Case Study: Leading Midwestern Health Plan strengthens dual-eligible care management with Altruista Health’s GuidingCare

Strong Partnership Serves Up Comprehensive Support To Duals

Leading Midwestern Health Plan, a multi-state health plan serving nearly 2 million members, partnered with Altruista Health to strengthen care management for dual-eligible members. The plan needed a better way to manage highly complex, person-centered service planning for members eligible for both Medicaid and Medicare, especially under HCBS waiver requirements.

Altruista Health implemented and re-tooled its GuidingCare® platform, including a new Service Plan capability designed to coordinate medical and non-medical supports, track delegated services, and support monthly planning. The solution improved workflow efficiency, reduced manual work, helped ensure members only received covered services, and gave care managers a more complete view of risk factors and backup supports. The plan expects to extend the Service Plan across other lines of business as well.