Solutions for Payers
Experience a new level of compassion with the sole care coordination program focused on Quality Stars and Risk Adjustment
Dedicated to each member, the Porter Care Guide coordinates the member’s care, assesses and addresses barriers to care, and explains their eligible benefits, cost sharing, and deductibles. We navigate their care journey by scheduling appointments with PCPs and specialists, securing the support for care-at-home, providing condition-specific education, and helping them understand their benefits. Our superior care coordination significantly impacts the quadruple-weighted Member Experience survey measures.
Our Quality Stars and Risk Adjustment-focused approach is tailored to each of your members. Porter matches the appropriate intervention services (personnel, modality, and intensity) with each member’s unique needs and barriers. We have four ascending levels of intervention that can include a combination of virtual, telephonic, and in-home resources. The highest level of intervention is a level-4 comprehensive In-Home Assessment performed by an In-Home Provider (Nurse Practitioner, Doctor of Osteopathic Medicine, or Doctor of Medicine) complete with in-home lab and diagnostic testing. No matter the intervention, our Care Guides continuously support your members with care coordination and member benefit navigation services across the continuum of care.
Porter’s comprehensive in-home assessment addresses quality and risk adjustment first. We perform a 360-degree evaluation of your members, complete with in-home diagnostics and biometric screenings. Lab tests are sent in advance to the member’s home, collected onsite, and processed through our intermediary or by your preferred lab vendor. We not only identify gaps and barriers to care but appropriately address them.
Your members are changing their health plan expectations to desire a more meaningful member experience. We understand your plan’s needs and determine the members that are most likely to benefit from targeted interventions and support. By deploying cross-functional initiatives and focusing on identified enrollees with the largest impact on your quality ratings, we improve health outcomes and member satisfaction.
Prospective risk adjustment activities to capture the true risk of your population and address potential health problems before they become more serious and expensive to treat. Investing in your high-impact enrollees can result in cost savings by reducing the need for expensive medical procedures and hospitalizations. We identify and address risk-adjustable conditions and novel HCCs, manage encounter facilitation by scheduling appointments with PCPs and specialists, and secure the in-home support needed to reduce risk.
Through our platform, your members can manage their care in one location. Here, they can find a navigable knowledge journey of curated content and a safe, supportive online health community of peers and experts. They can access a marketplace of covered products and services needed for care at home and gain a better understanding of their eligible benefits, cost sharing, and deductibles.
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