We focus on delivering whole health for our members by connecting physical, behavioral, social, and pharmacy care and capabilities through Carelon, our broad portfolio of integrated healthcare services.
The Concierge Care Program:
Helping Members Manage Complex Needs
People living with a chronic health condition such as cancer or Crohn's disease can find it challenging to manage the complex care they need. They may develop new symptoms, have concerns about their medication, or notice a change in their health. It can also be hard to stay on track with a healthy lifestyle while managing a chronic condition. We are meeting these needs with our digital concierge care program, which includes an app designed to help affiliated health plan members manage their health with the support of a dedicated case-management team.
Digital concierge care is making a difference. Among enrolled members:
- 60% are actively engaged with the program app.
- Over 50% initiate chats with their care team.
- 76% are using the app to complete surveys and track health data.
- For members in the app's oncology program, emergency department use has fallen by 39%.
- For those with Crohn's disease, 25% report a decrease in symptoms and flares.
Post-Acute Care Solutions:
Supporting Members in Recovery
Post-acute care support after a hospitalization and inpatient stay due to illness or medical procedure is a crucial part of a person's recovery process and whole health. In 2023, our Carelon Post Acute Solutions (PAS) significantly expanded the Post Acute Institutional Management (PAC-IM) program.
Read More >>Behavioral Health Support:
Advancing Crisis Care Through Evidence-Based Practices
In 2023, we launched the national Crisis Center of Excellence, a Carelon Behavioral Health initiative promoting evidence-based best practices in crisis systems of care. The Crisis team is focusing on research, quality, analytical insights, policy, and advocacy and offers training and support to state and local crisis systems, health plans, and industries. The work of the Center includes:
- Standardization of crisis quality metrics.
- Provider recognition for adherence to best practices.
- External training for providers of crisis services.
- Training for all Elevance Health contact center associates.
- Monthly workgroup for information sharing and best practices.
- Data collection for research and policy analyses.
- Advocacy, policy promotion and promulgation of public policy.
Helping Close the Rural Healthcare Gap
In 2021, CarelonRx began partnering with Community Pharmacy Enhanced Services Networks (CPESN®) USA, a network of independent community pharmacies, to support Medicaid members in managing their medications. Using data-driven criteria, CarelonRx identifies clinically high-risk members and alerts their community pharmacy. The pharmacy then contacts the member directly to offer an array of medication-management support.
A study by the Elevance Health Public Policy Institute showed that Medicaid members supported by a CarelonRx and CPESN® USA partnership during a two-year period had improved health. Benefits included:
Expanding Access With BioPlus
In 2023, CarelonRx acquired specialty pharmacy BioPlus, allowing us to scale our offerings and promote the affordability of limited distribution drugs. This acquisition helps our organization meet the specialty drug needs of our clients and customers with a whole-health approach, supported by integrated services and tailored programs across Elevance Health and Carelon.
With its streamlined services and infrastructure, BioPlus is ensuring less administrative burden for providers, allowing them to focus on informed, cost-effective decisions for their patients.
It also boasts a time-to-start-therapy guarantee that's 3 to 4 times faster than the competition and offers oncology patients "hope in 24 hours," guaranteeing all new oncology patients' prescriptions ship within 24 hours of a prescription being written by a care provider.
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