Social Determinants of Health (SDOH/Social Care)
Social determinants of health have a massive impact on health and are often the underlying factor in preventing access, compliance, and quality improvement.
Factors such as housing, food, transportation insecurity, and inadequate support systems can render even the best care management programs completely ineffectual, cutting members off from the resources they need to engage and comply with care team support.
Vulnerable communities and individuals impacted by SDOH can be difficult to identify and even more difficult to address, requiring a sophisticated data analytics function as well as nuanced outreach programs that leverage care professionals as well as community resources.
Leveraging Jiva Platform for SDOH Challenges
The SDOH Social Care Platform seamlessly assembles data from a wide range of sources, including assessments, claims data, and government databases to create a holistic view of the interconnected social factors impacting the member. Our AI-powered, automated workflows are carefully customized to combine care management interventions with coordinated third-party social services, in-house benefit programs, and community resources.
The result is a nuanced approach tailored to the specific needs of individuals and specific communities, with a closed-loop reporting and collaboration process that aligns plan, provider, and community resources around shared goals and methods.
Who We Serve
Commercial Health Plans
A one-stop shop for care management, benefits administration, process automation, organizational optimization, and efficiency across the enterprise.
Exceed your value-based care benchmarks leveraging combined clinical and claims data to reduce risk, close gaps, and ensure optimal outcomes.
Accountable Care Organizations
From risk-stratification to gap identification and closure strategies, our capabilities are unmatched, and built in SDOH criteria helps you reach at-risk communities with effective programs.
Medicare Advantage Plans
Built-in risk adjustment to drive consistent success in PMPM payment models and maximize Star ratings performance.
ZeOmega is #1 Best in KLAS for Payer Management Solutions 2022 and 2023
Impact of the New CMS Healthcare Interoperability Rules | ZeOmega
Much of the direction of the 2020 proposed rule is in the new proposed rule, particularly the sharing of prior authorization decisions/status with patients.
AbsoluteCare Selects ZeOmega for Chronic Care Management for High-Risk Patient Populations
ZeOmega announced today that value-based integrated healthcare provider AbsoluteCare has selected ZeOmega’s Jiva platform to fulfill its needs for comprehensive care management, utilization management, and clinical assessment support.