Case study: Getting LTSS services in place faster and more efficiently
The project
For health plans, getting Medicaid LTSS members the services they need is a top priority. The goal is care in place by 10 days. In the past, care managers were tasked with contacting providers by any means necessary to solidify commitment.
The Problem
Health plans struggle to achieve the 10-day service in place goal, due to inefficient communication methods.
The process went something like this:
- Care manager attempts to gets in touch with provider
- Provider takes time to respond
- Multiply this times however many providers the care manager has to manually contact till they can find one who is qualified and available.
The result: Significant delays in services.
Our Objective
Create a way for:
- Care managers to create a service request one time and broadcast to ALL QUALIFIED PROVIDERS in a region.
- Providers to view all the necessary details for that request, and provide a response back to the care manager.
My role
- Facilitation of discovery sessions
- UX design
- User research
- Content writer
Collaborators
- Business/Health Plan stakeholders
- Systems Analyst
- Solutions Architect
- Service Developer
- Front End Developer
- UX Design Team
The solution
The solution is a referral dashboard that displays all referral opportunities available for that provider.
From this dashboard, providers can:
- View all available referral opportunities
- See all pertinent details, at-a-glance
- Select one or more referrals to respond
- The response flow offers a lot of flexibility. Providers can accept, accept pending recruitment, decline or request more information for each referrral
- After response, referrals are moved to the appropriate tab
- Guidance on next steps is provided every step of the way
Care managers can now create a single referral via an internal application, and broadcast to every qualified provider in a geographic region. This translates to much faster turn around times. A significant win for care managers, providers and most importantly, LTSS members.
>