Medicare

8 Reasons to Pre-Board your Members Before the New Year

Have you ever thought about “pre-boarding” your members?  Why not reach out early to engage members before their effective date, especially if it means you can identify transition of care needs.

Pre-boarding new healthcare members before January 1 preps them for a smooth transition to their health plan in the new year. Timely, personalized outreach goes a long way in the minds of your members.  Behavioral research demonstrates that little things make a big difference when it comes to social interaction.[i] Let them know that you are thinking of them and are ready to take care of them in the New Year.  A warm welcome can help ease any anxiety and supports them into new benefits.

Don’t wait until January to educate members on plan benefits, collect critical contact and consent information or identify transition of care needs when you can do it now. Pre-boarding can reduce costs, improve satisfaction and retention in the long run.

Here are eight reasons to pre-broad your members:

  1. Identify transition of care needs  
  2. Collect critical contact and consent information including email addresses, cell phone numbers and permission to contact via text and email
  3. Ease anxiety for new members by reassuring them they have coverage starting the first of the year
  4. Educate members on their plan benefits
  5. Remind members to be on the lookout for their new ID cards
  6. If applicable, make sure members understand how to make premium payments
    {15% of Marketplace enrollees fail to make their first premium payment and never effectuate their enrollment. Get ahead of this problem by welcoming members to the plan before their benefit year starts and remind them to make that first payment to ensure they’re covered on January 1.}
  7. Reduce the burden on your call center's anticipated January 1 volume
  8. Member loyalty and retention starts with your welcome message 

Contact us today at eliza@hms.com, 844.343.1441, so we can create your pre-boarding program so you can successfully onboard your members for a healthy 2018.  

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[i] Psychology Today, Mar 06, 2012, Sam Sommers PhD. https://www.psychologytoday.com/blog/science-small-talk/201203/the-power-hello

 

Fall Priorities to Better Engage Healthcare Consumers and Prepare for a Healthy 2018

Happy Fall! Autumn is a time for closing those last quarter gaps in care, encouraging flu immunizations, and planning for the health plan 2018 benefit year. Here are some quickly-deployable Eliza health engagement management solutions that can reduce costs and improve outcomes and the member experience that you might find valuable this fall.

Welcome and Onboarding – First impressions are lasting. Timely and relevant conversations are designed to get to know your members and capture critical information to make the healthcare journey successful while building loyalty and enhancing satisfaction. The welcome outreach is also an optimal time to conduct a Health Risk Assessment and connect members to plan resources. Some results delivered to clients include:

  • 4x improvement in HRA completion
  • $625,000 in savings by using email instead of mail

Marketplace plans – don’t wait until January to start outreaching to new members. 15% of Marketplace enrollees fail to make their first premium payment and never effectuate their enrollment. Get ahead of this problem by welcoming members to the plan before their benefit year starts and remind them to make that first payment to ensure they’re covered on January 1. For more information on the importance of Marketplace Payment Reminders, check out this blog post.

Flu Shot Reminders – This preventive health reminder is a quick and effective way to drive behavior and address barriers around the vaccination. One client increased its CAHPS scores 12% over the previous year thanks to increased flu shot rates. Another client reported increasing flu shot rates by 34% over a control group. Eliza’s approach allows you to:

  • Debunk some persistent myths about the flu shot (46% of people asked believe the flu shot causes the flu).
  • Point members to appropriate resources, whether it’s their provider, a local drug store, or an on-site flu clinic.

Risk Surveys – Eliza offers off-cycle HOS and CAHPS surveys to support health plan interventions and member-specific information to create targeted actions for improvement. Some Medicare Advantage plans have seen 15 - 20% increases in HOS and CAHPS scores, and Star measure improvements by 2-3 Stars.

Year-end Gap Closure – Eliza’s year-end gap closure programs provide a last-minute push to close critical gaps in care and improve quality ratings. Members are notified of any care gaps and educated on the importance of health screenings. If they need help scheduling an appointment they can be transferred to plan resources or Eliza’s live agents. In just two months, Eliza assigned 162 members to PCPs and scheduled over 1,700 appointments to close care gaps.

For more information on these solutions or for help with any of your other health engagement management needs, contact us at eliza@hms.com or 1.844.343.1441.

Is Patient Engagement an Unnatural Act?

Nearly five years ago, a healthcare tech pundit called patient engagement “the blockbuster drug of the 21st century.” [https://www.forbes.com/sites/davechase/2012/09/09/patient-engagement-is-the-blockbuster-drug-of-the-century/#52bd29525638] The enthusiasm and excitement are understandable: patients who are more actively engaged in their care appear to have better outcomes and improved healthcare experiences. [http://content.healthaffairs.org/content/32/2/207.abstract]

But if patient engagement is such a good thing, why haven’t we seen the “blockbuster” outcomes that should come along with it? The answer is that in many ways, patient engagement is akin to levitating: it sounds good, but it’s awfully hard to do. That’s because when we try to increase patient engagement, we’re fighting millions of years of evolution.

Of the 10 million bits of information the human brain processes each second, a skimpy fifty bits are under our control. This means that we point our scant fifty bits at issues that are either pressing or pleasurable.

In other words, almost everything our brains do is automatic, happening below the radar and beyond our grasp. This leads to lots of inattention and inertia, often keeping us from engaging in better behaviors and decisions.

Fortunately, there are a number of proven strategies for activating patients’ pre-existing good intentions. We can use these strategies to craft interactions designed to address this “fifty bits” limitation.

None of this means that patient engagement is hopeless, or that it’s a bad thing. But it does mean that we should all appreciate the serious challenge that we’re taking when we call for greater patient engagement. And it absolutely suggests that we should thoroughly investigate other strategies for activating the good intentions that most people already have – whether that requires engagement or not.

Join me at the 3rd Annual Eliza Client Summit – Outcomes2017 where I will deliver the day one keynote and share proven strategies that can lead to better health outcomes. 

Dr. Bob Nease is an Eliza Engage blog guest writer, keynote speaker at Outcomes2017, chief scientist emeritus at ESI and author of The Power of Fifty Bits: The New Science of Turning Good Intentions into Positive Results

Cultural Intelligence: When knowing a language does not translate to knowing a culture

By: Mara Jimenez, Health Engagement Designer and Hispanic Approach Lead; and Marirosa Goetz, Certified Spanish Translator at Eliza

Let’s imagine you go to a restaurant with your friends. It’s your first time there. You open the menu and you quickly realize that none of the dishes seem familiar to you. Your eyes glance at the “Baked Alaska.” You’re craving fish, so you confidently order it. Your friends look at you a little strangely but you ignore it. Then, your meal arrives and... Surprise!  It’s a piece of cake!  You’ve just experienced a time when knowing a language does not mean knowing a culture. In this case you knew what the word “baked” meant and what “Alaska” meant, but you didn’t realize that together they meant something else. Now imagine if this happened to you every day, whether at the supermarket or at the hospital. You would be feeling lost, confused and stressed most of the time. This is the reality that many people face when they are trying to adapt to a new culture.     

Consider communicating in the context of healthcare. No matter which language you speak, healthcare has a culture all of its own – a series of phrases, euphemisms, and acronyms that even the most fluent can struggle with at times. For instance, what if a doctor diagnosed you with synchronous diaphragmatic flutter? Sounds scary and complicated... But it merely means that you have the hiccups. So try to picture a Hispanic patient who just mastered the concept that ‘hipo’ means ‘hiccups’ and how confused they’d be by this diagnosis? Entering the American healthcare space requires yet another complex layer of communications skills. The challenge of this undertaking often results in barriers that may seem impossible to overcome for a non-English speaker.

This is where communicating with cultural intelligence, defined as “the ability to cross boundaries and thrive in multiple cultures”1, plays a key role in effective communication. Here’s an analogy – if knowing a language allows you to talk and listen to somebody, having cultural intelligence allows you establish a relationship. This learning asset has become an essential element in the field of intercultural communication and is a necessary skill to develop in the growing global economy. It is particularly helpful in healthcare – when adapting campaigns about behavior change require so much more than simple ‘word-for-word’ translation. In a recent article in the Cleveland Clinic Journal of Medicine addressing disparities in healthcare, co-authors Anita Misra-Herbet and J. Harry Isaacson note that barriers to good outcomes go beyond language, and include issues involving authority, physical contact, communication styles, gender, sexuality and family – just to name a few.  

It’s essential to understand its cultural context In order to engage a Hispanic population and inspire action in healthcare. Where many communicators fail is in the notion that every English message can be simply translated to Spanish word-for-word and have the same impact. Enter Eliza. Eliza’s Health Engagement Management solution and our culturally adapted approach helps healthcare organizations overcome barriers to engaging the Hispanic Population to improve overall health, reduce costs and improve member satisfaction. This month, Population Health News released a Case Study written by both Mari and I, along with Michael Zagami, Eliza Vice President of Health Engagement Design that shares considerations and variations in the content that made a difference in the way Spanish speakers received well-child and diabetes care outreach. Download the case study and discover the impact a culturally adapted approach had for one client that resulted in a 3.2% higher nephropathy testing rate, a 4.7% higher HbA1c testing rate (based on HEDIS methodology) and a 16.6% higher annual well-child HEDIS rate among those choosing Spanish outreach.

Contact Eliza today so we can start the conversation to help you overcome barriers in engaging with your Hispanic members. Email info@elizacorp.com or call 844.343.1441

1 http://commonpurpose.org/knowledge-hub/all-articles/what-is-cultural-intelligence/

 

Webinar Recap: Social Determinants of Health

 

Eliza Corporation recently hosted a webinar on, “Identifying and Addressing Socioeconomic Barriers to Care". Our guest presenter was Betsy Mazzoni, Manager of Quality Improvement at Gateway Health, a valued partner of Eliza since 2013. Gateway expanded its partnership with Eliza this year and launched an integrated, multi-channel health engagement solution, focused on improving health outcomes. 

Access the ‘Social Determinants of Health’ webinar on-demand here.

Betsy noted, “Many plans and providers can fall into the trap of presuming that our interests around health promotion align with the priorities of our members.” Too often, socioeconomic barriers fall outside the benefit structure of health plans. The reality is that life factors have an enormous impact on health and wellbeing. 

This is why Gateway Health has taken a comprehensive, proactive approach to identifying and addressing social determinants of health. Betsy spoke about the tools Gateway uses, including ensuring member materials promote health literacy, risk stratification, and Prospective Care Management™. They have also enhanced the ways in which consumers can interact with the plan, including Eliza-led, multi-channel outreach such as email and text messaging. 

Each personalized, automated outreach that Eliza conducts on behalf of Gateway Health, whether it’s a flu shot reminder or a check-in after being discharged from the hospital, integrates a social determinants of health module. Creating a direct and open personal dialogue assessing socioeconomic risk allows Eliza to connect members in need with valuable health plan and community resources. 

Aimee Delorey, Eliza’s Senior Director of Data Science and Analytics concluded the webinar by reviewing best practices when engaging healthcare consumers on social determinants of health and presented some results from Gateway’s program. 30% of those asked, reported significant concerns about life necessities, such as food, shelter and safety, and were 2-3 times more likely to report fair or poor health.  

Through these interactions, we were able to help Gateway identify and engage members who could use some extra help that otherwise may have slipped through the cracks. After all, things like access to food, shelter, and safety, can’t be found on claims. 

To hear more best practices to identify and address social determinants of health, watch and listen to the webinar on-demand or contact us at info@elizacorp.com or 1-844-343-1441.

 

5 Tips for Building an Effective Healthcare Welcome and Onboarding Engagement Program

When done right, an effective welcome and onboarding strategy will have a positive effect on member retention, quality improvement and risk mitigation. Recently, Eliza’s SVP of Market Strategy and Consulting, Ellen Harrison, and I hosted a webinar on best practices in health plan welcome and onboarding engagement. If you missed it, you can watch it in your own time on-demand here.

Here are five tips for building an effective welcome and onboarding program:  

1. First Impressions Matter 

Don’t miss an opportunity to build loyalty by welcoming members to the plan and orienting them to their new benefits. The last thing you want is a member’s first interaction with the health plan to be a claims dispute. Take a proactive approach and reach out to members with something more than an Evidence of Coverage that is likely to be lost in the mail or at the bottom of a pile of junk mail.

2. Timing is Everything

Reach out to members early to make sure they have the information they need to use, and keep, their benefits. When it comes to Marketplace and Medicare Advantage plans, don’t wait until coverage has started to start the orientation process. 15% of Marketplace enrollees don’t pay their first month’s premium, and never effectuate coverage. Thank members for choosing your plan and remind them how and when to pay their premium in order to access their benefits.

3. Get to Know Your Members Early

This is the best time to assess risk and barriers to care. Don’t wait for a claim to come in noting a chronic condition, comorbidities, or an avoidable ER visit to identify high-risk members for care management programs. Use this time to conduct a health risk assessment, including social determinants of health. Whether you’re talking to someone with diabetes, an expectant mom, or someone who doesn’t know where their next meal is coming from, find out what’s going on and connect them with the resources they need to be their healthiest selves.

4. Go Multi-channel, Multi-touch

A multi-channel, multi-touch approach yields improved reach and satisfaction rates, as well as outcomes. A welcome call is the perfect opportunity to verify contact information, collect email addresses and permission to send text messages. We consistently see a lift in engagement rates when adding channels to the engagement strategy.  Email and text are great channels for reinforcing key information contained in welcome messages. –And once you have that data, use it to fuel future interactions.

5. Make it Meaningful

Each population is going to have different needs upon enrollment. For new Medicare members, it’s imperative to transfer prescriptions. Marketplace members are probably going to need a brief tutorial on health plan lingo. And Medicaid enrollees should be given a primer on the redetermination process and how to keep their benefits. Make sure you evaluate and address the specific onboarding needs of your population, instead of taking a one-size-fits-all approach.

While the welcome and onboarding process is traditionally thought of as a marketing function, it is truly a cross-departmental exercise that serves as the kick-off for retention, quality improvement and care management activities, while covering critical compliance requirements. It’s important to set a welcoming and supportive tone, in a timely manner, with relevant information for your members to get the most out of their membership in order to influence clinical quality, member loyalty and costs.

For more information on best practices in welcome and onboarding strategies, watch the on-demand webinar, or contact us at info@elizacorp.com and 1.844.343.1441

Flu Outreach: Enhanced Flu Awareness and Education is Essential

 

Recently, the CDC raised concerns about a potential decline in flu vaccination rates this coming flu season due to the removal of the nasal flu spray option. While the nasal flu spray made vaccination much less uncomfortable, it has proven to be ineffective for children and is no longer an option. This change could result in a decline in voluntary flu vaccinations for the 2016-2017 flu season.

During last year’s flu season the number of flu vaccinations declined by 1.5%, resulting in a target population rate of about 45.6% -far below our national goals. According to CDC Director Tom Frieden, a 5% boost in vaccination rates would prevent 800,000 illnesses and nearly 10,000 hospitalizations. To increase compliance, enhanced flu awareness and education is essential.

It’s not too late to get healthcare consumers to act and this year it’s going to take more than just a single outreach to raise awareness. Eliza offers a quick-to-market flu outreach program with proven results, ready to launch to health plan members across multiple channels. One health plan client saw a 34% increase in vaccination in one season. Our flu outreach program increases flu shot compliance by addressing potential barriers and providing appropriate resources to help the individual take action. Use Eliza to:

  • Debunk myths about flu shots and provide easy to understand information. 46% of people we asked believe the flu shot actually causes the flu, and didn’t know a flu shot can take up to two weeks to be fully effective.
  • Direct members to appropriate resources, whether it’s their provider, a local drug store, or a flu clinic.

How we do it? You can be ready to launch within weeks:

  • Data Analytics: Our analytics team will oversee the data integration by either taking your identified list of members or working with you to identify your at-risk population and confirm contact information.
  • Engagement Design: Deploy our standard flu outreach program, pre-programmed and ready to go, or allow our health engagement design experts to tailor an outreach strategy to meet your specific population needs.
  • Launch: Within weeks, we can execute a multi-channel, multi-touch program. We have found adding more channels, only improves results. In a recent case study we saw a 6.2% greater rate of well-child visits for those who received multi-channel outreach vs. one channel alone. 
  • Results: Our team monitors the success of your program and will make enhancements to drive further engagement.      

Don’t forget, it’s also a great end-of-year opportunity to engage with your members in relevant ways that drive loyalty and retention – such as adding it to a renewal campaign or ANOC outreach. To learn more and discuss how quickly we can get a program up and running for you, call 844-343-1441 or email info@elizacorp.com.

Struggling with HOS and CAHPS Measures? You are not alone.

Did you miss the Eliza Webinar on HOS/CAHPS on August 11th?  Listen to Ellen Harrison, SVP Market Strategy and Consulting at Eliza Corporation in the on-demand webinar as she discusses:

  • Opportunities to address the challenges all Medicare Advantage plans face and how some health plans have leveraged Eliza’s multi-channel solutions to efficiently and effectively engage their population with HOS and CAHPS proxy assessments — delivering the population and member level insights they need to address potential issues before they impact Star scores.

Access the recording here or read the webinar excerpt below.


We don’t have to tell you that HOS and CAHPS scores are important. They count for 25% of a Medicare Advantage (MA) plan’s overall Star rating, meaning that members’ perceptions about their care experiences directly affects the bottom line. These are difficult measures for all plans to improve. Over the last 3 years, HOS and CAHPS scores for MA plans have remained stagnant, with CAHPS scores hovering around 3.4 Stars and HOS scores at 3.0 Stars. And it’s no wonder. The HOS and CAHPS are based on a sample population’s perceptions about service, access and coordination of care and outcomes.  Plans receive aggregated output highlighting the broad opportunities but only limited actionable insights at a detailed member level.

Health plans need member-level data so limited resources can be used to create a focused and realistic action plan that will yield an effective return. Eliza’s approach provides early and deep insights into the drivers of perceptions that can help boost Star scores. We believe micro-targeted assessments that approximate the HOS and CAHPS key questions and issues applied across the health plan population, can provide you with early direction on results, specific information on member perceptions, and allow for laser-focused interventions.

Eliza’s HOS and CAHPS outreach impacts member perceptions and results in three ways:

  1. Recency and relevance play a role – We have found that the action of completing a survey of similar questions provides some lift in completion of the formal CAHPs and HOS surveys.
  2. Drive to act – We expand on standard HOS and CAHPS question sets by including tips and recommendations for immediate action to influence the member to act on care and outcomes issues. For example, if a member confirms some issues with balance or a recent fall, we include persuasive messaging to encourage the member to speak with their provider and seek out support and treatment. This messaging helps to not only captures member details for targeted intervention, but can result in enhanced member activation and early intervention.
  3. Actionable outputs – Our population based surveys give health plans member level details that cannot be gleaned through formal HOS and CAHPS results, which are reported in aggregate. The data collected is invaluable in connecting individual members with plan resources to address areas of concern that impact outcomes and satisfaction.

Our programs can be tailored to a plan’s specific objectives, we offer the flexibility to target key areas for improvement that matter most in your market.  And, with our integration experience gained from over 440,000 programs we can be market ready in as little as weeks.

Year_over_year_Star_Improvment

Recently, a regional Medicare Advantage plan turned to Eliza because they had a 1-Star rating in 2014 for many of their CAHPS measures. Eliza was able to provide targeted support, survey branching logic utilizing personalized questions based on individual responses and key problem areas, and survey tailoring based on past CAHPS and HOS opportunity areas for this particular plan. The results were at least a 1-Star improvement in the target CAHPS measures, and in some instances, improvement by two or three Stars.

Access the webinar recording here.

For more information on Eliza’s HOS and CAHPS solutions, email us at info@elizacorp.com.

Women’s Health – Could We Be Doing More?

An estimated 40,000 women die each year from breast cancer and another 4,000 from cervical cancer according to the CDC.[i] One in eight women will be diagnosed with breast cancer in her lifetime and it is the 5th leading cause of death for women over 50 years of age. Breast and cervical cancer screening offer early detection and treatment for better outcomes and fewer deaths. Information about breast and cervical cancer screening is widespread. Guidelines, headlines, and subject lines are put in front of women daily to remind them to make appointments and get tested. So why do screening rates continue to lag all our goals?

Why are only 70% of targeted women seeking mammography every two years, and less than 65% of eligible women are receiving recommended cervical cancer screening (PAP and HPV testing)? Many times, messages aren’t getting through the clutter of busy lives. Some are numb to the messages as they relate to ourselves and our families. For others, the messaging isn’t culturally appropriate, and doesn’t resonate with some of our most at-risk populations in a personal and engaging way. Race, income and education play a significant role. Black and Asian women are less likely to have recommended screenings. Lower income populations have low screening rates as well. Not surprisingly, women with a high school or higher education are much more likely to obtain recommended screening. While the Affordable Care Act has attempted to reduce barriers to care, a recent Kaiser Family Foundation survey of Marketplace enrollees, showed that nearly 33% think that copays and deductibles still apply to preventive services.

At Eliza, we understand engagement and messaging. We have demonstrated the ability to move populations when other types of communications haven’t had the desired impact. In one program, we were able to help a large regional health plan increase mammogram rates by 27.7% and increase Pap test rates by 22.5% over a control group that received no intervention.

chart1

Breast Cancer and Cervical Cancer Screening Outcomes

We believe that messages need to be tailored to the populations and personalized to have the greatest impact. Eliza’s women’s health solution utilizes targeted outreaches including phone calls, email and text messages to uncover barriers to care and encourage women to have appropriate screenings. For example, 37% of women stated that they hadn’t had their mammogram because they were unable to find a convenient time or location. Eliza outreach offers direct appointment scheduling to speed up gap closure and ensure a higher rate of cancer screening.

Mammogram direct appointment outreach

Listen to one patient as she shares how an outreach by her healthcare plan through Eliza motivated her to get a mammogram and ultimately saved her life:

CancerScreening_Comment.wav


Early detection and treatment of breast and cervical cancer saves lives. The best way to cheat these cancers is through simple proven screenings. Let’s not be satisfied with 70% compliance when 80+% percent is well within our reach.

Eliza gets modern healthcare consumers to act by engaging them in personalized conversations – at enterprise scale. Unlike disjointed point products requiring extensive integration, Eliza’s unified solution is more adaptable to change and easier to deploy, so it drives better healthcare outcomes, faster.

[i] U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2013 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2016. Available at: http://www.cdc.gov/uscs

Post-hospital discharge engagement reduces adverse events and improves patient safety

The transition from hospital to home is a particularly vulnerable juncture in patient care that requires significant oversight and checkpoints. In addition to the largely avoidable costs of readmissions, there is a significant patient safety issue associated with post-hospital care transitions.

CMS issued a proposed rule late last year in an effort to modernize and improve discharge planning and follow-up. CMS notes that, “post-discharge telephone call programs can improve patient safety and patient satisfaction, and may decrease the likelihood of post-discharge adverse events and hospital readmission. Post-discharge follow-up can help ensure that patients comprehend and adhere to their discharge instructions and medication regimens. Furthermore, post-discharge follow-up may identify problems in initiating follow-up care and detect complications of recovery early, resulting in early intervention, improved outcomes, and reduced re-hospitalization.”

We’re glad to see that CMS acknowledges the benefits of telephonic post-discharge follow-up, but it needs to be executed effectively in order to truly impact patient safety and improve health outcomes. That’s where Eliza comes in. Our post-hospital discharge solution is proven to reduce readmissions and improve patient outcomes, and here’s why:

  1. Our message is effective. We get results. Eliza conducted an outreach to patients who were recently discharged for a behavioral health event. Those reached by Eliza were 72% less likely to be readmitted than those who weren’t reached.
  2. Outreaches are timely and relevant. We follow-up with patients 24-48 hours post-discharge in order to quickly assess and address the most common drivers of readmission – whether they fully understand the discharge instructions, whether they’re following the prescribed medications, and whether they’ve scheduled an appointment with a clinician. Patients are also offered resources ranging from nurse advice lines, to health coaches and care managers, to emails with further information on post-discharge care. In the behavioral health post-discharge outreach discussed above, 57% of those asked, requested a follow-up email.
  3. We find people who need extra help. We are able to identify those who need a little support or a lot, and connect patients to appropriate resources quickly. Over 30% of those asked accepted a transfer to a health coach for additional support, and 40% of those who did not take the transfer, requested that a health coach call them back later.
  4. We’re efficient. Time is of-the-essence when contacting patients who have been recently discharged from inpatient care. Our automated multi-touch, multi-channel outreaches reach more people, faster and more efficiently than live callers or direct mail.
  5. We build patient trust and satisfaction. People appreciate that their provider or health plan care enough to check-in on them during a difficult time with some extra help if they need it.

Engage Eliza to connect your recently discharged patients to resources that can keep them moving forward on the road to recovery.

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