We sat down with HMS® Eliza’s Chief Medical Officer, Dr. Gary Call to share with our Eliza® Engage community his vision and influence on Total Population Management (TPM) at HMS and how Eliza fits into moving healthcare forward.
Dr. Call is a unique and valued member of the HMS TPM team and a rarity in the industry by virtue of his healthcare background and experience. Dr. Call is a licensed and board-certified family physician with experience in private practice, a former veteran health plan executive who oversaw quality, medical cost management and policy development for a major national payer, and presently the clinical leader of HMS’ broad portfolio of technology-based healthcare solutions.
The Transformation of HMS
Dr. Call joined HMS in 2015 when the company was undergoing a transformation. During the previous 40 years, the company built a reputation for providing solid value to health plans and agencies across the United States through Coordination of Benefits (COB) and Payment Integrity (PI) offerings. In 2015, HMS leadership embarked on a full-scale development program around proactive total population management, helping health plan customers address healthcare imperatives by better identifying the risks of their member populations. Dr. Call joined HMS to boost the clinical relevance of the company’s existing offerings and provide medical oversight of the new, rapidly developing solutions the company called Total Population Management.
Leading the Move into Total Population Health
HMS’ TPM efforts have risen from the company’s deep-rooted industry expertise and are designed to provide health plans with actionable insight into their entire member populations. Specifically, TPM is designed to help clients identify population risk, engage members to take action and manage health outcomes through the company’s powerful population health technology.
HMS leadership realized that this new trajectory would require an even deeper level of understanding of individual health as well as health plan operations and requirements. HMS retained Dr. Call early in its journey into TPM to provide clinical leadership for the development, implementation and ongoing execution of those programs, including population risk intelligence, care management, and member engagement.
In his new role with HMS, Dr. Call provided clinical leadership and insight as HMS acquired care management SaaS vendor, Essette, in 2016, and he was directly involved with the acquisition of Eliza, a leader in healthcare member engagement that extended HMS’ touch beyond health plans to helping empower their members to better manage their own health. Specifically, over the past year, Dr. Call has been instrumental in overseeing the clinical aspects of the successful acquisition of Eliza in April 2017 and the development of member engagement processes that ensure that the right message is delivered to the right member at the right time to prompt them to take positive healthcare action. By helping improve client success in this regard, Dr. Call has been instrumental in transforming HMS Total Population Management.
How does Eliza fit into Total Population Management?
"Improvements for plan members are a big part of what our TPM efforts are all about," says Dr. Call. "Our HMS Essette care management technology platform gives us a great tool for managing that work in a way that helps health plans be efficient with their resources and their staff; it helps them develop individualized care plans for their members. Eliza brings the power to get information out of the healthcare system and into the hands of members in a way they can understand and act on. Right now, health plans have all the information, yet they don’t always have great ways to share it on an enterprise scale. Because of our data and analytics strength and our member engagement products, we’re able to take data and create actionable interventions that directly impact member’s health and improves financial outcomes.”
As HMS’ Chief Medical Officer, Dr. Call sees this member-centric approach as one of the company’s most vital callings — and his medical practice and health plan leadership experience have positioned him to lead the company in this push for meaningful and personalized member communication.
Should you have any questions for Dr. Call, please email: email@example.com, we'd be happy to connect you directly.
To learn more about HMS Total Population Management, watch this AHIP sponsored webinar co-presented by Dr. Call