Medical management, cost and quality programs

Programs

We offer medical management programs designed to support our members at any stage of their health care journey. Our member programs are enhancements to our members’ total benefit package. They help our members lead healthier lives, and our programs reinforce and support your treatment plans.

Medical management

Our medical management programs are either targeted to specific conditions or designed to improve or maintain overall health. Programs include case management, diabetes and disease management, palliative care, radiology, cardiology and physical and sleep medicine.

Quality Incentive Program

Earn incentives when you address and close care gaps for on-exchange members.

Quality

When you share cost and quality data with our members—your patients—they can make more informed health care decisions. Learn about our Quality Program and read about best practices in our Quality in Action newsfeed.

Quality Program Quality in Action

Member programs and tools

Member programs highlight the enhancements to the total benefit package provided to our members, such as health coaches, a 24-hour nurse advice line, and discounts on health products and services. These programs help our members live healthier lives.

Risk Adjustment program

Risk adjustment is designed to encourage insurers to compete on quality and efficiency, preserve consumer choice and improve quality of care for patients.