DANVERS, Mass., Aug. 26, 2015 /PRNewswire/ -- Eliza Corporation ("Eliza"), the pioneer and recognized leader in Health Engagement Management, today announced Eliza for Qualified Health Plans (QHPs), a member engagement solution suite that addresses key milestones and Quality Rating System (QRS) measures for QHP populations. Eliza for QHPs combines Eliza's data, analytics, patented technology and services to close gaps in care, and improve HEDIS ratings by uncovering how and where to focus communications efforts. Eliza then designs, tailors and triggers member outreach to influence the behaviors that are impacting costs, utilization, and satisfaction.
"We know that if health insurers want to stay relevant in a world driven by consumer choice, they must understand how to influence the health-related behaviors of thousands of individuals," said John Shagoury, President and CEO of Eliza Corporation. "We help our QHP clients effectively predict, assess and address key outcomes across their member populations. Our approach to improving HEDIS measures, for example, lets us not only capture members' responses, such as intent to have a recommended screening, but also uses our algorithmic scoring to add a unique dimension of understanding, such as which QHP members are likely to take care of themselves, or which members are likely to leave the health plan next year. We apply these insights in actionable ways to influence better outcomes, financial results, and most importantly, improve lives."
The Eliza for QHPs solution suite is comprised of 16 tailored solutions designed to target specific QRS/HEDIS measures. The solutions work together to create a holistic communication experience for members. Clients have the flexibility to choose any combination of solutions based on their objectives and goals. Eliza for QHPs includes a discovery and assessment phase which provides the right information needed to optimize the solution to meet specific client needs. These solutions are enabled by Eliza's award-winning, multi-channel platform. Eliza for QHPs also features an optional mix of data visualization, data management, and data integration services with a focus on claims-based HEDIS targeting, population analysis, consumer segmentation, propensity analysis and outcome analysis and reporting.
The Eliza for QHPs solution suite improves outcomes in critical areas to achieve administrative, clinical, financial and operational goals. Eliza does this by:
Better understanding the needs and risks of individual members and populations, including the specific challenges they face and the ways in which they cope
Working with clients on payment strategies to ensure valuable premium payments are made by a population that is new to carrying a monthly health insurance bill
Assisting with health literacy and care navigation to reduce ER/ED utilization, and direct members to appropriate and low-cost care settings for low-acuity needs
Identifying new opportunities for targeting and engagement
Reaching out in ways that meet an individual member's current needs and challenges
Segmenting populations using Eliza's proprietary Engagement Index, allowing for smarter messaging
In addition, Eliza for QHPs helps clients:
Target for QRS/HEDIS measures across all domains
Actively monitor and track for key QRS/HEDIS measures
Monitor engagement metrics such as reach rates, win rates, etc. through the client portal
Dynamically generate lists for micro-targeting
Support live one-to-one, micro-targeted interactions
Seamlessly adapt to QRS/HEDIS program changes over the years
Added Shagoury, "Our data asset on the attitudes, behaviors, and motivations that drive people's health and healthcare decisions gives Eliza the ability to build our solutions, such as Eliza for QHPs, based on our unique learnings. Eliza's approach is data driven -- and our data asset -- arguably the largest longitudinal warehouse of interactions with real healthcare consumers -- allows us to assess what works and what doesn't in a very fact-driven way, so we can recommend and execute the most effective approaches."
About Eliza Corporation Eliza Corporation ("Eliza") is the pioneer and recognized leader in Health Engagement Management. Eliza combines technology, data, and analytics to provide the most advanced solutions and services that measurably improve quality, cost and care outcomes. Over 15 years and billions of interactions, Eliza has amassed the world's largest data asset of people's healthcare actions, behaviors and decisions through the Company's award-winning, multi-channel communications platform. Eliza is based in Danvers, Massachusetts. For more information, visit www.elizacorp.com or contact 1.800.701.7864.
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