Outcomes-Based Approach

NationsBenefits offers customizable healthcare solutions through a diverse offering of supplemental benefits that are designed to drive growth, improve outcomes, reduce costs, and delight members.

Our approach in partnering with health plans that are committed to providing value-based care programs is to advance member experiences and build stronger results over time. We can deliver a powerful combination of service and support through strategic interventions that are based on analytics and data-driven insights, tailored to the unique needs of health plans and members alike, and delivered during critical intervals to help targeted populations make informed decisions so they can achieve a better quality of life.

We believe that strong, well-structured and integrated benefits can impact member satisfaction, clinical outcomes, and reduce the Cost of Health Care (COHC).

As you select, customize, and launch care programs with NationsBenefits, integrating your members’ current and historical medical claims and values data sets with our real-time utilization and satisfaction data will create unsurpassed insights into how these care programs support your health plan's growth, CMS Star Ratings, and overall COHC goals.

CAHPS®,
CMS Star Ratings

Overall satisfaction, health plan NPS & retention rate

Members’ health resilience, including self-efficacy, and ability to self-manage

Members’ overall
health and COHC

Our Approach

LEVERAGING EXISTING DATA

We take a strategic approach to leveraging clinical health plan data by analyzing current and historical facts by running algorithms to assess known and unknown member needs.

DRIVING ACTION

The result is an action plan and comprehensive roadmap for engaging members over time through a sequence of initiatives that are delivered at critical intervals to drive action.

member satisfaction

We are proactive in working to positively impact each member’s health through their supplemental benefit(s), and we focus on ensuring member satisfaction while also determining ways in which to contain costs and facilitate a decrease in healthcare spending.

PERSONALIZED APPROACH

The cornerstone of our service model is the personalized, concierge-style approach we take to meeting members where they are in their healthcare journey.

SERVICE LEVEL

We ensure the very best experience at each touch point to ensure your members are getting the most out of their benefit program and that they are receiving the best service possible.

TRAINING

Our team is highly trained and demonstrates real expertise and responsiveness while providing a best-in-class experience to ensure complete member satisfaction. Our number one priority is to successfully connect members to the care and services they need at precisely the optimal time while considering how best to improve outcomes.

customizable

Our hearing, OTC, PERS, and optimized companion care benefit programs are flexible and completely customizable, which enables you to design a competitive solution that your members can appreciate.

TAILORED SOLUTION

We take a consultative approach and work to address your organizational needs. Together, we can tailor a comprehensive benefits program that’s modern and innovative to make it easier for your members to engage and achieve improved outcomes.

ADVANTAGES

Our member experience is unique, which offers strategic, financial, and service-level advantages. We go above and beyond what members expect by taking extra steps to ensure they are satisfied. In turn, this can help your bottom line.

EVOLVING CONSUMER NEEDS

The role of technology is becoming a central part of everyday life for more seniors aging in place and it can have a beneficial effect on their quality of life. We are committed to being agile and meeting the members’ needs that are borne out of today’s changing environment while providing access to proper care when it’s needed the most.

meeting Those needs

Our technology-based solutions provide members with access to their benefits to encourage greater utilization. For example, through our hearing technology, members have the ability to take an online hearing test and connect to a live representative from any location.

CONVENIENT AND SIMPLE

Each digital solution is designed with convenience and simplicity in mind to encourage engagement while simultaneously helping to improve health outcomes. For example, we offer an e-commerce experience through our OTC portal, which enables your members to order OTC products using their benefit.

comprehensive reporting

We provide a comprehensive suite of standard reporting that highlight call centric metrics, claims and billing, utilization, grievances, provider network management, credentialing, and more.

DATA INSIGHTS

We can also create custom and ad-hoc reports that offer you further insights to plan performance and close the feedback loop. Our team of dedicated client service representatives can effectively and efficiently handle all of your reporting needs.

Outcomes Benefits

We offer a unique member experience that is designed to improve member outcomes while decreasing healthcare spending and increasing health plan offerings.

Our Impact

Customized outcomes interventions result in healthier members

Healthier members result in decreased healthcare costs

Comprehensive benefit management results in improved Star Ratings

Improved measures and increased revenue results in greater benefit design flexibility

Greater benefit design flexibility yields increased membership and satisfaction

Increased membership and satisfaction supports sustainable growth