Strategy that delivers on Quadruple Aim

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The health plan business is changing faster than ever

To help health plans achieve Quadruple Aim, we guide them on key initiatives in each area.

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Better member experience

  • Value-based care strategy

  • Population health management

  • Higher clinical quality/STAR ratings

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Reduce costs

  • Compliance

  • Reduced medical loss ratio (MLR)

  • Reduced administrative costs

  • Higher-quality processes/HEDIS measures

  • Actuarial analysis/support

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Better health outcomes

  • Omni-channel member engagement

  • Effective wellness and disease management

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Better provider experience

  • Provider contracting

  • Credentialing

  • Provider engagement

Build best-in-class engagement strategies

Health plans are contending with an increasingly sophisticated consumer base, expecting better experiences and higher-quality service. We’ll help you deliver for your members and providers.

For members

Use member data and analytics to streamline communications and touchpoints, encourage improved health through engagement programs and services, and increase member satisfaction scores.

For providers

Launch provider engagement programs that guide providers on encouraging member compliance, use technology to increase provider effectiveness and improve risk-score accuracy and star ratings.

Gain a competitive edge

Evaluate your market to understand product-market fit and learn what tools will best engage members and providers.

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Competitive analysis

We help plans identify key competitors in your market, uncover their competitive advantage, and create business plans and FRP responses to win in their market.

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Line of business product design

Our consultants partner with plans to develop innovative products with greater customer appeal, generating revenue and positive health outcomes.

Navigate a changing landscape

Navigate regulatory compliance, accreditation complexity and AI transformation.

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Stay in compliance

Our teams conduct risk assessments and training to ensure plans are effectively detecting and preventing a wide array of compliance issues, including in medical documentation, billing and coding, health and safety, human resources and HIPAA/HITECH.

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Meet key accreditation requirements

We help plans with accreditation preparation and reaccreditation with major organizations to ensure the quality delivery of clinical programs, such as case management, utilization review and disease management.

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Evolve with changing digital trends and AI

Catalyst works with health plan stakeholders to develop strategies that meet a plan’s unique challenges while keeping pace with changing trends in the market.

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Start driving the best results for your health plan