Data-driven clinical navigation and care

CareHive’s platform provides seamless integration of care modalities, patient navigation, remote monitoring, risk assessment, and follow-up.

Connected Care Solutions for Health Plans

CareHive improves performance for health plans

CareHive guides patients to high quality, low-cost network providers, solving the information gap in patient navigation knowledge and health system access. We improve performance for health plans in risk contracts by guiding patients to clinical areas with better health and cost outcomes, avoiding ER usage along the way.

CareHive provides intelligent triage and protocol-based navigation at every point of patient engagement. This ensures the right resources are used to attain the optimal medical outcomes for patients, while matching specific patient needs in the care cycle to the healthcare system’s highest efficiency.

CareHive provides navigation at every point of patient engagement
CareHive is data-driven

Risk analytics: We are data-driven, using evidence to deliver the most appropriate resource, modality, and timing in the care path so as to deliver meaningful savings and patient satisfaction. CareHive leverages a virtual/asynchronous-first approach for populations to assess and stratify risk.

We work with Health Plans, Payers, Primary Care Practices, Health Systems, Employers and Risk‑Bearing Entities

CareHive has industry-best ratings and patient satisfaction
10,000 5-Star Reviews
CareHive's net promoter score exceeds industry standards
92 Net Promoter Score

CareHive’s Healthcare and Patient Navigation Process

UNDERSTANDING

Population Analysis

Opportunity Analysis

Data analytics optimize value-based opportunities

The first step in CareHive’s process is to understand the population under management. Whether it is disease specific or an entire book of business, our Data & Analytics team will leverage the data that you provide (electronic medical records (EMR), claims and other information), and augment it with social determinants of health (SDOH), our proven clinical protocols, and additional health information exchange (HIE) data. Our technology, AI, and clinicians then leverage this aggregated information to best identify opportunities for improving HCC code capture, reducing expensive utilization and leakage, and enhancing clinical outcomes.

Impact

Patient Engagement and Activation

Improved Outcomes

Impactful patient engagement and clinical guidance

Understanding the relevant population is meaningless without appropriate connected care plans. CareHive360 uses asynchronous member engagement in conjunction with patient navigators and clinical escalation pathways to get patients efficiently to the right level of care and their value-based targeted outcomes. Instead of patients entering the system randomly, encountering multiple spend events, they are guided to the appropriate level of care and always informed. The result: better experiences, better outcomes, and less spend.

Remuneration

Improved HCC Coding

Reduced Leakage

Data-driven, risk-based remuneration

By gathering clinical documentation in a streamlined, asynchronous fashion, CareHive ties this data to ICD-10 codes and HCC codes, ensuring timely and accurate condition capture for risk-based payments. Moreover, our patient navigator referrals deliver 24/7 acute access and reduced leakage.

AI Learning and ROI

Improved Analytics

Better Datasets

Continuous improvement and predictive ROI

CareHive’s process provides data that is leveraged to improve our impact over time: our AI learning system drives specific population optimization as more patients and providers engage. This means better modeling and precision around population segment risk, more timely interventions and escalations, and improved results as CareHive manages more patients.

Value-based care that retains your patients and differentiates your practice

CareHive’s digital health solutions contribute to significant savings in addition to better patient satisfaction, flexibility, convenience, and outcomes. Our wraparound care also prevents leakage to urgent care centers and emergency departments.

after-hours patient navigation and primary care referral support for Health Plan partners

CareHive’s digital front door for after-hours patient navigation and primary care referral support

  • CareHive Navigation Services offer wraparound care for in-network providers to limit emergency room utilization when providers are not available.
  • Primary Care referral support is configured specifically for patient referrals to desired high quality, low-cost network providers.
  • Our patient portal, coupled with best-in-class healthcare navigation by our patient guides, creates a frictionless care pathway experience for patients and a seamless workflow integration for providers – leveraging the power of asynchronous communication and escalation to synchronous when appropriate.

Want to create a more cost-effective, connected care path for your members?

CareHive Partnership Inquiry

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