Super Utilizer Solution
According to the Department of Health and Human Services, 5% of Medicaid beneficiaries accounted for 54% of total Medicaid expenditures in 2014.
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.
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.
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. Data show that Super Utilizer resulted in a 45% decrease in total PMPM health plan costs.*
The Super Utilizer Process
- 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.
Enhancing Case Management
Super Utilizer’s data-centric, person-centered and truly localized community-based approach, augments existing case management by positively impacting chronic physical health conditions, co-occurring behavioral health disorders, and social barriers.