Rewards serve as the primary tool for Managed Care Organizations (MCOs) to incentivize healthy behaviors by their members. However, despite the investment some health plans put into these programs, they don’t always reach their intended goals. Rewards are used to promote healthy behavior to drive completion rates, but results are sometimes disappointing. If this has happened to your organization, don’t drop the idea of using rewards just yet. Instead, here are three ways you can create a rewards program that drive the results you want.

Getting ready for payer-to-payer data exchange as part of the CMS Interoperability mandate? If so, your priority as a payer is to address the need to aggregate your members' data from various former payers. While this mandate focuses on empowering members, it also makes payers rethink how member data needs to be aggregated and distributed. 

How can you get members to do what you need them to do? This is the number one challenge facing many Medicaid Health Organizations (MCOs). Member engagement is crucial for encouraging healthy activities that can improve outcomes and drive down costs for your organization. Plus, it’s the best way to make a positive impact in the lives of your members.

While we have said it before, it bears repeating: 2020 was a roller coaster year for state workforce agencies and was the most challenging year since the program’s inception in 1935. State workforce agencies struggled with unprecedented claims volume and massive legislative changes to the program virtually overnight. As such, the focus last year was to empower state workforce agencies to respond to the demand and improve customer service with innovative solutions. Sagitec was able to help multiple state workforce agencies with everything from a comprehensive cloud-based Pandemic Unemployment Assistance solution (that was paying people as soon as four weeks after the legislation was signed) to chat technology that reduced call-center volumes and provided another communication channel for claimants.

Mass adoption of DevOps, significant shifts in cloud technology, and real use cases for AI are all trends with some common purpose. Organizations want to build new capabilities faster than ever before and for less money. The truth is, most organizations are struggling with the best way to manage a large portfolio of niche applications across their organization.

Close your eyes and imagine… just kidding! Don’t close your eyes. You need them to read this blog. With your eyes open, imagine working for an organization that has zero IT backlog. As soon you request IT or identify requirements, the IT organization fulfills them without painful processes requiring extra time, extra resources, and additional budget. Also, imagine the applications and technology IT is delivering are flawless. Everyone in the organization works together in a collaborative utopia where end users have a big hand in fulfilling their own IT needs, quickly completing processes, scaling automatically for great performance whenever needed, and the business can just focus on, well, the business.

Does the thought of upgrading your enterprise systems daunt you? You are not alone. According to Gartner, enterprise software upgrades can cost an average of 30 percent of the original software installation price, take months, even a year to complete, and require meticulous planning.

"Technology allows people to connect anytime, anywhere, to anyone from almost any device. This is dramatically changing the way we work, facilitating 24/7 collaboration with colleagues dispersed across time zones, countries, and continents." – Michael Dell

For the healthcare industry, it's evident that the cloud is here to stay. Managed Care Organizations (MCOs) are no longer trying to determine whether the cloud is right for them. Instead, the conversation has evolved to determine how best to leverage the cloud to meet their organization's strategic goals. The cloud has proven to be an effective tool, but there are a few avenues for MCOs to maximize this resource better and achieve their desired outcomes.

API Management is a critical component of the payer’s FHIR infrastructure. It helps in fulfilling the security requirements of the CMS mandate and business services integration requirements to orchestrate with enterprise systems and services. Further, effective management helps you comply with the security requirements for monitoring, reporting, and managing access to the FHIR resources by external stakeholders, including third-party apps and health plans. We will briefly touch upon how this API management functionality is implemented within Sagitec’s HealFHIR in this blog.