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Payer Partners

Deliver on Health Equity, While Reducing Total Cost of Care and Improving CAHPS Scores

Medicare Advantage, Dual Eligible, and Medicaid plans are all challenged when it comes to eliminating health disparities in a way that is both good for the member, and good for their financial performance. Guideway Care partners with health plans to deliver on the promise of health equity in a way that fills that need, and integrates seamlessly within the existing care management infrastructure.

Avoiding acute care utilization is a byproduct of reducing disparities in healthcare.

30%
DECREASE

in acute care utilization –
West Coast Medicare Advantage Plan

Payer Partners

Positive Return on Investment Guaranteed

Guideway Benefits

  • Decrease total cost of care

  • Improve CAHPS scores

  • Drive operational efficiency

  • Make health equity actionable

  • Increase clinical capacity

  • Deliver on the promise of rural health

  • Provide value-added benefits to network partners

  • Improve stars ratings for member satisfaction

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32% Reduction

We reduce readmissions in AMI, CABG, COPD, HF, PN, and Sepsis by an average of 32% across all payer client partners.

31% Increase

We were able to increase CAHPS scores and annual wellness visits in a large Medicare Advantage plan through patient activation.

90th Percentile

Patients we guide rank us in the highest percentile due to the peer-to-patient relationships our highly skilled and thoroughly trained Care Guides are able to build.

Our Model

Achieving 
Consistent
Results

Guideway Care’s operating model is based on using human interaction, driven by its proprietary patient activation platform. We work with our client partners to customize our engagement to integrate and augment their current care management workflows. The result is a seamless implementation and execution, which drives optimal patient and financial outcomes.

Skilled Care Guides

Guideway Care utilizes personality and cognitive tests to hire optimal Care Guides. After extensive training in motivational interviewing and Respecting Choices, Care Guides resolve patient / member barriers related to Social Determinants of Health (SDOH) and disparities, overcome clinical and non-clinical barriers to quality care and promptly address the physical, practical, emotional, informational, spiritual and familial issues that impact patient outcomes.

Proprietary Patient Activation Platform

Guideway Care’s proprietary platform automates protocols to uncover both non-clinical and clinical issues and barriers for Care Guides. The platform automates the ingestion of tasks, the next step process, clinical escalation, and barrier resolution. The automated prompting and workflow design allows the Care Guides to build peer-to-patient relationships, while stacking non-clinical and clinical assessments in structured reportable data.

Patients & Members

Guideway Care’s mission is to achieve health equity for all patients by effectively addressing Social Determinants of Health (SDOH) and disparities, and proactively resolving non-clinical and clinical barriers to quality care. Patients / members who need our assistance don’t typically ask for it, but deserve and appreciate the peer-to-patient relationship. Our Care Guides work with our patients to improve their lives on a daily basis.

Partner Clinical Teams

Guideway Care guides act as an extension of our client partners’ clinical teams, allowing them to operate at the highest level of their license. We collaborate with our partners both in the implementation, as well as the execution of our Service-as-a-Solution. We are able to resolve non-clinical patient barriers and automate the escalation of clinical patient barriers to our partner clinical teams.

Integration

Guideway Care integrates with client partners both operationally and technologically. Our implementation process ensures that we conform to our client partners’ workflows, so we can seamlessly operate within their environment. Our technology integrates with EHR/EMR and care management platforms to provide bidirectional interfaces, prompts and alerts.

Learn more about how we work with health plans.

Email us or contact us via LinkedIn.

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