Redetermination Fails If You Cannot Connect
?In this post-COVID setting, redetermination of eligibility becomes a hurdle once again.?? Loss of eligibility threatens continuity of care as well as revenue streams.? It is very disruptive for everyone involved, at a minimum.? It can be terrible for health outcomes with serious consequences.?? Many times, connecting with vulnerable members is where things fall apart due to an inability to engage with them on their terms.??
We have found communication breaks down through a lack of trust in institutions, including government agencies and health plans.? Many times there are language and cultural barriers.
This is where we turn to community based organizations (CBOs) like food pantries, FQHCs, shelters, churches, and so on.?? These organizations are in the community and they have the trusted relationships with these vulnerable populations already.??
Harmony Health builds close bonds with these CBOs by providing them free access and use of a simple and elegant text-based communication platform so they can replace their legacy outreach tools with a more robust and efficient way to get their messages out to their clients.? These messages can be anything that helps the CBO further their primary missions, whether it is about a local health fair, a picnic, a shot clinic for the kids, etc.???
?The state Medicaid programs and health plan payers sponsor Harmony Health to make these tools available at no cost to the CBOs.? In turn, these payers piggy-back onto the stream of messages going out to the target populations.? They are the invisible ambassadors for the payers. This is where a trust bridge is built ultimately between the target beneficiaries and the state agencies or the payers.??
?In one way of thinking of it is that Harmony Health digitizes trust.? The payers benefit from the existing trust held by the CBOs that also benefits the beneficiaries by linking them up with services and care to which they are entitled.?
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?The State of California and MediCal health plans currently work with Harmony Health to message more than 1.7 million people in this cohort of beneficiaries. They hired them to help connect them with CalAim, case managers, MediCal enrollers, with FQHCs, and more. They are also helping with redeterminations, which we know is a huge issue in this space.
?They utilize an elegantly simple text-based platform working through Community-Based Organizations. The platform supports 112 languages and has shown dramatic results.
?One population health example demonstrates the valuable capabilities of Harmony Health. They worked with a monolingual Chinese community church in the San Gabriel Valley on the following initiatives: 68 outreach programs in 2023 including prevention and management of colorectal and breast cancer, diabetes, substance abuse, positive parenting, and trauma support with strong results.
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