Super-Utilizer Solution

 

According to the Department of Health and Human Services, in 2014, 5% of Medicaid beneficiaries accounted for 54% of total Medicaid expenditures. 

 

LifeShare’s Super-Utilizer solution is a short-term, intensive approach for Health Plans seeking to reach and stabilize the highest users of emergent services. In addressing the needs of this population, the Super-Utilizer Solution assists Health Plans to make significant inroads in aligning with the triple aim goals of creating a higher quality healthcare experience, improving outcomes and reducing costs. 

 

This group requires far greater engagement than traditionally needed by members.  Super-Utilizer is designed to address the numerous social determinants of health, such as access to housing, transportation, food, and employment, that affect health outcomes and drive frequent, intense and extended utilization of high-cost services.

 

  • Super-Utilizer is built upon a proprietary algorithm identifying, in concert with the health plan, the difficult to reach and most frequent utilizers of emergent services. 

 

  • Upon member identification, LifeShare leverages its more than 20 years of truly localized human services expertise to make in-person contact and engage the member into services.

 

  • Working in tandem with Health Plan Case Management, LifeShare’s Community Resource Specialists become the main point of contact as they work with members for 45 to 90 days. 

 

  • Stabilizing the necessary social determinants for the member by connecting them with appropriate community and Health Plan resources, Community Resource Specialists facilitate a warm transfer of the member to the Health Plan Case Manager at the end of the engagement period.

 

Super Utilizer’s data-centric, person-centered and truly localized community-based approach, enhances existing case management by positively impacting chronic physical health conditions, co-occurring behavioral health disorders, and social barriers.  

 

For more information, contact our Business Development team.