Deliver high-quality
care programs for your
chronic care populations
with WellSky^®

Deliver high-quality care programs for your chronic care populations with WellSky^®

WellSky’s chronic care management solutions enable you to deliver coordinated care models at scale, leveraging our home- and community-based connected networks, to reduce costs for your highest utilization populations. Whether it’s delivering solutions for congestive heart failure (CHF) readmissions, complex diabetes populations, chronic kidney disease/end-stage renal disease (CKD/ESRD) programs, or delivering better outcomes at lower cost with SNF-at-home programs, WellSky can help you realize material impact for your most complex populations.

Explore WellSky’s value-based care management solutions

Turnkey coordinated care models High performance networks Performance management Data-driven program insights Provider collaboration Evidence-based care management

Turnkey coordinated care models

WellSky can provide turnkey delivery of evidence-based protocols for programs such as heart failure readmissions, CKD/ESRD programs, non-clinical social determinants of health (SDoH) support; SNF-at-home programs, and other models. Alternatively, you can specify the exact protocols that need to be followed and automate coordinated models of home- and community-based care to deliver personalized, patient-centered care and increase coordination with providers across care settings. Optionally, WellSky will partner with you in risk-based models incented on outcomes and other success metrics.

High performance networks

Contract WellSky’s high performing network of more than 12,000 home- and community-based providers that use our solutions all day, every day for their operational and clinical delivery. Our expansive network of providers operates in every state and both urban and rural geographies across the U.S.

Performance management

Report on pre-defined KPIs and prioritize patient referrals and provider network participation based on performance. Apply advanced analytics to identify the metrics that best reflect outcomes.

Data-driven program insights

Payers and providers are able to collaborate on risk-based contracts by aggregating patient data and using WellSky’s best-in-class analytics to identify which measures can have the greatest impact on cost and quality, track performance against those measures, and determine where to focus improvement efforts.

Provider collaboration

Coordinate and reimburse connected network partners leveraging WellSky to help process and adjudicate claims and facilitate payment.

Evidence-based care management

WellSky combines EHR data, negative events, and digital signals to provide insights that enable provider teams to implement interventions to shape desired outcomes and predict future events and behaviors.

Advance the mission of value-based care

Deliver interventions for improved outcomes

Seamlessly coordinate home- and community-based providers with the member’s clinical care team to monitor risk and deliver interventions for targeted patient populations such as programs for high-risk diabetes, CHF, CKD/ESRD, or SNF-at-home.

Close gaps in care

Easily identify where members may be experiencing gaps in care to automatically flag high-risk patients based on rules and machine learning predictions and seamlessly create and dispatch a coordinated care management program.

Support risk adjustment

Access the data you need to understand the risk level of members and predict their costs. Measure current care management program performance and identify the value-based payment programs that have been successful.

Shaping the future of value-based care delivery

Extend the power of WellSky with these payer solutions

Health plans can deliver highly differentiated, coordinated care models at scale leveraging WellSky’s connected networks. As the EHR and operating solution for more than 12,000 providers, WellSky has pioneered transformative models for building and coordinating with high performance home- and community-based networks. Through our API-compatible care coordination solution, WellSky provides payers with a single point of access, visibility, and coordination across home-based settings of care and the ability to deliver impactful care models at scale.

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WellSky Human Services manages your Medicaid Waiver, Older Americans Act, and other funded programs in one comprehensive care management system. Whether you’re a state department, agency, or managed care organization responsible for aging, intellectual and developmental disabilities (IDD), behavioral health, traumatic brain injury, or other human services programs, we are your trusted partner. From eligibility and intake, to the assessments your provider network uses, to claim adjudication and processing, WellSky has you covered.

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WellSky offers the only Electronic Health Records solution for behavioral health and intellectual and development disabilities (IDD) providers that connects directly to your payer’s system. Our closed-loop, payer-provider data sync eliminates duplicative data entry, speeds eligibility checks, accelerates authorizations, and shortens reimbursement timelines.

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States use WellSky to meet their responsibilities for the oversight of public and professional guardians. Our cloud-based solution gives states full visibility into key aspects of their Public Guardianship program activities to better protect the public while collaborating with its guardian network. Easily monitor guardian compliance, respond quickly to complaints and grievances, and fulfill legislative requests for information.

Mobilize your workforce to increase productivity in the field. Mobile Assessments equip your team to complete thorough evaluations from any location, with or without the internet. The tool is fully integrated with our care management solution and obeys your existing organizational and role-based security configuration.

The 21st Century Cures Act mandates that states implement electronic visit verification (EVV) for all Medicaid personal care services (PCS) and home health care services (HHCS) that require an in-home visit by a provider. WellSky Personal Care (ClearCare) and WellSky Human Services provide EVV solutions to assist agencies in meeting state and federal compliance requirements.

Ensuring that the right care is delivered in the right place at the right time for your members has never been easier. WellSky^® care coordination technology is built to coordinate clinical and operational protocols and optimize the flow of information across the care continuum. Gain access to the nation’s most expansive network of acute, post-acute, and community care providers — along with the powerful technology needed to facilitate lasting connections and quality care.

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CarePort^®, powered by WellSky streamlines the authorization process between payers and providers to help ensure members go to in-network organizations. With CarePort, you can improve relationships with partners through direct communication and increased visibility to referral sources.

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In today’s value-based care environment, payers need access to advanced predictive analytics to effectively work with post-acute and community care providers. WellSky’s analytics solutions for payers help you connect directly with providers and gain insight into real-time patient care. Optimize member outcomes, drive savings, and enhance your post-acute relationships with WellSky.

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