Medicaid Managed Care Organizations

Improve care planning and patient engagement for specific populations

Investing in your Providers to Meet the Needs of Specific Populations

MCOs are being challenged to try new initiatives for care plans to be successful. Empower your providers with education tools to perform within the current and new measures and to meet organizational strategic imperatives and goals.

impacting patient satisfaction

Impacting Patient Satisfaction using Social Determinants

Deliver whole-person care by educating staff on all health factors, such as social determinants, to increase patient satisfaction and retention.
maintaining compliance

Maintaining Compliance Amidst Changing Mandates

Ensure compliance under federal and state regulations, including any changes under the new administration.
treating high risk patients

Treating and Managing Complex, High-Risk Patients

Educate on best practices for actively managing complex, high-risk populations, in order to reduce short and long term costs.

Increase Patient Satisfaction Using Knowledge on Social Health Factors

Provide comprehensive education on social health factors that contribute to the treatment and management of members.

Incorporate social and external factors into the member care

Of the multiple factors that influence a person’s health, the healthcare community has mainly focused on family history, diet, and clinic data. Growing research is indicating that there are social factors, such as education and housing, that need to be taken into consideration during patient care.

Ensure that your providers understand different social health factors and how they can influence patient treatment and management. Physicians and staff who are well-trained on the impact of different social factors are able to provide better whole-person care, which includes increased communication and more relational trust-building. Through customized care experiences, patients are more satisfied and likely to stay.

Learn more about improving your care experience through education on different social health factors.

social determinants of health

Staying Compliant During Transitioning Regulations

Communicate current compliance requirements for CMS, while keeping informed about new regulation developments.

reliable training

Deliver consistent, reliable compliance training to all levels of staff

In healthcare, complying with federal and state mandates is always top of mind. New benefit rules or regulations will have an impact on your business and how you and your providers deliver care.                      

Ensure that all provider staff is consistently trained on mandatory requirements to fulfill performance and value-based guidelines. Create a strong compliance culture that promotes both clinical and regulatory expertise. Clinical expertise can identify areas of risk in care delivery, while regulatory expertise can help avoid non-compliance offenses.

Relias provides the most current CMS regulatory training through an easy-to-use online platform- all at a tremendous cost savings over traditional methods. Automate your distribution of training, as well as any provider communications, while tracking compliance and reporting on attestations.

View our new CMS Regulatory Package and learn more about delivering, maintaining, and tracking compliance.

Sucessfully Managing High-Cost Populations

Train your providers' staff and physicians to be able to correctly diagnose and treat high-risk, complex patients.

Build knowledgeable teams who are equipped to treat complex patients

Since the passage of the ACA, healthcare has become available to a wider net of clients, including those with chronic conditions or serious co-occuring physical and behavioral health conditions.

Initiatives targeted towards the newly insured, high-risk patients, have become an avenue for payers to improve care and reduce costs.  Build and train care teams who are thoroughly prepared and educated on correctly identifying and managing complex patients. Avoid spending your already stretched finances on incorrect diagnoses or multiplied readmissions.

Learn more about educating providers on managing complex populations and successfully managing chronic diseases.


managing high-cost populations

Improve Your Quality of Care Through Analytics

What role does analytics play in your organization?

healthcare analytics

Deliver better care while reducing costs through comprehensive data analysis

With the pressure to deliver better care while simultaneously reduce costs, payers need to be able to use data and predictive modeling to become more efficient. Population health management and use of predictive analytics are keys to success in the future of healthcare, are you guiding your providers?



Helpful payer resources available for download.


November 07 , 2017

Health and Human Services Payers Value-Based Performance Management

Improving Care Coordination in a Value-Based World

Learn how to implement better care coordination within your organization and discover three simple steps you can take to actionize care coordination improvement.


September 19 , 2017

Payers Opioid Addiction

Balancing Therapy and Harm: Treating Pain and the Opioid Epidemic

This webinar discusses the details of pain management today and strategies payers can take to help their providers address the opioid crisis with actionable plans.


September 07 , 2017

Health and Human Services Payers Social Determinants

How Social Determinants of Health Influence Reimbursement and Patient Experience

Watch this webinar as we discuss and learn about the social determinants of health and how they can impact the patient experience and how this, in turn, determines provider reimbursement.