Deliver value-based
home care programs at scale

Deliver value-based home care programs at scale

With WellSky^®, payers can successfully deliver home- and community-based care models at national scale using our connected network of more than 12,000 providers. Identify high performing home-based providers and tightly coordinate clinical and operational home-based protocols to deliver impact to your members. WellSky helps payers coordinate care to optimize quality and star ratings, improve outcomes, lower member costs, and increase satisfaction.

Explore how our connected networks help you optimize care

Home care networks Referral and dispatch Coordinated care delivery Centralized data collection Performance management Reimbursement management

Home care networks

Contract WellSky’s high-performing network of more than 12,000 in-home providers spanning home infusion, home health, hospice, and personal care 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.

Referral and dispatch

Authorize and dispatch care to patients across a contracted network of 4,000+ personal care providers and 4,500+ home health and hospice providers across the U.S. using secure, compliant communications between the payer and its network.

Coordinated care delivery

Made possible by interoperable technology, WellSky provides payers with a single point of connectivity, enabling centralized management to deliver precisely specified care plans and interventions in the home. Incoming referrals containing a pre-defined care plan inform intake, insights, intervention, and delivery of care, ensuring care management teams can clearly define and deploy operational and clinical workflows under which all provider care teams operate.

Centralized data collection

Leverage WellSky’s real-time data collection as your high-performance network engages your members, with centralized visibility into the progression of in-home care models as they are delivered member-by-member, including the collection of payer-specified clinical data.

Performance management

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

Reimbursement management

Adjudicate claims and mitigate fraud, waste, and abuse with comprehensive transparency to provider operational and clinical data.

Execute complex care models consistently across the continuum

Deliver programs at national scale

WellSky provides the largest single point of connectivity, allowing you to contract, manage network quality, specify protocols, provide real-time data from the field, and integrate with selected care models.

Operationalize complex care models

Operationalize models that require interplay of multiple settings of care, such as SNF-at-home, by enabling referrals between and coordination across providers.

Differentiate through better outcomes

Reduce admissions to hospitals and facility-based settings by combining home health services and non-medical personal care into a more comprehensive alternative to inpatient options.

Outperform current and future value-based care programs

Extend the power of WellSky with these payer solutions

WellSky’s chronic care management solutions enable payers 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 heart failure 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.

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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.

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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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