strategies. Our Pathfinder suite has become a game-changer for Community Care Hubs, providing the tools needed to thrive in a complex healthcare landscape. By integrating social and clinical risk analysis with strategic planning, Pathfinder enables CCHs to deliver impactful, sustainable care to their communities. If you’d like to learn more about joining us on this journey towards enhanced value-based care, leave a comment below or visit www.Nascate.com. #HealthcareInnovation #CommunityCare #NascatePathfinder #ValueBasedCare #CommunityCareHubs

Client Case Study: Putting Disparate Datasets to Work for Community Health Centers A Community Health Center (CHC) network is benefiting from our deep experience in managing disparate data sources, which has significantly impacted their progress toward value-based care excellence. This multi-year partnership has been designed to enhance patient outcomes, reduce costs, and elevate patient experiences through unique analytics and strategic insights. Key achievements to date include: Data Integration. We tackled the complex challenge of integrating claims, eligibility, attribution, and quality data from various payers and sources. By ensuring data completeness and accuracy, our CHCs have gained a comprehensive view of their performance across multiple contracts, allowing for more effective management. Enriched Analytics and Insights. Leveraging extensive claims data processing and reporting expertise, we enhanced claims data with public sources and built nationwide benchmark datasets. This approach facilitated clear analysis and benchmarking, empowering CHCs to drive continuous improvement and make data-driven decisions. Healthcare Contract Assessments. Our experience and understanding of payer contract terms and variations in claims data feeds across payers were instrumental in developing efficient data ingestion and quality check processes. This enabled CHCs to stay aligned with contract terms and effectively manage their value-based care populations. Support Across Data Sources. With experience in Medicare FFS Data, Medicaid Managed Care Data, and Commercial Payer Sources, we provided comprehensive data and analytics for population management and network performance optimization. We empowered positive change from member-level insights incorporating claims and social determinant factors to detailed reports highlighting key KPIs and actionable metrics. Additional results include:     - Identifying and addressing gaps in care and service provision.    - Implementing targeted interventions to improve patient outcomes.    - Optimizing network performance and reducing costs.    - Elevate patient experiences through data-driven interventions. Our expertise in managing multi-domain datasets, ensuring data integrity, and delivering actionable insights significantly affects how CHCs participate in value-based care. By harnessing the power of comprehensive analytics, CHCs are better equipped to navigate the complexities of healthcare, ultimately driving performance improvements and enhancing the well-being of their communities. If you’d like to learn more about joining us on this journey towards enhanced value-based care, leave a comment below or visit www.Nascate.com.  #HealthcareAnalytics #ValueBasedCare #CHCTransformation #NascateExpertise

Case Study: How One Community Health Center Is Navigating Value-Based Care with New Insights Navigating the complexities of value-based care can be daunting for Community Health Centers (CHCs). Nascate’s analytics platform is making this journey more productive and successful by improving insights and outcomes. Here’s how. Identifying Under-Utilizers. Leveraging predictive modeling, Nascate pinpoints patients at risk of increased healthcare utilization. The CHC can prioritize care management and tailored interventions, reducing avoidable admissions and ED visits. Social Complexity Index (SCI). Understanding patients' social complexity helps identify those needing extra support. Proactive measures mitigate the social risks, thereby impacting healthcare outcomes and expenses. Network Management. A Comprehensive Opportunity Analysis reveals network performance and gaps. Creating high-performing networks and reducing leakage enhance patient outcomes and provider performance.  Growth, Retention, and Revenue Optimization. Relationship insights help identify at-risk members and capitalize on growth opportunities. Improved patient-provider relationships boost performance and revenue. New Nascate Tools Power Success. Nascate analytics and dashboards put all of the above information at the fingertips of CHC leaders. From KPI dashboards to the Nascate Member Profile, CHCs gain a clear view of patient and provider behaviors. Nascate’s platform empowers CHCs to win with value-based care, delivering exceptional care to communities and driving significant improvements in performance, patient outcomes, and revenue growth. If you’d like to learn more about joining us on this journey towards enhanced value-based care, leave a comment below or visit www.Nascate.com. #HealthcareInnovation #ValueBasedCare #CHCTransformation #NascateAnalytics #CommunityHealthCenters

Top Trends and Insights from the USAging Tampa: Addressing HRSNs and Driving Sustainable Health Equity We wanted to share some key takeaways from the recent USAging conference in Tampa. It was an inspiring and motivating event with insightful discussions and innovative ideas.  Our team of James Lawson, Michael McCarthy, and Gordon Reynolds were able to attend many of the sessions. However, they also learned a great deal from conversations in the Tech Lab, where they showed the latest Nascate solutions for Hubs and AAAs. Here’s a topline summary of what they saw and heard:  Health-Related Social Needs Remain Front and Center: There's a growing emphasis on integrating—and paying for—health-related social needs mitigation in the healthcare ecosystem. Medicare and Medicaid are actively working on creating funding mechanisms to support this integration. Hubs and AAAs need help quantifying these populations' opportunities and calculating their impact. Provider Contracting Is A Growing Concern Among Social Services Providers: Building mutually beneficial relationships through contracting with payers is crucial. Highlighting the value proposition within the appropriate populations can enhance these partnerships significantly, and Hubs and AAAs are simply seeking a fair share of the results achieved. Interoperability and Data Sharing Needs Increase: Interoperability and data sharing are challenges. While solutions exist for referral management and closed-loop referrals, better risk identification and data exchange capabilities are still needed. Impact and ROI Calculations Lacking, But Improving: Many AAAs possess valuable data but need more resources to leverage it fully. Understanding the ROI is essential, but current data availability is limited. Effective segmentation can lead to solid ROI and should be widely practiced. Sustainability through Fair Contracting Is the Way: While referral and case management remain focal points, there's a noticeable shift towards contracting as a means for sustainability. Matching people to appropriate programs and revenue streams is critical, particularly in supporting grant activities and healthcare contracting. The conference highlighted the importance of strategic partnerships, data utilization, and innovative funding mechanisms to drive better health outcomes and sustainability, primarily as they address HRSNs. We look forward to implementing these insights in our work in the coming weeks and months. #USAging2024 #HealthcareInnovation #DataDrivenDecisions #HealthEquity

Join us tomorrow, July 10, from 1-5 p.m. in the Tech Lab at the USAging Conference in Tampa. We'll be meeting with Community Care Hub and AAA executives from around the country on payer contracting. We'll show how our Combined Risk (Social+Clinical) approach is helping Hubs and AAAs determine true population risk and measure their impact on downstream healthcare outcomes and costs. Stop by to see James Lawson, Michael McCarthy, or Gordon Reynolds to learn more. #USAging #Communitycarehubs #Areaagenciesonaging #payercontracting

How Community Health Centers Are Managing and Improving Performance – Even with Fragmented Datasets The journey towards value-based care excellence for Community Health Centers (CHCs) presents numerous challenges, especially when dealing with fragmented data sources. We’ve been helping CHCs normalize and reconcile these datasets and we’ve summarized the tactics and results below. It All Starts With A Vision Our work with CHCs has focused on managing value-based care initiatives and Key Performance Indicators (KPIs) related to patient outcomes and financial performance to: Foster Better Outcomes: Improve patient health through targeted interventions. Reduce Costs: Streamline operations and reduce unnecessary healthcare utilization. Enrich Patient Experience: Enhance the overall quality of care delivered to patients. Tackling Difficult and Fragmented Data Sources One of the primary challenges is integrating claims, eligibility, attribution, survey, and quality data from various payers and sources. This approach ensures: Data Completeness and Accuracy: Comprehensive and reliable data integration. Comprehensive Performance View: Enabling CHCs to have a holistic understanding of their performance across contracts. Leveraging Claims Data for Insights By enhancing claims data with other public data sources and building nationwide benchmark datasets, we’ve empowered CHCs to: Conduct Robust Analysis: Utilize enhanced data for in-depth analysis and benchmarking. Drive Continuous Improvement: Identify areas for improvement and implement effective strategies. Understanding Contract Terms and Claims Data Feeds A deep understanding of contract terms and variations in claims data feeds across payers is also invaluable for: Managing Performance Against Contract Terms: Maximize financial performance against varying contract terms and the underlying outcomes that drive performance. Effectively Manage Value-Based Care Populations: Optimize care delivery and outcomes to meet contract, cost, and quality KPIs. Using our experience with Medicare FFS Data, Medicaid Managed Care Data, and Commercial Payer Sources, we can show: Member-Level Insights: Incorporating claims and social determinant factors for a detailed understanding of patient needs. Detailed Reports: Highlighting key KPIs and actionable metrics to drive informed decision-making. But analytics are only as good as the data assets that inform them. Our experience has delivered metrics used to manage and improve performance, enabling CHCs to make informed decisions and drive positive change. We’re on the front lines with CHCs nationwide, diving into these data problems and figuring out new ways to overcome them every day. Contact Michael McCarthy to find out more and start exploring the possibilities today. Or learn more for yourself at Nascate. #CommunityHealthCenters #PayerContracting #Healthcaredata #ValueBasedCare #HealthEquity

We’ve had a wonderful two days at the Aging Concerns Unite Us conference here in Albany. We wrapped up our time with Michael McCarthy giving a quick lunch key note focusing on our work in the state of NY. Looking forward to continuing our work in this state with this great group.

How Community Care Hubs Are Measuring Impact and Building Healthcare Partnerships Community Care Hubs (CCHs) face significant challenges in today’s healthcare landscape. To thrive, they must meet the needs of their communities while navigating new market pressures such as increased competition, resource scarcity, and rising demand for services. Here’s how we’ve been helping CCHs understand their market, measure impact, and build transformational partnerships with healthcare stakeholders. Understanding and Meeting Community Needs One of the first steps in enabling CCHs to address community needs is to provide comprehensive insights into their client base. It aids in strategic planning and partnerships by analyzing social and clinical risks. This analysis allows CCHs to assess the return on investment (ROI) and performance of community-based service providers, particularly for high-risk clients, by quantifying savings in downstream healthcare costs. Tactics and Use Cases for Community Care Hubs In working with CCHs, we’ve seen several helpful recurring use cases. Below are the most common use cases and our approach to handling them. Analyzing the Impact of Community-Based Services We model the effects of targeted services on clients with high degrees of clinical and social complexity. We then quantify the impact and savings of these upstream services in reducing downstream healthcare costs and utilization. Managing ROI with Healthcare Savings We help CCHs understand their ROI impact, using healthcare savings as part of a broader contracting strategy with payers and healthcare providers. Ensuring Appropriate Care We develop insights to help CCHs provide the proper care in the right setting at the right time. Curating Networks for Results We support network curation to achieve desired results and meet contractual obligations. Supporting Resource Allocation and Sustainability We recommend resource allocation, budgeting, and payment models to ensure operational sustainability and success. Leave a comment below to learn more about our work with CCHs, or see for yourself at Nascate.com. #HealthcareInnovation #ValueBasedCare #CommunityHealth #DataAnalytics #HealthcareStrategy #PopulationHealth