CultureGuide® for Medicare Advantage
CultureGuide from SameSky Health delivers personalized member healthcare journeys, guiding members to the tools, resources, and care they need. Read an overview of CultureGuide.
Studies show that Medicare members who participate in their Annual Wellness Visits (AWVs) also complete preventative cancer screenings and vaccinations compared to those who do not.¹ Preventative services also play an important role in reducing health disparities for Medicare enrollees in underserved populations.
We partnered with a large, national health plan to engage their Medicare Advantage members and accomplish specific goals around motivating previously unengaged or hard-to-reach members (those who had not had a healthcare visit in more than 16 months) to complete their Annual Wellness Visit. In addition, we worked to identify needs within the social determinants of health, while collecting important health-equity-related data. The results are compelling and demonstrate the impact of taking a culturally tailored member engagement approach. Read the full case study.
Looking ahead
The Centers for Medicare and Medicaid Services (CMS) intends to advance health equity for Medicare Advantage members. The new health equity index within the Star Ratings program will focus on creating incentives for plans that provide excellent care for members in underserved populations. Additionally, CMS is requiring plans to provide cultural and linguistic capabilities. SameSky Health is successfully engaging member populations with limited English proficiency today. We partner with health plans across the country today to help advance their health equity initiatives.
¹ Fabian Camacho, Nengliang (Aaron) Yao, and Roger Anderson. J Prim Care Community Health. The Effectiveness of Medicare Wellness Visits in Accessing Preventive Screening. Published online 2017 Oct. 28.
CultureGuide Pathways
With CultureGuide, each member’s personalized health journey is created and tailored based on the information we know (as provided by the health plan), or that we discover along the way (through our interactions with a member). These interactions are also shaped by Pathways — each one representing a specific set of health engagement objectives.
The Core Pathway is a standard component of CultureGuide and is focused on collecting health-equity-related data, driving compliance with essential screenings, and other fundamental objectives that are common to nearly every implementation. Our optional Focus Pathways allow additional health objectives to be incorporated, based on the health plan’s specific priorities.
Featured Focus Pathways
Core Pathway
A standard component of CultureGuide, the Core Pathway helps augment member data (including race, ethnicity, and language preferences), while helping surface barriers to care, ensuring PCP selection, and driving preventative care visit completion.
Women’s Health Pathway
Addressing the unique health needs of women, the Women’s Health Pathway helps members overcome barriers to care, while educating women on key screenings and healthy lifestyles, plus promotes plan benefits, and reminding members about key health visits.
Diabetes Care Pathway
Leveraging known member data and gaps, the Diabetes Care Pathway directs diabetic members to plan programs and services, while providing educational resources on controlling their condition and proper channels for care, and driving important screenings and exams.
SDOH Screening and Navigation Pathway
The Social Determinants of Health Screening and Navigation Pathway helps surface challenges through SDOH screening, while directing members to plan resources or care management services, and gauging satisfaction and success.
Behavioral Health Pathway
Designed to support the behavioral health needs of members, the Behavioral Health Pathway provides holistic education, while destigmatizing and driving awareness, and promoting seeking help when needed.
Learn more about CultureGuide and the CultureGuide Pathways. Contact us today.
Learn more about how CultureGuide® works within specific lines of business
The systems used to provide CultureGuide have achieved HITRUST Risk-based, 2-year (r2) Certified status.