Case Study: Non-profit Midwestern Health Company achieves a unified care management implementation with Altruista Health GuidingCare

Secrets of a Successful Implementation Executive Support and Collaboration Are Critical

Non-profit Midwestern Health Company, a non-profit midwestern health plan with 1 million-plus members, needed to move from two separate clinical systems connected to four claims systems to a single, consistent care management platform. Facing a vendor sunset, an upgrade deadline, and the added disruption of the COVID-19 pandemic, the organization turned to Altruista Health and its GuidingCare care management technology platform to support the transition.

Altruista Health helped the health plan implement GuidingCare in three phased waves, starting with a smaller commercial population and then expanding to Medicare, Medicaid, and additional commercial lines of business. The rollout included care management, utilization management, appeals and grievances, population health, Mobile Clinician, reporting, and business rules. The result was a successful, large-scale go-live completed across January, April, and September 2020, with strong executive alignment, close collaboration, and no regrets about choosing GuidingCare.