In the beginning we gauged our growth by the climbing piles of paper phone bills outside our CEO's office. Today, we measure our success with demonstrated improvements in HEDIS rates, a BlueWorks award, national recognition for innovative first of kind applications, and ongoing programs that extend the ability of our technology to impact member behavior.

Our customers have analyzed and documented significant improvements in such diverse areas as:

Eliza specializes in the design, development, and hosting of speech recognition software applications exclusively in healthcare. Our phone-based programs automate the collection and sharing of information between patients, providers and healthcare organizations with personalized and conversational interactions.

We have developed hundreds of programs in partnership with our managed care, disease management, pharmaceutical, retail pharmacy, and PBM customers. In the process, we have learned that there is no single technology or off-the-shelf solution that can effectively address the unique and complex challenges in healthcare. We have developed a highly flexible platform - nearly twenty years in the making – that allows us to create innovative solutions with our customers.

As a result, our programs are optimized to reflect the unique needs of our customers and their patients. And we are proud that, without exception, 100% of our customers have continued to expand their partnerships with us over the past six years.


HEDIS Outreach


HEDIS outreach needs no introduction. In fact, for many plans, HEDIS outreach was one of the earliest organized preventive outreach efforts. And over time, folks have settled into their HEDIS routine-whatever it may be. Eliza's goal is to revolutionize traditionally-minded HEDIS support...by making it member-centric, interactive, and dynamic. Through our highly-personalized programs, we not only help to drive member behavior, but we also gather real-time and actionable information for future outreach.

Our clients have demonstrated measurable outcomes that are supported by validated claims data across millions of members. A few examples:

  • A top Blues Plan was awarded a BlueWorks award by the Blue Cross Blue Shield Association and Harvard Medical School for their Eliza Preventative Health Program. Not only do their Eliza interventions offer highly personalized reminders, but they also provide barrier questions, live call-transfers to assist women in scheduling mammograms, and access to additional resources for hundreds of thousands of members. Over the course of one year, HEDIS rates for childhood and adolescent immunizations, mammograms, pap tests, and prenatal and postpartum care all increased-some by as much as 25%.

  • A non-profit integrated health care delivery system developed an innovative hypertension program in partnership with Eliza. The program's success was assessed using HEDIS guidelines, and showed that 84% of the members believed their hypertension was under control (defined as ≤ 140/90), compared to the plan's HEDIS rate of 71.8% in control. During the Eliza call, an additional 9% of members reported they were unsure of their control status, while 7% felt that their hypertension was not under control. Real-time feedback and support were provided based on the members' self-reported status. Overall, the plan's 2005 HEDIS rate improved by over 5%, from 66.2% in 2003 to 71.8% in 2005.

  • As part of a GAO study, a Northwest Blues plan was asked to share information on how their organization uses technology to better deliver healthcare. In a briefing before the Senate Committee on Health, Education, Labor, and Pensions, they provided examples of clinical improvements their health plan gained over two years using Eliza's technology. Examples they shared include: diabetic retinal exams increased from 71.3% to 92.9%; HDL cholesterol screenings increased from 77.9% to 86.6%; and Hemoglobin A1C testing increased from 85% to 89.9%.

Our HEDIS programs include:

  • Adolescent Immunizations
  • Adult Immunizations
  • Asthma Medication and Treatment Support
  • Behavioral Health Support
  • Beta-Blocker Adherence
  • Breast Cancer Screening
  • Cervical Cancer Screening
  • Childhood Immunizations
  • Chlamydia Screening
  • Cholesterol Management
  • Colorectal Cancer Screening
  • Diabetes Support
  • Flu and Pneumococcal Immunizations
  • High Blood Pressure Management
  • Osteoporosis Management
  • Prenatal and Postpartum Care

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Medicare Part D


It’s the plan that launched a million calls to your benefit specialists. Eliza’s interactive Medicare Part D programs proactively assuage some of the concerns that members may have about their plan, while offering valuable, member-specific information that helps influence retention.

Results from Eliza’s Medicare Part D outreach programs have been impressive:

  • Proactive enrollment period outreach offset client’s call center volume by about 80%
  • In a follow-up outreach, nearly 70% of members reached wanted to hear how they could save on their prescriptions
  • 97% of respondents indicate that they intend to stay with their plan

Streamline administrative tasks and offset call center volume with proactive outreach, which can be timed to daily events:

  • ANOC letter notification
  • Membership card shipped notification
  • Benefit explanation and support
  • Enrollment form confirmation
  • Effective start date notification
  • Order status updates
  • Coverage gap notification
  • Coordination of benefits support
  • Medication Therapy Management (MTM) outreach

Then influence long-term retention by reaching out to members with ongoing education and support—based on a member’s individual benefit design and stage—with programs such as:

  • Brand to preferred switching
  • Brand to generic switching
  • 30 to 90-day prescription switching
  • Brand to OTC switching
  • Prescription home delivery
  • Prescription refill and adherence
  • Drive to web/other supportive resources
  • Member satisfaction and retention programs
  • …and many more

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Operational Support


How do you make a call about COB engaging- as opposed to off-putting?

How do you let a member know that their rates are going up in a way that will retain them as a loyal customer?

How do you explain one of the most confusing government-sponsored benefit programs in a way that minimizes call center work load and maximizes member satisfaction?

And, most importantly, how do you do all this in a way that delivers a clear and fast ROI…

Eliza's operational outreach has engaged and impacted millions of patients, members, consumers, and beneficiaries. Our programs include:

  • Appointment Reminders
  • Benefit Explanation and Support
  • Benefit Change Notification
  • Coordination of Benefits
  • First Call Resolution and Support
  • Medicare Part D Outreach
  • Satisfaction Surveys
  • Student Verification
  • Support programs for Consumer Directed Plans

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Pharmacy Programs


The rising cost of prescription drugs is on the minds of an increasing number of members, so therefore it's on ours as well. Our integrated pharmacy programs focus on sharing information about less expensive alternatives for current prescriptions and explaining benefit structures and formularies.

Our pharmacy programs also provide proactive and timely notification of co-pay changes, feedback on how to maximize the positive aspects of those changes, and even provide adherence support-including real time transfers to pharmacies.

Our pharmacy programs include:

  • Brand to preferred switching
  • Brand to generic switching
  • 30 to 90-day switching
  • Brand to OTC switching
  • Prescription home delivery
  • Order status updates
  • Medication Therapy Management (MTM) outreach
  • Adherence support
  • Refill support
  • Co-pay change notification

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Pharmaceutical/Biotechnology Solutions


Become an active partner in your patients' condition management from the very start. Eliza's pharmaceutical interventions acknowledge patients' concerns in real time, offer education, and help set expectations around their treatment. Follow-up outreach keeps the momentum going, building on information shared in the initial call to further engage patients and win their loyalty.

Eliza also helps identify and address barriers to adherence or retention, helping gain insight into ways to address these issues and recouping lost revenues.

As a result, our outreach has proven to cost-effectively increase patient adherence and compliance. Meanwhile, patient feedback indicates that they find Eliza interactions helpful.

Outreach is personalized and based on patient-specific events, with programs such as:

  • Condition-specific education and support
  • Multi-stage adherence programs
  • Proactive and tardy prescription refill reminders
  • Therapy compliance outreach
  • Patient surveys
  • ...and much more

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Seniors


It's not too long into a meeting before someone will ask "This all sounds great, but how do seniors react to the technology?" It's our favorite question. Seniors have proven to be one of Eliza's most receptive and appreciative populations - across the spectrum of Eliza programs. It may be the highly interactive and human quality to an Eliza program; it may be the level of personalization; or it may best be summed up by a 70 year-old member who recently commented on an Eliza call "I think it's a great thing that they call to remind you, because you're meaning to do it and then someone really calls and tells you okay, you know it's your time. So I think this is a great service from (Plan Name). Bye."

Our senior programs include:

  • Medicare benefit related outreach - including Medicare Part D
  • Condition-specific support - COPD, CHF, diabetes, secondary prevention, and more…
  • Age-appropriate screenings - osteoporosis, colon cancer screening, glaucoma, mammograms, flu, and more…
  • Quality of life surveys
  • Health Risk Assessments
  • Welcome outreach - including Medicare Part D

Turns out, seniors just might be the most receptive of all!

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Debit Cards — Proactive Plan Administration


For every claim that can't be electronically substantiated, Third Party Administrators send an average of three outreach letters. Add up printing costs, postage, and administrative hours spent on this paper-based outreach, and profits may start to dwindle. And, with each denied claim based on a lost receipt, so does member satisfaction.

Our proactive plan administration outreach is personalized and timed to specific events, with programs such as:

  • Enrollment support
  • Welcome and plan explanation
  • "Did you Know?" educational support
  • Receipt notification outreach
  • Periodic balance updates
  • End-of-year retention outreach

Whether deployed as a suite or individually, Eliza's debit card optimization programs offer reduced costs, increased timeliness, reduced administrative burden, and increased customer loyalty.

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