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A COVID-19 update from our company’s consulting physician

Throughout 2020 and as we plan for 2021, Sagility has trusted the professional insights of Dr. Virginia Gurley, whose steady and reliable point of view has provided us with a sound perspective regarding the pandemic. Her end-of-year statement offers guidance as well as words of encouragement for the months ahead. “COVID-19 has spread by leaps […]

Member experience: Never a better time for digital enablement

Health plans are all too familiar with the challenges of member experience—that perfect storm of call/processing volume surge, staffing challenges, and critical moment-of-truth engagement pressures. And the stakes are even higher for 2021, according to JD Power research.  The organization’s fourth annual study found that member satisfaction averages dropped from 712 on a 1,000-point scale […]

Seamless customer experience begins with enhanced direct enrollment

This year’s open enrollment period takes place from November 1 through December 15, when consumers can select or renew an individual exchange plan either on or off marketplace. For the millions who purchase these plans, the experience can be cumbersome and frustrating as they struggle to make complex decisions based on balancing competing interests of […]

Precision utilization management: Meeting patients where they are

Providers view prior authorization as a manual, burdensome, and laborious process, mostly because of process missteps such as lack of clinical data integration, inconsistency in data exchange standards, and differing policies among payers. According to a recent American Medical Association survey, handling the surging prior authorization requests translates into a “high” or “extremely high” burden […]

Bridging provider-payer gaps with today’s technology

Across the world, today’s healthcare organizations are sharing one critical challenge: the rising costs associated with improvement in quality care. The underlying mandate is that all stakeholders must keep a sharp focus on making healthcare more effective, efficient, and affordable. To meet this new demand, both payers and providers have made adjustments to service delivery—and […]

For a more holistic SDoH picture, look at social determinants of mental health

By Daniel A. Schulte, Senior Vice President, Provider Operations, Sagility As members of the broader healthcare community, we have been reviewing the many facets of the general healthcare delivery environment: from the old-school “diagnosis and treatment plan” strategy to understanding more about the patient’s real-world constraints on the path to wellness. In addition to […]

Social Determinants of Health: Insights from our Experts

Recent reports show that up to 80% of payers are integrating social determinants of health (SDOH) into their member programs. To address this market focus, Sagility recently sponsored a webinar on Best Practices in Addressing Social Determinants of Health Issues Impacting Highest-Need Populations with AHIP. This well-attended event deserved a follow-up session as there were […]

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