Treating people as people. That's what matters to us.

Eliza Quality and Cost Management programs focus on closing gaps in care. Our programs are designed to engage healthcare consumers and drive results that align with HEDIS and CMS measurements. While we  engage your entire member population, we work with you to identify and activate specific members to drive utilization to your quality improvement programs, optimizing your resources and driving ROI to your budget. 

 

PREVENTIVE CARE

  • Adolescent/Well Child
  • Annual Wellness Visit
  • Dental
  • BMI
  • Chlamydia
  • Colonoscopy
  • Mammogram/Pap
  • Osteoporosis
  • Vision

IMMUNIZATION

  • Adolescent Immunization
  • Childhood Immunization
  • Flu Immunization

CONDITION MANAGEMENT

  • Asthma
  • COPD
  • Depression
  • Diabetes
  • Heart Health
  • Postpartum
  • Prenatal
  • Smoking Cessation
  • Wellbeing
  • ADHD
  • Osteoporosis

MEDICATION

  • Medication Adherence
  • Medication Therapy Management
  • Disenrollment Survey

CARE MANAGEMENT

  • Appointment Reminder
  • Appointment Scheduling
  • Post Hospital Discharge
  • ER Utilization
  • Targeted Gaps in Care

ASSESSMENTS & SURVEYS

  • CAHPS
  • Care Management Survey
  • Disenrollment Survey
  • HOS
  • HOS/CAHPS
  • HRA (Health Risk Assessment)

Quality & Cost Management Solutions for:

You have helped me—you have saved my life. Because I went in to have a mammogram when you told me to have one, they found cancer, and now it’s gone. And I’m cancer free.

Medicare member feedback after Eliza Outreach

Results

PREVENTATIVE

Combined outreach increased the cervical cancer screening rate by

53%

and increased mammograms by

45%

 

ER UTILIZATION

693

fewer members (annualized) were readmitted to the ER, resulting in projected savings of

$811,503

 

DIABETES

Increased gap in care closures by as much as

32%

Client achieved

5-star

status across a range of clinical and satisfaction measures

 

IMMUNIZATION

30%

increase in childhood immunization rates in Newark, NJ

 

CLIENT SUCCESS STORY:
Diabetes Gaps in Care Closure

 

CHALLENGE:
Improve client's diabetes measures from 3.5 to 4.0 Stars by influencing 500 additional members to schedule a Primary Care Physician (PCP) visit.

 

RESULTS:

  • Increased potential appointments by 13%—exceeding program goal
  • Increased potential Star bonus to approximately $22M for the year

 

CLIENT SUCCESS STORY:
Medication Adherence

 

CHALLENGE:
Increase antidepressant medication adherence

 

RESULTS:

  • 13% increase in 90-day compliance
  • 61% of members report scheduling a MD visit following the Eliza outreach

CLIENT SUCCESS STORY:
Post Hospital Discharge

 

CHALLENGE:
Reduce 30-day hospital readmittance

 

RESULTS:

  • 2.2% reduction (360 fewer members) in 30-day, all-cause readmission, resulting in $3.8M in savings

ON-DEMAND WEBINAR

QUALITY MANAGEMENT

Review methods to quickly analyze your results to date and target key quality actions needed to boost HEDIS, STAR and QRS measures.

“Get your quality act in gear”

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