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Ensure Efficient Care Collaboration Between Payers and Providers
Managing high-risk populations while ensuring patients receive the care they need is an ongoing challenge in a value-based care model. Reducing unnecessary emergency department visits, preventing avoidable admissions and readmissions, and improving connectivity to community-based providers post-discharge all contribute to cost-efficient care.
Bamboo Health supports Commercial, Medicare Advantage, and Medicaid plans’ care management, utilization management, and quality initiatives to coordinate and impact member care using admission, discharge, and transfer (ADT) data.
Intervene in ED and inpatient settings to inform care planning, improve post-discharge follow up rates, and ensure safe transitions post discharge.
Reduce administrative burden for newly enrolled members by automating utilization management workflows such as census tracking and prior authorization.
Identify out-of-network utilization in real time to engage members at the point of care.
Receive updated member contact information to improve engagement efforts for unable-to-reach member population.
Improve identification and engagement of high and rising-risk members (ED high utilizers, high-risk pregnancies, chronically ill) in real time.
Leverage longitudinal member encounter history to gain real-time insight into member risk and utilization for newly enrolled members.
Share relevant administrative and clinical context such as care team contact information and member-specific care plans to the relevant providers.
Improve Care Coordination for Better Whole Person Care
Unmet behavioral health needs have risen at an alarming rate during the pandemic due to sickness, isolation, job loss, and other emotional challenges. The Centers for Medicare & Medicaid Services (CMS) has prioritized reimbursement parity for behavioral health, intensifying the area of focus for health plans.
At Bamboo Health, our care coordination solutions improve payer and provider collaboration and actionable insights across the physical and behavioral health care continuum. The result – higher quality care for members at a lower cost.
Greater Access to Behavioral Health for Rapid Referral to Care
Through our OpenBeds referral management solution, we connect social workers, EDs, psychiatrists, and care teams to mental health and substance use disorder (SUD) treatment programs in one comprehensive interface – to rapidly refer patients to care.
Real-time visibility (and reporting) of provider capacity
Insights into treatment referral and flow, and dynamics
Accurate, up-to-date data on network of available treatment facilities, providers, and services
Clinical decision support tools to ensure referral to appropriate level of care
Enhanced collaboration with your network providers
Bamboo Health is proud to be an AHIP Affiliate Organization, an ACAP Preferred Vendor, a MAHP Gold Affiliate Member, a TAHP Affiliate Member, & an OAHP Premium Supporting Member
Bamboo Health serves a role for us in that it gives us that real-time information for those members that go into the ED. For our Medicaid population, I will say that some of them are harder to reach, so they may go into a hospital and leave a hospital and oftentimes we don’t have the opportunity to outreach to them and help connect them with the services that they need. Pings closes that gap for us so that we know in real-time when they’re there and we can reach out to them right when they’re in the hospital and get them the care and services they need.
Tina Zurita, Director of Quality Management
Complete Care Management Partners, FKA NextLevel Health, IL
[Bamboo Health]… gives us a lot of updated information because it’s real time and when that member goes into the ED or hospital, we get updated phone numbers, sometimes addresses, and even if the member discharges we still have other alternatives for reaching them. We’re also excited about that bidirectional information that we can share with many of our facilities and closing some of those gaps for our members.
Tina Zurita, Director of Quality Management
Complete Care Management Partners (FKA NextLevel Health)
See how health plans leverage Bamboo Health care collaboration solutions to improve patient outcomes.