Healthmine to Increase Provider Visits, Barrier Identification with QRM Connect™

DALLAS, TX, January 7, 2025 /Business Wire/ - Healthmine, a leader in technology-enabled member engagement solutions, continues connecting members to trusted providers through coordinated, quality-led engagement with QRM Connect™. By delivering more impactful, digital-first engagement, Healthmine increases primary care provider (PCP) visits and risk code capture earlier in the year to deliver a holistic and coordinated care experience.

QRM Connect puts the member at the center of every interaction, identifying barriers to care and offering end-to-end support as members navigate finding the right provider, scheduling and preparing for appointments, and gathering member feedback post-visit.

“There’s a significant segment of Medicare and Affordable Care Act (ACA) membership that doesn’t have a PCP,” says Paul Mango, former Health and Human Services Deputy Chief of Staff for Policy, and Chairman of Healthmine’s Board of Directors. “Healthmine is uniquely positioned to assist these members in finding the right PCP and quickly getting them to establish care.”

With QRM Connect, barrier resolution goes beyond finding a new provider. Plans can identify each member’s social risk factors and coordinate appropriate intervention that makes healthcare more accessible. Once a visit is scheduled, Healthmine uses up-to-date data to populate a dynamic checklist for members to bring to their appointment, improving the member’s experience with their provider and facilitating more comprehensive visits.

This digital-first, member-centric approach means health plans can rely less on expensive, uncoordinated in-home assessments (IHA) by getting more members to their provider for in-person or virtual visits and leveraging IHAs only for the members who really need them. Supported by holistic reporting, plans are equipped with the right data to understand the impact of member engagement. All outreach data is aggregated, including the number of scheduled PCP visits, completed PCP visits and IHAs, and updated PCP information for member records and closing the loop with members post-IHA to ensure follow up care with their provider.

Healthmine’s approach to engagement with its Quality Relationship Management™ (QRM®) platform uses consolidated data to put quality and risk teams, and members, on the right path for optimal, ongoing engagement and continued gap closure. By using every member’s preferred outreach method and language, and other demographic data, plans will see improved message relevancy for each member and increased engagement rates as a result. With this level of personalization, care continues well beyond the initial provider visit.

“We know that trust is everything for the member,” says Kimberly Swanson, Chief of Staff at Healthmine. “Once a plan gains member trust, it’s much easier to get them to their PCP, to close care gaps and to re-enroll. That’s why we put so much emphasis on personalized touchpoints with every member – to make them feel understood, valued and supported at every step.”

About Healthmine

Healthmine is the industry’s leading member engagement solution, simplifying how health plans make the most of every member moment. Our SaaS-based, always-on Quality Relationship Management™ (QRM®) platform eliminates data chasing so plans can capture whole views of each member. Our team of behavioral scientists and regulatory experts partner with each health plan to use this member-level detail to build personalized outreach that motivates members to take the right next step in their health journeys. With customized triggers based on clinical, pharmacy, CAHPS and HOS measures, and when paired with intelligent incentives, plans can see accelerated results in health equity and member outcomes while better managing medical spend and reducing the burden on their teams. Real-time data dashboards with actionable insights allow plans to act fast and better prioritize areas of opportunity to meet revenue and quality goals. Connect with us at Healthmine.com and on LinkedIn.