Case Study: Mercy Care Plan and Mercy Maricopa achieve value-based success—clinicians earn full contract incentives with HealthBI

Mercy Care Plan Sets up Clinicians for Value-Based Success

Mercy Care Plan and Mercy Maricopa, one of Arizona’s largest Medicaid plans serving about 400,000 members, struggled to help contracted clinicians succeed under value‑based contracts because member risk and care‑gap data were incomplete, outdated, and trapped in cumbersome spreadsheets. Clinicians also needed integrated visibility across medical and behavioral health to meet a state mandate for whole‑person care, so Mercy Care Plan turned to HealthBI’s care management and coordination (Care Navigation) platform.

HealthBI implemented a payer- and provider-facing solution that integrates EHR and HIE feeds to deliver a holistic, near‑real‑time view, risk stratification, alerts, and suggested workflows. As a result, Mercy Care Plan’s clinicians are earning value‑based incentives in full by reducing unnecessary ED and acute-care use, increasing primary care visits for members with behavioral health needs, improving timeliness of information from months to near‑real‑time, and establishing mechanisms to identify, track, and improve quality initiatives.

Mercy Care Plan and Mercy Maricopa

Christi Lundeen

Chief Innovation Officer