CultureGuide® for Managed Medicaid
CultureGuide from SameSky Health delivers personalized member healthcare journeys, guiding members to the tools, resources, and care they need. Read an overview of CultureGuide.
Medicaid members can often feel lost, confused about, or disengaged from their health journeys. At the same time, many health plans have programs in place and still struggle to help their members overcome these obstacles to guide them to the resources and care they need. When members stop engaging, their health outcomes worsen, and it becomes increasingly difficult for plans to close gaps in care.
We partnered with a large, multi-state health plan to engage their Medicaid members and accomplish specific goals around motivating members to complete their Annual Wellness Visits, identifying social determinant of health needs, and 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 studies.
Looking ahead
States and the Administration view the advancement of health equity as a top priority. According to KFF, future areas of focus and expanded health benefits could include things such as pregnancy and postpartum services, housing related support, and community health services. In addition, there are many initiatives underway by states and national organizations such as NCQA to improve the collection of important health-equity related data such as race, ethnicity, language, SDOH data and more.
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.
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.
Medicaid Continuous Enrollment Pathway
Designed to ensure coverage continuity, the Medicaid Continuous Enrollment Pathway raises renewal awareness, allows members to update contact information, provides important due dates, and facilitates access to renewal resources.
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.
Prenatal/Postpartum Pathway
The Prenatal/Postpartum Pathway provides guidance before and after delivery, ensuring that members are given information and guided throughout the process, while addressing health disparities among prenatal and postpartum members.
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.
Children’s Health Pathway
Children and their parents have unique needs, and the Children’s Health Pathway helps them overcome barriers to care, educating parents and promoting plan benefits and services, while helping members understand when and where to seek care.
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.