Managed Service and Care Organizations

Managed Service and Managed Care Intensive

Our Managed Services and Managed Care Intensive is a program that provides an in-depth analysis of your current payer partnerships, provider panels, and key patient data to develop optimized workflows that improve operational, financial, and clinical performance as well as drive efficiency for your care teams and engagement with your patients. Our Managed Care and Managed Service Intensive supports organizations of all sizes, from start-up to established, and can be tailored to support the needs of the markets you serve.

• In-Depth Analysis of Key Patient Data, Provider Performance and Payer Programs
• Workflow Discovery and Assessment of Current Processes and Protocols
• Design Company’s Playbooks
• Structured Action Plan for Performance Improvement and Growth
• Training for Clinical and Administrative Teams
• Vendor Partnership Assessment and Support
• CMS Proactive Preparation Program

Provider Engagement and Alignment Program

Our Provider Engagement and Alignment Program is to help MSOs and MCOs better connect with the medical groups they support through the implementation of key resources, provider education, and performance transformation initiatives.

• In-Depth Analysis of Key Patient Data, Provider Performance, and Current Goals
• Structured Action Plan for Performance Improvement and Growth
• Educational Sessions for Clinical and Administrative Teams
• Vendor Partnership Assessment and Support
• CMS Proactive Preparation Program

The Patient Outcome and Experience Program

As a MSO or MCO, we are able to support how you best connect with the most important person to your organization: the patient. Our Patient Outcome and Experience Program is for care organizations that are determined to create patient-centric initiatives that improve experience, health literacy, and care outcomes.

• Patient-Centric Outreach and Engagement Initiatives
• Patient Health Outcome Improvement
• Patient Experience Survey and CAHPS Support
• Member Growth Support (Annual Election and Open Enrollment)
• Tailored Member Initiatives Development

Value-Based Care Intensive

Our Value-Based Care Intensive is a program for care organizations interested in entering in or managing current value based care programs. Pygmalion Health supports you from beginning to end with establishing your contracts, implementing stop-loss, restructuring your workflows, and improving your performance.

• Initiation and Negotiation of Value Based Care Contracts
• Value Based Care Program Onboarding and Contractual Support
• Review of Eligible Programs and Assessment of Current Goals
• Value Based Care Payer-Partner Guidelines and Protocols
• Patient Attribution Collection for Participating Programs
• Payer Program Playbooks
• Data Integration Set-Up and Operational Meeting Cadences
• Strategic Value Based Care Vendor Relationship Development
• Negotiation or Renegotiation of Capitation and Incentive Terms 
• Data Integration Monitoring
• Reconciliation of Patient Attribution and Claims Data
• Supplemental Data and Attestation Submission Initiation and Support
• Ongoing Vendor Relationship Initiation and Support
• Full Value Based Care Training For Clinical and Administrative Teams

Health Equity Intensive

Our Health Equity Intensive is a program for care organizations that are implementing or restructuring their Health Equity processes. We are experienced in building national Health Equity plans that are tailored to addressing diverse markets, health inequities, and the unmet needs of underserved communities.

• SDOH Surveying and Data Analysis
• Patient-Centric Healthy Equity Initiatives
• Patient Education and Health Literacy Support
• Clinical Education
• Tailored Health Equity Program Playbook Development

At Pygmalion Health, we know that when providers prosper, patients thrive. We're using that principle to guide how we revolutionize care.